Enhancing Physical Activity in Older Adults More Than 6 Months Post Total Hip or Knee Replacement Through Telerehabilitation: A Pilot Randomized Controlled Trial.

Background: Physical activity levels often remain suboptimal in older adults undergoing total hip replacement or total knee replacement after surgery, which can affect functional independence and quality of life.

Purpose: To explore the feasibility and potential effects of a telerehabilitation delivery mode that combines activity tracking with remote physical therapist counseling on physical activity levels in older adults post total hip replacement or total knee replacement.

Methods: The participants were randomly allocated to receive either a 12-week telerehabilitation program involving brief weekly telephone counseling from a physical therapist (n = 19) or a control group (n = 18). Activity trackers (Fitbit Sense) were used in both groups to objectively measure daily step counts, sedentary time (in minutes per day), low-intensity physical activity (in minutes per day), and moderate to vigorous physical activity (in minutes per day). These measures, along with physical function tests, were assessed at baseline and Weeks 12 and 24. The primary outcome was the change in physical activity levels across these parameters.

Results: No adverse events were reported among the 37 participants. The telerehabilitation group demonstrated a significant increase in low-intensity physical activity at Weeks 12 and 24 compared with the control group (mean between-group difference: +30.9 min/day at 12 week and +29.0 min/day at 24 week; p = .04, effect size r = .33 at 12 week, r = .34 at 24 weeks). No significant differences emerged in step count, sedentary time, or moderate to vigorous physical activity.

Conclusions: This pilot study showed telerehabilitation's potential to promote active lifestyles in post total hip replacement or total knee replacement older adults, particularly for increasing low-intensity physical activity. Future research should develop more intensive programs to improve moderate to vigorous physical activity and physical functions.