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Objective: To assess the feasibility of a program to increase physical activity as part of lifestyle management after joint replacement surgery (PALMS). Design: This pragmatic pre-post feasibility study included participants referred to community rehabilitation post total hip or knee replacement surgery. Participants attended in-person for 1 h, twice-weekly for six weeks. PALMS consisted of a health screen, including point-of-care testing for metabolic syndrome, a group exercise program based on a cardiac rehabilitation model, and education. Feasibility outcomes were acceptability, demand, implementation and practicality. Secondary exploratory outcomes included physical activity and physical functioning. Results: Forty-six participants (23 men, 23 women), mean age 62 (SD 8) years and a mean of 7 (SD 4) weeks post knee (n = 27) or hip (n = 19) joint replacement surgery were enrolled. PALMS was well accepted by participants and clinicians, was implemented with high rates of adherence (mean 10.4/12 (SD 3.0) sessions attended), and 76% (28 of 37) had metabolic syndrome indicating high demand. However, recruitment did not meet threshold targets of 7 recruits each month (achieved 5.1) and 50% of eligible clients agreeing to participate (achieved 38%). There were no serious adverse events. Post-program, physical activity (mean change 1,678 METS min/wk, 95%CI 997 to 2,359) and physical functioning (6-min walk test mean change 167 m, 95%CI 120 to 215) increased. Conclusion: The PALMS group program was feasible and associated with short-term improvements in physical activity and physical functioning. With attention paid to recruitment strategies the next step is to evaluate program effectiveness with an adequately powered trial.
Bowman et al. (Thu,) studied this question.