Physical Activity Interventions After Hip or Knee Joint Replacement: a Systematic Review

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. Purpose of Review: This study is aimed at describing and evaluating physical activity interventions in individuals that have undergone hip or knee joint replacement due to osteoarthritis. Recent Findings: A total of 11,873 studies were screened. Seven studies with 627 participants, aged 50 to 85 years, met the review criteria. There are five randomised control trial, one longitudinal quasi-experimental study with a control group, and one pre-/post-test study with control group. Interventions included health coaching, a walking programme, a behavioural change intervention, and an alpine skiing intervention delivered between 6 and 24 weeks. Two studies reported change in physical activity using patient activity diaries and five used objective accelerometer data. All studies showed an increase in time spent being physically active in the intervention groups. One study also reported an increase in vitality. Summary: Few studies have investigated physical activity interventions after hip or knee joint replacement, and evidence for the effectiveness of physical activity interventions post-replacement is low. High-quality studies are needed in this area to explore the potential benefits presented within this review

Non-randomised evaluations of strategies to increase participant retention in randomised controlled trials:a systematic review

Peer reviewedPublisher PD

Prevalence and determinants of chronic kidney disease in women with hypertensive disorders in pregnancy in Nigeria: a cohort study

Abstract Background Worldwide, hypertensive disorders in pregnancy (HDPs) complicate between 5 and 10% of pregnancies. Sub-Saharan Africa (SSA) is disproportionately affected by a high burden of HDPs and chronic kidney disease (CKD). Despite mounting evidence associating HDPs with the development of CKD, data from SSA are scarce. Methods Women with HDPs (n = 410) and normotensive women (n = 78) were recruited at delivery and prospectively followed-up at 9 weeks, 6 months and 1 year postpartum. Serum creatinine was measured at all time points and the estimated glomerular filtration rates (eGFR) using CKD-Epidemiology equation determined. CKD was defined as decreased eGFR< 60 mL/min/1.73m2 lasting for ≥ 3 months. Prevalence of CKD at 6 months and 1 year after delivery was estimated. Logistic regression analyses were conducted to evaluate risk factors for CKD at 6 months and 1 year postpartum. Results Within 24 h of delivery, 9 weeks, and 6 months postpartum, women with HDPs were more likely to have a decreased eGFR compared to normotensive women (12, 5.7, 4.3% versus 0, 2 and 2.4%, respectively). The prevalence of CKD in HDPs at 6 months and 1 year postpartum was 6.1 and 7.6%, respectively, as opposed to zero prevalence in the normotensive women for the corresponding periods. Proportions of decreased eGFR varied with HDP sub-types and intervening postpartum time since delivery, with pre-eclampsia/eclampsia showing higher prevalence than chronic and gestational hypertension. Only maternal age was independently shown to be a risk factor for decreased eGFR at 6 months postpartum (aOR = 1.18/year; 95%CI 1.04–1.34). Conclusion Prior HDP was associated with risk of future CKD, with prior HDPs being more likely to experience evidence of CKD over periods of postpartum follow-up. Routine screening of women following HDP-complicated pregnancies should be part of a postpartum monitoring program to identify women at higher risk. Future research should report on both the eGFR and total urinary albumin excretion to enable detection of women at risk of future deterioration of renal function