Impact of a tailored activity counselling intervention during inpatient rehabilitation after knee and hip arthroplasty – an explorative RCT

BACKGROUND: The aim of the study was to improve physical activity (PA), well-being and clinical outcome after total knee and hip arthroplasty through tailored activity counselling during inpatient rehabilitation. METHODS: 65 patients (aged 70.4 ± 7.3 years, BMI 28.5 ± 4.3) starting inpatient rehabilitation after primary knee or hip arthroplasty due to osteoarthritis were recruited and pseudo-randomized into an intervention (IG) and a control group (CG). Twice a week, the IG was encouraged to increase their daily step count by 5%. PA, e. g. number of steps, step frequency, or active minutes, was measured by step activity monitoring. Well-being and clinical outcome were assessed using the SF-36, Oxford Knee/Hip Score and Global rating of Change. Procedures were conducted at the onset of inpatient rehabilitation, and repeated one and 6 months after inpatient rehabilitation. RESULTS: Data sets were obtained from 49 patients (IG: n = 23, CG: n = 26). Both groups significantly increased their number of daily steps from the 1 month to the 6 months follow up after rehabilitation: CG: 9019 (95%CI: 7812, 10,226), IG: 9280 (7972, 10,588) and CG: 10921 (9571, 12,271), IG: 11326 (9862, 12,791) respectively. Additionally, well-being and clinical outcome improved significantly in both groups. No significant differences in physical activity, clinical outcome and well-being were found between the groups. CONCLUSIONS: PA counselling during inpatient rehabilitation does not improve PA, well-being and clinical outcome in patients with primary knee or hip arthroplasty in addition to the rehabilitation program. PA interventions may be more effective after the completion of the inpatient rehabilitation phase

Climate change and air pollution: the connection between traffic intervention policies and public acceptance in a local context

Urban mobility is the main source of air pollution in Europe and accounts for 25% of greenhouse gas emissions. In order to address this, a range of interventions and policies are being implemented across major European cities and studies in sustainable urban transport have proliferated. One such mitigation strategy involves redesigning urban form through ‘hard’ traffic policies, with a view of decreasing emission levels and therefore mitigating the effects of air pollution and climate change. However, efforts to assess public response to such interventions and the effectiveness of policy instruments in promoting sustainable travel in cities remain sparse. The city of Potsdam, Germany implemented a trial traffic measure aimed at reducing motorized traffic and promoting the use of bicycles and public transport systems. This study analysed data from 3553 survey participants who responded to a survey conducted prior to the implementation of the traffic measure. We aimed to identify mobility behaviours and underlying attitudes within the context of a ‘hard’ policy instrument, in order to obtain insight into the opportunities to more effectively define policy priorities that improve air quality and upscale climate mitigation. An exploratory cluster analysis identified four groups, characterised by mobility habits, their attitudes towards the measure, and general level of environmental concern. By identifying and understanding the differing attitudes and perceptions across population groups we are able to highlight group-specific barriers and opportunities, as well as potential transition pathways to encourage more sustainable transportation use. This study exemplifies how context can help to further shape mobility group typologies, identify policy-related priorities useful for decision-makers and assess the feasibility of policy instruments to facilitate a transformation towards more sustainable cities

Determinants of Public Acceptance for Traffic-Reducing Policies to Improve Urban Air Quality

Air pollution remains a problem in German cities. In particular, the nitrogen dioxide (NO2) annual limit-value set by the European Union of 40 µg/m3 was not met at ~40% of roadside monitoring stations across German cities in 2018. In response to this issue, many cities are experimenting with various traffic-reducing measures targeting diesel passenger vehicles so as to reduce emissions of NO2 and improve air quality. Identifying the determinants of public acceptance for these measures using a systematic approach can help inform policy-makers in other German cities. Survey data generated from a questionnaire in Potsdam, Germany, were used in predictive models to quantify support for investments in traffic-reducing measures generally and to quantify support for a specific traffic-reducing measure implemented in Potsdam in 2017. This exploratory analysis found that general support for investments in such measures was most strongly predicted by environmental and air pollution perception variables, whereas specific support for the actual traffic measure was most strongly predicted by mobility habits and preferences. With such measures becoming more common in German cities and across Europe, these results exemplify the complexity of factors influencing public acceptance of traffic-reducing policies, highlight the contrasting roles environmental beliefs and mobility habits play in determining support for such measures, and emphasize the connections between mobility, air pollution, and human health