Publication Date

2017-12-14

Availability

Open access

Embargo Period

2017-12-14

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Kinesiology and Sport Sciences (Education)

Date of Defense

2017-11-16

First Committee Member

Wesley N. Smith

Second Committee Member

Kevin A. Jacobs

Third Committee Member

Arlette C. Perry

Fourth Committee Member

Lee D. Kaplan

Abstract

Patients recovering from orthopedic surgery experience reduced physical activity, increasing future risk for cardiometabolic disease and weight gain. A post-operative wellness consultation, with exercise and nutrition components, may modify the behavior of orthopedic patients to mitigate the detrimental effects of inactivity following surgery and the associated adverse health effects. PURPOSE: To evaluate the efficacy of a nutrition and exercise consultation on post-operative physical activity, serum metabolic markers, body composition, knee function, pain, and quality of life. METHODS: Twelve partial meniscectomy patients were randomly assigned to control (CON) or post-surgical consultation (PSC) and evaluated 1 week (1W) and 6 weeks (6W) post-surgery. The PSC received exercise and nutrition recommendations and a fitness tracking device for adherence. A questionnaire was used to predict physical activity level (PAL). Subjects were assessed for fasting blood glucose, fasting insulin, C-reactive protein, and non-HDL cholesterol. The Lysholm Knee Score was administered to assess pain, and the Short Form Health Survey (SF-12) was further divided into a mental component summary (MCS) and a physical component summary. Body mass, percent body fat, and skeletal muscle mass were assessed using a multi-frequency bioelectrical impedance. Likert scales were used to measure the effectiveness of the PSC. Repeated measures ANOVAs were used to assess mean differences in between intervention groups at 1W and 6W. RESULTS: A significant mean difference in MCS scores was observed (F(1,10)= 8.465, p=0.016, η2p=0.458) as PSC subjects did not experience the reduction in MCS seen in CON. Subjects reported pre-injury PAL (1.59 ± .209) that were significantly reduced to (1.38 ± .093, p=0.001) during the pre-surgery period, but restored at 6W (1.47 ± .139) (p=0.001). No other differences were detected in the analyzed blood markers or body composition measurements between groups. CONCLUSION: A wellness consultation, focused on nutrition and exercise, appears to combat the decline in patient vitality and emotional well-being following surgery, without affecting markers of metabolic health. The high levels of healthy behaviors in our sample may have improved the patient resiliency to diminished cardiometabolic health following orthopedic injury.

Keywords

Exercise Prescription; Arthroscopic Knee Surgery; Partial Meniscectomy; Wellness Intervention; Behavioral Intervention

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