Psychological Aspects of Stair Use: A Systematic Review

Comparison of Early Postoperative Step and Stair Counts With the Direct Anterior Approach Versus the Posterior Approach for Total Hip Arthroplasty

BACKGROUND

The purpose of this study was to evaluate the impact of direct anterior approach (DAA) or posterior approach (PA) on step and stair counts after total hip arthroplasty using a remotely monitored mobile application with a smartwatch while controlling for baseline characteristics.

METHODS

This is a secondary data analysis from a prospective cohort study of patients utilizing a smartphone-based care management platform. The primary outcomes were step and stair counts and changes from baseline through one year. Step and stair counts were available for 1,501 and 847 patients, respectively. Longitudinal regression models were created to control for baseline characteristics.

RESULTS

Patients in the DAA group had significantly lower body mass index (P = .049) and comorbidities (P = .028), but there were no significant differences in age (P = .225) or sex (P = .315). The DAA patients had a higher average and improvement from baseline in step count at 2 and 3 weeks postoperatively after controlling for patient characteristics (P = .028 and P = .044, respectively). The average stair counts were higher for DAA patients at one month postoperatively (P = .035), but this difference was not significant after controlling for patient demographics. Average stair ascending speeds and changes from baseline were not different between DAA and PA patients. Descending stair speed was higher at 2 weeks postoperatively for DAA patients, but was no longer higher after controlling for baseline demographics.

CONCLUSIONS

After controlling for baseline characteristics, DAA patients demonstrate earlier improvement in step count than PA patients after total hip arthroplasty. However, patient selection and surgeon training may continue to influence outcomes through a surgical approach.

Burden of disability in type 2 diabetes mellitus and the moderating effects of physical activity

The growing diabetic epidemic has created a substantial burden, not only on the people with diabetes but also on society at large. This mini-review discussed the limitations and patterns of disability in type 2 diabetes mellitus and put forward a case for the moderating effects of physical activity (PA) in the management of diabetes. The limitations and impairments associated with diabetes include vascular, neurological, cardiac, and renal impairments. Moreover, individuals participate less in their daily lives and in their instrumental activities of daily living, which negatively impacts the quality of life of individuals with diabetes. This often leads to a loss of quality of life due to disabilities, resulting in an increased rate of disability-adjusted life years among people with type 2 diabetes mellitus. Moreover, there are psychosocial sequelae of diabetes mellitus. This necessitates looking for moderating factors that may reduce the burden of the disease. PA has been shown to be one of the factors that can mitigate these burdens. PA does this in several ways, including through the benefits it confers, such as a reduction of hemoglobin A1c, a reduction of excess fat in the liver and pancreas, and the reduction of cardiovascular risk factors, all of which favorably affect glycemic parameters. Specifically, PA regulates or moderates diabetes disability through two mechanisms: The regulation of glucolipid metabolism disorders and the optimization of body mass index and systemic conditions. Therefore, efforts should be directed at PA uptake through identified strategies. This will not only prevent diabetes or diabetes complications but will reduce its burden.

Measuring Achievement, Affiliation, and Power Motives in Mobility Situations: Development of the Multi-Motive Grid Mobility

The current study introduces the Multi-Motive Grid Mobility (MMG-M) in an age-stratified sample (N = 206) that aims to disentangle six motive components - hope of success, hope of affiliation, hope of power, fear of failure, fear of rejection, and fear of power - in mobility-related and mobility-unrelated scenarios. Similar to the classical Multi-Motive Grid (MMG), we selected 14 picture scenarios representing seven mobility and seven non-mobility situations. The scenarios were combined with 12 statements from the MMG. Both the MMG-M and MMG were assessed to allow comparability between psychometric criteria. The results of confirmatory factor analyses yielded a good model fit for a six-factor solution with an additional mobility factor for the MMG-M. Internal consistency of the items was similar to the MMG. Lastly, we investigated associations between the motive components and mobility-related variables. We found that risk awareness was positively related to all fear components in both mobility and non-mobility scenarios. Most importantly, physical constraint was positively associated with fear of rejection and fear of power in mobility situations underlining the importance to create support systems to reduce these concerns in people's everyday lives.