Physical activity and fitness measures in healthy older adults and hip osteoarthritis patients

Background

Physical inactivity and functional decline represent significant challenges for aging populations, warranting effective intervention strategies and reliable assessment methodologies. This thesis investigated test-retest reliability of physical activity and fitness measurements in older adults, examined effects of structured exercise, and assessed longitudinal recovery trajectories in hip osteoarthritis patients following total hip arthroplasty (THA).

Methods

Four studies were conducted. Study I (n=78, age 70.9+4.7 years) evaluated accelerometer measurement reliability and monitored physical activity changes following an 8-week exercise intervention (twice-weekly, 60-minute combined training). Study II (n=1,407, age 65-84 years) assessed test-retest reliability of a comprehensive field-based fitness test battery and post an 8-week exercise period across multiple age groups. Study III (n=265, age 71.4+4.7 years) examined sustained and cumulative effects of identical 8-week exercise programs performed in consecutive years. Study IV (n=78, age 74.0+4.5 years) investigated physical fitness and activity patterns in hip osteoarthritis patients undergoing THA, with two assessments pre-operative, 4 months, and 1-year post-surgery.

Results

Physical activity parameters demonstrated good to excellent test-retest reliability. Similarly, field-based fitness tests generally showed good reliability across age and sex strata. The 8-week exercise intervention produced significant improvements in physical activity pattens and multiple physical fitness tests. Most fitness test parameters remained stable during the 9-month inter-intervention period, with declines observed in trunk strength endurance. Hip osteoarthritis patients exhibited pre-operative deficits compared to healthy controls in several fitness tests and in moderate- to vigorous physical activity, whereas post-operative improvements at 1-year follow-up were observed for a multitude of physical fitness parameters and exceeding the recommended physical activity levels.

Conclusions

This thesis established good test-retest reliability of accelerometer-measured physical activity and most included fitness assessments for monitoring older adults. Structured exercise generated physical activity and fitness benefits in healthy older adults. Moreover, substantial functional and activity improvements were seen following total hip arthroplasty without structured post-operative intervention. These findings underscore the importance of exercise engagement and appropriate surgical intervention to improve both functional capacity and physical activity in older adult populations.

List of scientific papers

This thesis includes four papers, these will be referenced using their Roman numerals listed below:

I. Manne Godhe, Marjan Pontén, Johnny Nilsson, Lena Kallings & Eva Andersson. Reliability of the accelerometer to control the effects of physical activity in older adults. Plos One, 17(9), e0274442. (2022).
https://doi.org/10.1371/journal.pone.0274442

II. Manne Godhe, Gustaf Rönquist, Johnny Nilsson, Örjan Ekblom, Lillemor Nyberg, Gustav Edman, & Eva Andersson Reliability in Novel Field-Based Fitness Measurements and Postexercise Scores from a Physical Fitness Test Battery in Older Adults. Gerontology, 70(6), 639-660. (2024). https://doi.org/10.1159/000538446
https://doi.org/10.1159/000538446

III. Manne Godhe, Johnny Nilsson, & Eva Andersson. Short-and Long-Term Effects on Physical Fitness in Older Adults: Results from an 8-Week Exercise Program Repeated in Two Consecutive Years. Geriatrics, 10(1), 15. (2025). https://doi.org/10.3390/geriatrics10010015
https://doi.org/10.3390/geriatrics10010015

IV. Manne Godhe, Anders Stålman, Johnny Nilsson & Eva Andersson. Physical fitness Improvements and Achievement of Recommended Physical Activity Levels One Year After Total Hip Arthroplasty: A Longitudinal Study of Physical Function and Activity Patterns [Manuscript]

Papers I & III were published under Creative Commons CC BY license. Paper II is reproduced in this thesis with permission from Karger Publishers. Paper IV is in manuscript form.