In the Dark About Physical Activity – Exploring Patient Perceptions of Physical Activity After Elective Total Knee Joint Replacement: A Qualitative Study

Abstract

Objective. The study aimed to explore patient perceptions of and motivations for physical activity after total knee joint replacement.Methods. Participants were purposively sampled after completing a public outpatient rehabilitation exercise group. Semistructured interviews were completed with 22 participants (mean age 70 years, 45% women) 6 to 12 months after total knee joint replacement. Interviews were audiotaped and transcribed verbatim. Themes were identified by an inductive and iterative process of data analysis.Results. The main theme to emerge was participants were in the dark about physical activity. Participants were typically not familiar with physical activity guidelines and had difficulty distinguishing between low-and moderateintensity physical activity. Three subthemes were identified: 1) people prioritize participation in meaningful life situations after total knee joint replacement, 2) rehabilitation was perceived to not explicitly address moderate-intensity physical activity levels, and 3) other health and social reasons replaced knee osteoarthritis as barriers to physical activity.Conclusion. Limited understanding of physical activity recommendations, prioritization of participation in meaningful life situations, rehabilitation that was impairment focused, and other health and social reasons appeared to contribute to low levels of moderate-intensity physical activity in adults after knee joint replacement. Addressing being in the dark about physical activity may be an important first step to increase the effectiveness of behavioral interventions designed to promote physical activity after total knee joint replacement.

A Nomogram for Predicting Non-Response to Surgery One Year after Elective Total Hip Replacement

“…This suggests a role for increasing physical activity in patients with significant comorbidities prior to undergoing THR to maximise post-operative outcomes. However, there is inadequate knowledge and motivation for adhering to physical activity recommendations among people with OA and concomitant comorbidities who undergo joint replacement surgery, which poses a barrier to change [ 44 ].…”

Does a consumer co‐designed infographic increase knowledge of physical activity after total knee joint replacement? A randomised controlled trial

“…Potential participants were eligible if they were 18 years or older, conversant in English and were 6–26 weeks after primary elective total knee joint replacement secondary to osteoarthritis. People with primary elective knee joint replacement were selected as this was the group where a knowledge gap about physical activity recommendations had been identified (Hawke et al., 2022). People with a documented medical history of cognitive decline were not eligible because of potential difficulties understanding the infographic.…”

“…Knowledge of a health behaviour (in this instance, physical activity) is a primary component of behaviour change theories and is a prerequisite for behaviour change interventions to successfully increase physical activity after joint replacement (Bandura, 2004). However, a recent qualitative study found that people with knee joint replacement lacked basic knowledge of physical activity constructs including physical activity recommendations (Hawke et al., 2022). Therefore, the knowledge gap specific to physical activity observed in people after knee replacement needs to be addressed so that the effectiveness of subsequent behavioural change strategies is optimised (Hawke et al., 2022).…”

“…However, a recent qualitative study found that people with knee joint replacement lacked basic knowledge of physical activity constructs including physical activity recommendations (Hawke et al., 2022). Therefore, the knowledge gap specific to physical activity observed in people after knee replacement needs to be addressed so that the effectiveness of subsequent behavioural change strategies is optimised (Hawke et al., 2022).…”

“…However, a recent qualitative study found that people with knee joint replacement lacked basic knowledge of physical activity constructs including physical activity recommendations (Hawke et al, 2022). Therefore, the knowledge gap specific to physical activity observed in people after knee replacement needs to be addressed so that the effectiveness of subsequent behavioural change strategies is optimised (Hawke et al, 2022). Furthermore, self-efficacy theory suggests that a person's confidence to change a behaviour (self-efficacy) determines their choice of actions, the effort they expend, their persistence in the face of obstacles and emotional responses in performing that behaviour (Bandura, 1977;Maddux, 2016).…”