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Patient Preference and Adherence

Longitudinal Changes in Exercise Adherence and Associations with Rehabilitation Outcomes After Total Knee Arthroplasty: A Prospective HAPA-Informed Study

1 de octubre de 2026Investigación original1 min de lectura

Por Jiao Wang, Shanbin Chen, Yuanyuan Li y 3 más.

Contenido en inglés

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Resumen
Palabras clave
Autores
Fuente

Resumen

Background

Exercise adherence is important after total knee arthroplasty (TKA), but its postoperative pattern and behavioral correlates remain unclear.

Objective

To characterize exercise adherence and examine its associations with HAPA-related factors and rehabilitation outcomes.

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Methods

This prospective study included 128 patients undergoing unilateral TKA. HAPA-related variables were assessed preoperatively. EARS, VAS, HSS, and range of motion (ROM) were assessed at 1, 3, and 6 months. Linear mixed-effects models, correlations, and regression were used.

Results

EARS scores changed over time (P< 0.001), increasing from 17.78± 3.27 at 1 month to 18.43± 3.64 at 3 months and remaining stable at 6 months (18.36± 3.68). Compared with 1 month, EARS was higher at 3 months (difference=0.651, 95% CI 0.340– 0.962) and 6 months (difference=0.601, 95% CI 0.290– 0.912; both adjusted P< 0.001); 3- and 6-month scores did not differ. VAS decreased, whereas HSS and ROM increased (all P< 0.001). At 6 months, action self-efficacy (B=0.248, 95% CI 0.065– 0.431) and maintenance self-efficacy (B=0.209, 95% CI 0.032– 0.387) were independently associated with higher EARS scores. EARS correlated with VAS ( r =− 0.360), HSS ( r =0.326), and ROM ( r =0.361; all P< 0.001).

Conclusion

Exercise adherence improved mainly during the first 3 months and then stabilized. Self-efficacy was associated with adherence, while higher adherence was associated with less pain and better function. These findings do not establish causality. Keywords: knee osteoarthritis, self-efficacy, health behavior, functional recovery, patient compliance

Palabras clave

Total Knee Arthroplasty Outcomes
exercise adherence
total knee arthroplasty
rehabilitation outcomes
Health Action Process Approach
postoperative rehabilitation
physical activity
knee arthroplasty
Open access

Autores

Jiao Wang
Shanbin Chen
Yuanyuan Li
Yuan Yuan
Jiahui Liu
Suiyuan Wang

Fuente

Publicado en Patient Preference and Adherence. El resumen se muestra tal como se publicó y sigue siendo obra de sus autores; lee el artículo completo en la fuente.

doi.org/10.2147/ppa.s630194

Prognia recoge este artículo como referencia y para la formación. No es consejo médico. Lee siempre el original y sigue las guías vigentes y los protocolos locales antes de actuar.

De un vistazo

Revista: Patient Preference and Adherence
Tipo: Investigación original
Publicado: 1 de octubre de 2026
Especialidad: Traumatología y ortopedia
Tiempo de lectura: 1 min
Autores: 6
DOI: 10.2147/ppa.s630194

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