title: Association of Psychosocial Factors With Physical Activity and Function After Total Knee Replacement: An Exploratory Study.
abstract: To examine the association between self-efficacy, social support, and fear of movement with physical activity and function at baseline and after 12 weeks of physical therapy.
  
  
  
  Nonrandomized cohort study, repeated-measures design.
  
  
  
  Outpatient rehabilitation clinic within the general community.
  
  
  
  Adults (N=49) undergoing outpatient physical therapy for total knee replacement (TKR).
  
  
  
  Not applicable.
  
  
  
  Self-efficacy for exercise (SEE), fear of movement, leisure-time physical activity (LTPA), 6-minute walk test (6MWT), and Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) were assessed at baseline and 12 weeks.
  
  
  
  Mean functional change scores significantly increased at 12 weeks for the 6MWT (95% confidence interval [CI], 42.3-106.2), KOS-ADLS (95% CI, 12.7-23.3), and LTPA (95% CI, 6.5-26.1). Self-efficacy and fear of movement were not significantly associated with function at baseline or 12 weeks. Participants with lower SEE had 6 fewer metabolic equivalents per week of improvement in LTPA than those with high self-efficacy (95% CI, -27.9 to 14.8), and those with high fear of movement had 26.1m less improvement in the 6MWT than those with low fear of movement (95% CI, -42.2 to 94.5). Most participants reported having no family or peer support for exercise.
  
  
  
  Physical therapy for TKR improves physical function and self-reported physical activity. High fear of movement and low SEE may be associated with less improvement in physical activity and function over time.
authors.affiliation: Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE. Electronic address: gdominic@udel.edu.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Dominick
authors.affiliation: Department of Physical Therapy, University of Delaware, Newark, DE.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Zeni
authors.affiliation: Department of Physical Therapy, University of Delaware, Newark, DE.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: White
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology* / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology* / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000523:psychology*; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D000070857:Walk Test
keywords: Arthroplasty, replacement, knee; Motor activity; Psychology; Rehabilitation