Abstract
Objectives
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.
Design
Nonrandomized cohort study, repeated-measures design.
Setting
Outpatient rehabilitation clinic within the general community.
Participants
Adults (N=49) undergoing outpatient physical therapy for total knee replacement (TKR).
Interventions
Not applicable.
Main Outcome Measures
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.
Results
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.
Conclusions
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.
Keywords
List of abbreviations:
BMI (body mass index), CI (confidence interval), KOS-ADLS (Knee Outcome Survey–Activities of Daily Living Scale), LTPA (leisure-time physical activity), OA (osteoarthritis), SEE (self-efficacy for exercise), 6MWT (6-minute walk test), TKR (total knee replacement)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 19, 2016
Footnotes
Supported by the American College of Rheumatology/Rheumatology Research Foundation and by Comprehensive Opportunities in Rehabilitation Research Training (grant no. K12 HD055931). Funding sponsors had no role in the study design, data collection, analysis, or interpretation of data; nor any role in writing the manuscript or submission for publication.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
