Social cognitive variables related to physical activity following total knee arthroplasty: an application of the health action process approach
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Background: Approximately 80% of people make an optimal functional recovery following total knee arthroplasty (TKA), but little is known about psychological variables that influence this recovery. The Health Action Process Approach (HAPA) is a behaviour change model which has been used to investigate variables related to physical activity. Aim: To investigate the relationships between the HAPA variables and physical activity at one to two years following TKA. Methods: Fifty-four adults who had undergone a TKA one to two years previously were recruited from three orthopaedic clinics. Participants completed activity-related questionnaires on: perceived risk; outcome expectation; task, maintenance and recovery self-efficacy; behavioural intentions; action and coping plans; and social support. Further questionnaires assessed co-morbidities, current pain, knee function and physical activity participation. Spearman’s correlations investigated relationships amongst the variables under study. Results: Moderate to weak correlations occurred amongst variables of interest. In the motivation phase, both task self-efficacy and risk perception were weakly related to intention to exercise. In the volitional phase, moderate relationships occurred between task self-efficacy and action planning and between task self-efficacy and coping planning. Intention to exercise was moderately related to action planning and weakly related to coping planning. Weak relationships were found between maintenance self-efficacy and action planning and between maintenance self-efficacy and coping planning. Social support was weakly related to coping planning and coping planning was weakly related to physical activity. Co-morbidities and function were weakly inversely related to physical activity. Conclusion: The variables of the HAPA show some ability to explain the participation in regular physical activity following TKA. Future research should evaluate the effectiveness of action and coping plans on improving the participation in physical activity amongst people following TKA.