After total knee arthroplasty, many people are not active enough to maintain their health and fitness: an observational study

J Physiother. 2012;58(2):113-6. doi: 10.1016/S1836-9553(12)70091-7.


Questions: What proportion of people after total knee arthroplasty adheres to the physical activity regimen recommended for maintenance of health (moderate intensity physical activity for at least 30min on 5 days/week)? What proportion adheres to the activity regimen recommended to improve fitness (vigorous intensity physical activity for at least 20min on 3 days/week)? What factors are associated with adherence to these recommendations?

Design: An observational study.

Participants: 830 adults who underwent a total knee arthroplasty between 2002 and 2006 at University Medical Center Gronigen or Martini Hospital Gronigen, the Netherlands.

Outcome measures: The Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) was used to measure the physical activity behaviour of the participants. These data were analysed as adherence to each recommendation.

Results: The health recommendation was adhered to by 51% of the participants. The fitness recommendation was adhered to by 53% of participants. Almost half (46%) of the participants fulfilled both recommendations, and 42% did not fulfil either recommendation. Males and more educated participants had higher odds of meeting the health, fitness, and both recommendations. Respondents living with family had higher odds of meeting the fitness recommendation.

Conclusion: After total knee arthroplasty, 42% of people are not active enough to maintain their health and fitness. Physiotherapists should encourage people with a total knee arthroplasty to undertake the recommended exercise regimens to maintain health and fitness, with particular attention to those people with characteristics known to be associated with poor adherence to the recommendations.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Arthroplasty, Replacement / rehabilitation*
  • Exercise
  • Female
  • Follow-Up Studies
  • Health Behavior*
  • Health Status*
  • Humans
  • Knee Joint / physiopathology*
  • Male
  • Middle Aged
  • Mobility Limitation*
  • Motor Activity
  • Physical Fitness / physiology*