In the Dark About Physical Activity – Exploring Patient Perceptions of Physical Activity After Elective Total Knee Joint Replacement: A Qualitative Study

Objective The study aimed to explore patient perceptions of and motivations for physical activity after total knee joint replacement. Methods Participants were purposively sampled after completing a public outpatient rehabilitation exercise group. Semistructured interviews were completed with 22 participants (mean age 70 years, 45% women) 6 to 12 months after total knee joint replacement. Interviews were audiotaped and transcribed verbatim. Themes were identified by an inductive and iterative process of data analysis. Results The main theme to emerge was participants were in the dark about physical activity. Participants were typically not familiar with physical activity guidelines and had difficulty distinguishing between low‐ and moderate‐intensity physical activity. Three subthemes were identified: 1) people prioritize participation in meaningful life situations after total knee joint replacement, 2) rehabilitation was perceived to not explicitly address moderate‐intensity physical activity levels, and 3) other health and social reasons replaced knee osteoarthritis as barriers to physical activity. Conclusion Limited understanding of physical activity recommendations, prioritization of participation in meaningful life situations, rehabilitation that was impairment focused, and other health and social reasons appeared to contribute to low levels of moderate‐intensity physical activity in adults after knee joint replacement. Addressing being in the dark about physical activity may be an important first step to increase the effectiveness of behavioral interventions designed to promote physical activity after total knee joint replacement.