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Updated: Oct 16, 2026
Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation
Published on: November 8, 2013
Longitudinal Changes in Exercise Adherence and Associations with Rehabilitation Outcomes After Total Knee
Jiao Wang1, Shanbin Chen1, Yuanyuan Li1
1Sixth Ward, Department of Orthopedics, The Fourth Hospital of Changsha (Changsha Hospital of Integrated Traditional Chinese and Western Medicine), Changsha, Hunan, People's Republic of China.
Background:
Exercise adherence is important after total knee arthroplasty (TKA), but its postoperative pattern and behavioral correlates remain unclear.
Objective:
To characterize exercise adherence and examine its associations with HAPA-related factors and rehabilitation outcomes.
Methods:
This prospective study included 128 patients undergoing unilateral TKA. HAPA-related variables were assessed preoperatively. EARS, VAS, HSS, and range of motion (ROM) were assessed at 1, 3, and 6 months. Linear mixed-effects models, correlations, and regression were used.
Results:
EARS scores changed over time (P<0.001), increasing from 17.78±3.27 at 1 month to 18.43±3.64 at 3 months and remaining stable at 6 months (18.36±3.68). Compared with 1 month, EARS was higher at 3 months (difference=0.651, 95% CI 0.340-0.962) and 6 months (difference=0.601, 95% CI 0.290-0.912; both adjusted P<0.001); 3- and 6-month scores did not differ. VAS decreased, whereas HSS and ROM increased (all P<0.001). At 6 months, action self-efficacy (B=0.248, 95% CI 0.065-0.431) and maintenance self-efficacy (B=0.209, 95% CI 0.032-0.387) were independently associated with higher EARS scores. EARS correlated with VAS (r=-0.360), HSS (r=0.326), and ROM (r=0.361; all P<0.001).
Conclusion:
Exercise adherence improved mainly during the first 3 months and then stabilized. Self-efficacy was associated with adherence, while higher adherence was associated with less pain and better function. These findings do not establish causality.