Bibliographic record
Abstract
Total knee arthroplasty (TKA) places a large burden on the Canadian Health care system with over 700 million dollars spent on this procedure annually. Exercise has been shown to be effective in improving pain, physical function, mobility and quality of life post-operatively. There is very limited research on adherence to rehabilitation and exercise after TKA. The aim of this thesis was to increase understanding of exercise adherence in this population. The first manuscript in this thesis was a scoping review that evaluated exercise adherence and the quality of reporting of exercise interventions within post-operative TKA rehabilitation trials. A systematic search of scientific databases was conducted for randomized controlled trials (RCT) with an exercise intervention for post-operative TKA. In total, 112 articles were included in this review. This study found that the vast majority of articles (85%) were of poor quality having either high/unclear risk of bias. The majority of RCTs (63%, N=71) on post-operative TKA rehabilitation did not adequately report exercise adherence (e.g., definition, outcome measure used and results), while only 23% (N=15) provided a definition of adherence in the context of their study. Overall reporting of the exercise intervention was poor, with 15 items (of 19) of the Consensus on Exercise Reporting Template (CERT) reported less than 60% of the time. Inadequate reporting of exercise interventions and adherence to exercises leads to decreased reproducibility and translation into clinical practice. Proper reporting of rehabilitation exercises after TKA will ensure standardization for future studies and clinical replication. The second manuscript in this thesis was a qualitative study that aimed to understand the patient- related barriers and facilitators to exercise adherence in patients immediately after undergoing TKA. Using an interpretive description approach, semi-structured qualitative interviews were conducted. Seven participants were interviewed at 8-weeks post-operatively in order to better capture physical, psychological, social and contextual factors linked to exercise adherence. Interview questions explored participants’ experience with physical activity and exercise, motivation to perform physical activity, beliefs that exercise will reduce pain, the factors that limit their ability to engage in exercise, and the importance of using self-regulation to improve exercise adherence. Emergent themes were mapped onto the domains of the WHO adherence framework. This study identified 4 themes that fit within the WHO adherence framework: patient-related factors, condition-related factors, health care system, and social support. In particular, self-regulation, previous knowledge of exercise, post-operative complications, comorbidities, social support, and lack of guidance from health care providers were identified as personal and environmental characteristics that affect exercise adherence. The overall findings of this study suggest exercise adherence is a multifaceted construct with interconnected concepts.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.055 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".