PTOTQualitativeDisability and rehabilitation2018

Understanding barriers and facilitators to healthy eating and physical activity from patients either before and after knee arthroplasty.

Christine A Pellegrini, Gwendolyn Ledford, Rowland W Chang and 1 others

PMID 28475433

WHAT IT FOUND

Patients cited pain, low fitness, and mood as top barriers to activity, while craving high-calorie foods and stress hindered eating.

Facilitators included pre-planning meals, using wearable trackers, and linking healthy habits directly to better surgical outcomes.

Key findings

01Pain, physical limitations, low fitness, and poor mood were the primary personal barriers to physical activity.

02Cravings for high-calorie foods, overconsumption, and negative mood were the most common barriers to healthy eating.

03Patients used meal planning, portion control, activity monitoring, and motivation to improve knee outcomes as facilitators for behavior change.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The sample was primarily white, highly educated adults, which limits generalizability to other demographic groups. Most participants expressed an interest in losing weight, so those less motivated may face different barriers. The study is qualitative and reports themes, not effect sizes or clinical outcomes. Participants were interviewed within 3 months of surgery, so findings reflect the acute recovery phase rather than long-term maintenance.

Declared interests

Research support was provided by the National Institutes of Health (N.I.H.) and the U.S. Public Health Service. No other conflicts of interest are reported in the provided text.

The easy way to misread this

Do not interpret these themes as evidence that specific interventions work. The study identifies what patients say hinders or helps them, but it does not test whether addressing these barriers improves clinical outcomes.

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