Background: Despite the known risks of physical inactivity, only 50% of adults meet the recommended guidelines for physical activity (PA). Therefore, numerous interventions have been designed to increase PA across a lifespan. The purpose of this systematic review was to determine the effectiveness of interventions based on the transtheoretical model to improve PA in healthy adults. Methods: Electronic databases (CINAHL, MEDLINE, Psychology & Behavioral Sciences Collection, PsycINFO, Sociological Collection, and SPORTDiscus) were systematically searched from January 2001 to May 2020. Results: A total of 11 randomized pretest–posttest studies were included in this review. Ten studies utilized a subjective measurement of PA, and 3 studies included an objective measure. Five studies demonstrated significant improvements in PA for the transtheoretical model-based intervention groups compared with control/comparison groups; however, 6 studies demonstrated no differences between groups. Conclusion: The findings suggest that there is inconsistent evidence to support the use of interventions based on the transtheoretical model to improve PA in adult populations. Interventions were more successful when materials were delivered via in-person counseling and when study participants were in the precontemplation or contemplation phases at baseline.
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The Effectiveness of the Transtheoretical Model to Improve Physical Activity in Healthy Adults: A Systematic Review
Rachel R. Kleis, Matt C. Hoch, Rachel Hogg-Graham, and Johanna M. Hoch
The Utilization of the Theory of Planned Behavior and Self-Determination Theory to Improve Physical Activity Following Anterior Cruciate Ligament Reconstruction
Rachel R. Kleis, Matthew C. Hoch, Deirdre Dlugonski, and Johanna M. Hoch
Patients with a history of anterior cruciate ligament reconstruction (ACLR) report decreased levels of physical activity participation, which can result in a significant public health burden. Psychosocial factors, such as fear of reinjury and decreased self-efficacy, negatively impact physical activity levels in this population. However, factors such as attitudes and beliefs toward exercise, motivation, self-efficacy, and social support are known to positively influence physical activity participation. The Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT) incorporate such constructs and have been utilized to predict and improve physical activity behaviors in a variety of populations. Emerging evidence has applied the TPB and SDT to rehabilitation adherence in populations with musculoskeletal injury and post-ACLR. However, we believe a combination of the TPB and SDT will provide a framework for increasing physical activity engagement for people with a history of ACLR. The purpose of this review is to present an integrated theoretical model that combines the TPB and SDT with the aim of increasing physical activity after ACLR. Recommendations for future research and clinical practice based on the proposed model are also discussed.
The Relationship Between Resilience and Self-Reported Function in Patients After Total Joint Arthroplasty: A Critically Appraised Topic
Ansley E. Swann, Rachel R. Kleis, and Johanna M. Hoch
Clinical Question : Is there a relationship between resilience and self-reported function in patients who underwent a total joint arthroplasty? Clinical Bottom Line : There is inconsistent, good-quality Level II evidence that investigates the relationship between resilience and self-reported function in patients after joint arthroplasty.
Personal and Social Correlates of Self-Reported Physical Activity in Individuals With a History of Anterior Cruciate Ligament Reconstruction
Rachel R. Kleis, Deirdre Dlugonski, Matthew C. Hoch, Rachel Hogg-Graham, Stacey Slone, and Johanna M. Hoch
Physical activity is negatively impacted after anterior cruciate ligament (ACL) injury and subsequent reconstruction. Previous evidence suggests that individuals with a history of ACL reconstruction (ACLR) may experience additional barriers to sport and physical activity participation. The purpose of this study was to identify personal and social factors (physical literacy, social support, and knee function) that are predictive of self-reported physical activity in individuals with a history of ACLR. Bivariate analyses determined that elements of physical literacy and knee function were positively correlated with self-reported physical activity. The final stepwise linear regression model demonstrated that the PLAYself Physical Literacy Self-description subsection accounted for 12.2% of the variance of self-reported physical activity (p = .003). The significant effect of the PLAYself Physical Literacy Self-description remained (p = .002) even when additional demographic covariates (age, time since ACLR, and sex) were added to the model. Findings suggest that physical literacy may be a salient factor to consider for promoting physical activity after ACLR.
Differences in Health-Related Quality of Life Among Patients After Knee Injury
Rachel R. Kleis, Janet E. Simon, Michael Turner, Luzita I. Vela, Abbey C. Thomas, and Phillip A. Gribble
While knee injury-related pain and functional limitations are common in the physically active, the impact on general health is not well documented. Further, it is not known how much these outcomes differ among individuals that did or did not have surgery following the knee injury, as well as compared to those without knee injury history. We examined differences in health-related quality of life (HRQoL) and general health among patients after knee surgery, knee injury that did not require surgery, and healthy controls. Knee surgery participants reported higher body mass index and lower SF-8 physical component scores than knee nonsurgery and control (p < .001 all comparisons) groups. Knee nonsurgery participants had lower SF-8 physical component scores (p = .01) than control participants. Patients after knee surgery report more adverse health effects than those with nonsurgically treated knee injuries.