Effectiveness of a behavioral change intervention in Thai elders after knee replacement

BACKGROUND: After total knee replacement, elders need an effective intervention to change exercise and physical activity behavior. OBJECTIVES: This study examined the effects of a behavioral change intervention (BCI) on self-efficacy and outcome expectations for exercise and functional activity, physical activity participation, and physical performance of older adults. METHODS: The study was based on the social cognitive theory (SCT), with a longitudinal quasi-experimental, pretest-posttest control group design. Sixty-three Thai elders undergoing knee replacement surgery were studied. The experimental group received a BCI based on SCT given by the investigator. Outcome measures were the Self-Efficacy for Exercise Scale (SEES) and Self-Efficacy for Functional Activity Scale (SEFAS), the Outcome Expectations for Exercise Scale (OEES) and Outcome Expectations for Functional Activity Scale (OEFAS), the Physical Performance Test (PPT), and the Physical Activity Diary (PAD). RESULTS: The experimental group had significantly greater improvements in self-efficacy for exercise, outcome expectations for exercise, and functional activity, significantly more participation in exercise and walking, and significantly greater improvement in physical performance than did the control group at postoperative weeks 2 and 6. DISCUSSION: The BCI based on SCT was effective in changing the outcomes in the expected direction. This BCI may be applicable, with modifications, to elders in other situations in which changing behavior is the key to recovery.