Determinants and implications of physical activity in hip and knee osteoarthritis: an integrated approach

Kanavaki, Maria-Archontissa ORCID: 0000-0003-2630-1437 (2020). Determinants and implications of physical activity in hip and knee osteoarthritis: an integrated approach. University of Birmingham. Ph.D.

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Abstract

This thesis aimed to advance the understanding regarding physical activity (PA) determinants in hip and knee osteoarthritis. A systematic review of qualitative evidence on PA barriers and facilitators revealed a complex interplay among physical, psychological, social and environmental factors. Next, a quantitative study assessed key factors from each category and accelerometer-measured PA. PA intensity/sedentary time (ST) classification was examined for age-relevant and commonly used cut points. The comparison yielded significant differences between the cut points for time spent in PA intensities/ST and for people meeting moderate-to-vigorous-PA(MVPA) guidelines, but had limited implications for MVPA (bouted, total) associations with health and well-being. Drawing from Social-Cognitive and Ecological Theories of behaviour, an integrated path model of self-efficacy and neighbourhood facilities predicting MVPA (bouted, total) and in turn physical function and quality of life was tested. The model showed a good fit for bouted, but not total MVPA. Lastly, a qualitative inquiry into peoples’ daily PA and sedentary experiences revealed that these were multifaceted and PA/sedentary behaviours were the outcome of a dynamic negotiation between the burden of osteoarthritis, the need to keep mobile/enjoying life, and life context. Overall the findings suggest potential PA determinants to target and outcomes to consider in future interventions.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):