• Sandra C Webber, Jacquie D Ripat, Navjot S Pachu, and Shaelyn M Strachan.
• Rady Faculty of Health Sciences, Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada.
• Disabil Rehabil. 2020 Jul 1; 42 (14): 1971-1978.

AbstractPurpose: To explore the understanding of physical activity and sedentary behaviour, including barriers and health influences in people with osteoarthritis and knee arthroplasty.Methods: Eight participants with knee osteoarthritis and 14 participants with total knee arthroplasty were recruited to five focus groups. Interpretive description was used with thematic analysis of data.Results: Three primary themes arose: (1) continuum of activity; (2) barriers to increasing physical activity and barriers to reducing sedentary behavior, and (3) knowledge gap. While participants were generally familiar with the concepts of physical activity and sedentary behaviour, they were not aware of health risks associated with high levels of sedentary time and did not consider substituting standing and light walking for activities typically done in sitting. Participants reported that extrinsic barriers (e.g., related to social and cultural contexts or the physical environment) influenced sedentary behaviour more than intrinsic factors.Conclusions: Patients would benefit from clinicians providing education about risks associated with sedentary behaviour and strategies to reduce and/or break up sitting time. Future research should continue to explore personal as well as societal, environmental, political, and economic influences on sedentary behaviour and physical activity to promote behaviour change.Implications for rehabilitationPeople with osteoarthritis and total knee arthroplasty are not aware of health risks associated with high levels of sedentary behaviour.This cohort tends to think about increasing moderate-to-vigorous physical activity levels (versus increasing light activity) when asked to consider ways to reduce sedentary behaviour.Social and environmental factors strongly influence sedentary behaviour. Clinicians need to be aware of the pervasive nature of sedentary behaviour and provide knowledge and strategies to change peoples' sitting habits.Addressing intrinsic factors (e.g., related to comorbidities, ageing, and personal preferences) with education and the use of existing behaviour change techniques may enable increased physical activity levels.

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