Attitude toward physical activity after total hip or knee replacement: A cross-sectional survey study of Dutch and Norwegian patients

Inge van den Akker-Scheek; Martin Stevens; Astrid J De Vries; Anne Marie Fenstad; Ove Nord Furnes; Håvard Østerås; Bregje E Raap-van Sleuwen; Katja Saris; Geranda E C Slager; Monica Unsgaard-Tøndel; Odd Magne Hals; Ann-Katrin Stensdotter

doi:10.1371/journal.pone.0325746

Attitude toward physical activity after total hip or knee replacement: A cross-sectional survey study of Dutch and Norwegian patients

Vertaalde titel van de bijdrage: Attitude ten opzichte van lichamelijke activiteit na een totale knie- of heupprothese: een cross-sectioneel enquêteonderzoek onder Nederlandse en Noorse patiënten

Inge van den Akker-Scheek, Martin Stevens, Astrid J De Vries, Anne Marie Fenstad, Ove Nord Furnes, Håvard Østerås, Bregje E Raap-van Sleuwen, Katja Saris, Geranda E C Slager, Monica Unsgaard-Tøndel, Odd Magne Hals, Ann-Katrin Stensdotter

Onderzoeksoutput: Article › Academic › peer review

Samenvatting

Doelstelling
Inzicht verkrijgen in de attitude ten opzichte van fysieke activiteit (PA) van Noorse en Nederlandse patiënten na een heup- of knie artroplastiek, mogelijke verschillen in attitude tussen de landen en welke factoren een meer positieve of negatieve attitude verklaren.

Methoden
Er werd een cross-sectionele vragenlijststudie uitgevoerd naar de attitude ten opzichte van PA 6–12 maanden na een heup- of knie artroplastiek in Noorwegen en Nederland. Patiënten ontvingen een vragenlijst bestaande uit drie delen: demografie, ontvangen zorg, en een enquête over de attitude ten opzichte van PA, bestaande uit 32 stellingen verdeeld over vier domeinen – kwaliteit van leven, niveau van PA, functie en kinesiofobie. De houding werd gescoord op een 4-punts Likertschaal. Een hoge score duidde op een positieve attitude ten opzichte van PA. De antwoorden van de Noorse en Nederlandse cohorten werden vergeleken met behulp van een one-way ANOVA voor groepsvergelijking. Om factoren te identificeren die de uitkomst van de houdingsenquête verklaren, werden stapsgewijze regressieanalyses gebruikt.

Resultaten
Gegevens van 732 Noorse patiënten en 575 Nederlandse patiënten werden opgenomen in de analyses. Over het algemeen waren de kenmerken van de twee cohorten vrij vergelijkbaar, hoewel een significant groter aantal in het Noorse cohort had deelgenomen aan “prehab”, terwijl deelname aan “rehab” vergelijkbaar was. In alle vier de domeinen waren de attitudescores over het algemeen hoog, wat wijst op een positieve houding, waarbij Noorse patiënten significant hoger scoorden. Een hogere deelname aan sport was de sterkste verklarende factor voor een positievere attitude ten opzichte van PA. Hogere leeftijd was de sterkste onafhankelijke variabele die een minder positieve attitude ten opzichte van PA verklaarde.

Conclusie
Patiënten lijken over het algemeen een positieve attitude te hebben ten opzichte van PA na een heup- of knie artroplastiek. Noorse patiënten hadden een positievere houding vergeleken met Nederlandse patiënten, wat mogelijk het gevolg is van meer gestructureerde en uitgebreide voorlichting over de voordelen van PA als onderdeel van de “prehab” in Noorwegen.

Vertaalde titel van de bijdrage	Attitude ten opzichte van lichamelijke activiteit na een totale knie- of heupprothese: een cross-sectioneel enquêteonderzoek onder Nederlandse en Noorse patiënten
Originele taal-2	English
Artikelnummer	0325746
Pagina's (van-tot)	1-14
Aantal pagina's	14
Tijdschrift	PLOS ONE
Volume	21
Nummer van het tijdschrift	1 JANUARY
DOI's	https://doi.org/10.1371/journal.pone.0325746
Status	Published - 23 jan. 2026

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SDG 03 – Goede gezondheid en welzijn

Keywords

mensen
noorwegen
cross-sectionele studies
artroplastiek, knievervanging/psychologie
nederland
vrouwelijk
mannelijk
artroplastiek, Heupvervanging/psychologie
ouder
middelbare leeftijd
vragenlijsten en enquêtes
kwaliteit van leven
sporten
houding ten opzichte van gezondheid
motorische activiteit

Research Focus Areas Hanze University of Applied Sciences

Healthy Ageing

Research Focus Areas Research Centre or Centre of Expertise

Gezonde leefstijl en leefomgeving
Kwetsbaarheid en passende zorg

Publinova thema's

Recreatie, Beweging & Sport

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10.1371/journal.pone.0325746Licentie: CC BY

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Attitude toward physical activity after total knee or hip replacement - a cross-sectional survey study of Dutch and Norwegian patients

4 Article
1 Abstract
1 Poster

Attitudes towards physical activity after total knee or hip arthroplasty: an exploratory cross-sectional study of physical therapists in Germany, Norway, and the Netherlands
Vertaalde titel van de bijdrage: Attitudes ten opzichte van lichamelijke activiteit na een totale knie- of heuparthroplastiek: een verkennende cross-sectionele studie onder fysiotherapeuten in Duitsland, Noorwegen en Nederland Nordlund-Bjørnset, J. (First author), Seeber, G., Østerås, H., Unsgaard-Tøndel, M., Magne Hals, O., Stensdotter, A.-K., Slager, G., van den Akker-Scheek, I. & stevens, M., 16 apr. 2026, (E-pub ahead of print) In: European Journal of Physiotherapy. blz. 1-10 10 blz.
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Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care in the Netherlands versus Germany
Vertaalde titel van de bijdrage: Effecten van revalidatie van werkende patiënten na een totale heup artroplastiek: een vergelijking van de usual care tussen Nederland en DuitslandWijnen, A., Heber, G., Dietz, G., Dijkstra, B., Dekker, J. S., Vermeulen, K. M., Slager, G., Hessel, A., Lazovic, D., Bulstra, S. K. & Stevens, M., 27 jun. 2023, In: BMC Musculoskeletal Disorders. 24, 1, 525 (2023).
Onderzoeksoutput: Article › Academic › peer review

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Effectiveness of a home-based rehabilitation program after total hip arthroplasty driven by a tablet app and remote coaching: nonrandomized controlled trial combining a single-arm intervention cohort with historical controls
Wijnen, A., Hoogland, J., Munsterman, T., Gerritsma, C. L. E., Dijkstra, B., Zijlstra, W. P., Dekker, H. J. S., Annegarn, J., Ibarra, F., Slager, G., Zijlstra, W. & Stevens, M., 27 apr. 2020, In: JMIR Rehabilitation and Assistive Technologies. 7, 1, 11 blz., PMID: 32338621.
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Citeer dit

van den Akker-Scheek, I., Stevens, M., De Vries, A. J., Fenstad, A. M., Furnes, O. N., Østerås, H., Raap-van Sleuwen, B. E., Saris, K., Slager, G. E. C., Unsgaard-Tøndel, M., Hals, O. M., & Stensdotter, A.-K. (2026). Attitude toward physical activity after total hip or knee replacement: A cross-sectional survey study of Dutch and Norwegian patients. PLOS ONE, 21(1 JANUARY), 1-14. Artikel 0325746. https://doi.org/10.1371/journal.pone.0325746

@article{df8b7ff4de274bcc9f7948772d4400d0,

title = "Attitude toward physical activity after total hip or knee replacement: A cross-sectional survey study of Dutch and Norwegian patients",

abstract = "Objective To gain insight into the attitude towards physical activity (PA) of Norwegian and Dutch patients after hip or knee replacement, possible differences in attitude between the countries and which factors explain a more positive or negative attitude. Methods A cross-sectional survey study investigating attitude toward PA 6–12 months after hip or knee replacement was conducted in Norway and the Netherlands. Patients received a questionnaire consisting of three parts: demography, received health service, and the survey about attitude toward PA consisting of 32 statements divided into four domains – quality of life, level of PA, function, and kinesiophobia. Attitude was scored on a 4-graded Likert scale. A high score indicated a positive attitude toward PA. Survey responses from the Norwegian and Dutch cohorts were compared using one-way ANOVA for group comparison. To identify factors explaining the outcome of the attitude survey, stepwise regressions were used. Results Data from 732 Norwegian patients and 575 Dutch patients was included in the analyses. Overall, the characteristics of the two cohorts were quite similar, although a significantly greater number in the Norwegian cohort had participated in “prehab”, while the participation in “rehab” was similar. In all four domains the attitude scores were generally high, indicating positive attitudes, with Norwegian patients scoring significantly higher. Higher participation in sports was the strongest explaining factor for a more positive attitude toward PA. Older age was the strongest independent variable explaining a less positive attitude towards PA. Conclusion Patients seem to have an overall positive attitude towards PA after hip or knee replacement. Norwegian patients had a more positive attitude compared to Dutch patients, which could be the result of more formalized and extensive education of the benefits of PA as part of the “prehab” in Norway.",

keywords = "Humans, Norway, Cross-Sectional Studies, Arthroplasty, Replacement, Knee/psychology, Netherlands, Female, Male, Arthroplasty, Replacement, Hip/psychology, Aged, Middle Aged, Surveys and Questionnaires, Quality of Life, Exercise, Attitude to Health, Motor Activity, mensen, noorwegen, cross-sectionele studies, artroplastiek, knievervanging/psychologie, nederland, vrouwelijk, mannelijk, artroplastiek, Heupvervanging/psychologie, ouder, middelbare leeftijd, vragenlijsten en enqu{\^e}tes, kwaliteit van leven, sporten, houding ten opzichte van gezondheid, motorische activiteit",

author = "\{van den Akker-Scheek\}, Inge and Martin Stevens and \{De Vries\}, \{Astrid J\} and Fenstad, \{Anne Marie\} and Furnes, \{Ove Nord\} and H{\aa}vard {\O}ster{\aa}s and \{Raap-van Sleuwen\}, \{Bregje E\} and Katja Saris and Slager, \{Geranda E C\} and Monica Unsgaard-T{\o}ndel and Hals, \{Odd Magne\} and Ann-Katrin Stensdotter",

note = "Copyright: {\textcopyright} 2026 van den Akker-Scheek et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2026",

month = jan,

day = "23",

doi = "10.1371/journal.pone.0325746",

language = "English",

volume = "21",

pages = "1--14",

journal = "PLOS ONE",

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number = "1 JANUARY",

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van den Akker-Scheek, I, Stevens, M, De Vries, AJ, Fenstad, AM, Furnes, ON, Østerås, H, Raap-van Sleuwen, BE, Saris, K, Slager, GEC, Unsgaard-Tøndel, M, Hals, OM & Stensdotter, A-K 2026, 'Attitude toward physical activity after total hip or knee replacement: A cross-sectional survey study of Dutch and Norwegian patients', PLOS ONE, vol. 21, nr. 1 JANUARY, 0325746, blz. 1-14. https://doi.org/10.1371/journal.pone.0325746

TY - JOUR

T1 - Attitude toward physical activity after total hip or knee replacement

T2 - A cross-sectional survey study of Dutch and Norwegian patients

AU - van den Akker-Scheek, Inge

AU - Stevens, Martin

AU - De Vries, Astrid J

AU - Fenstad, Anne Marie

AU - Furnes, Ove Nord

AU - Østerås, Håvard

AU - Raap-van Sleuwen, Bregje E

AU - Saris, Katja

AU - Slager, Geranda E C

AU - Unsgaard-Tøndel, Monica

AU - Hals, Odd Magne

AU - Stensdotter, Ann-Katrin

N1 - Copyright: © 2026 van den Akker-Scheek et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2026/1/23

Y1 - 2026/1/23

N2 - Objective To gain insight into the attitude towards physical activity (PA) of Norwegian and Dutch patients after hip or knee replacement, possible differences in attitude between the countries and which factors explain a more positive or negative attitude. Methods A cross-sectional survey study investigating attitude toward PA 6–12 months after hip or knee replacement was conducted in Norway and the Netherlands. Patients received a questionnaire consisting of three parts: demography, received health service, and the survey about attitude toward PA consisting of 32 statements divided into four domains – quality of life, level of PA, function, and kinesiophobia. Attitude was scored on a 4-graded Likert scale. A high score indicated a positive attitude toward PA. Survey responses from the Norwegian and Dutch cohorts were compared using one-way ANOVA for group comparison. To identify factors explaining the outcome of the attitude survey, stepwise regressions were used. Results Data from 732 Norwegian patients and 575 Dutch patients was included in the analyses. Overall, the characteristics of the two cohorts were quite similar, although a significantly greater number in the Norwegian cohort had participated in “prehab”, while the participation in “rehab” was similar. In all four domains the attitude scores were generally high, indicating positive attitudes, with Norwegian patients scoring significantly higher. Higher participation in sports was the strongest explaining factor for a more positive attitude toward PA. Older age was the strongest independent variable explaining a less positive attitude towards PA. Conclusion Patients seem to have an overall positive attitude towards PA after hip or knee replacement. Norwegian patients had a more positive attitude compared to Dutch patients, which could be the result of more formalized and extensive education of the benefits of PA as part of the “prehab” in Norway.

AB - Objective To gain insight into the attitude towards physical activity (PA) of Norwegian and Dutch patients after hip or knee replacement, possible differences in attitude between the countries and which factors explain a more positive or negative attitude. Methods A cross-sectional survey study investigating attitude toward PA 6–12 months after hip or knee replacement was conducted in Norway and the Netherlands. Patients received a questionnaire consisting of three parts: demography, received health service, and the survey about attitude toward PA consisting of 32 statements divided into four domains – quality of life, level of PA, function, and kinesiophobia. Attitude was scored on a 4-graded Likert scale. A high score indicated a positive attitude toward PA. Survey responses from the Norwegian and Dutch cohorts were compared using one-way ANOVA for group comparison. To identify factors explaining the outcome of the attitude survey, stepwise regressions were used. Results Data from 732 Norwegian patients and 575 Dutch patients was included in the analyses. Overall, the characteristics of the two cohorts were quite similar, although a significantly greater number in the Norwegian cohort had participated in “prehab”, while the participation in “rehab” was similar. In all four domains the attitude scores were generally high, indicating positive attitudes, with Norwegian patients scoring significantly higher. Higher participation in sports was the strongest explaining factor for a more positive attitude toward PA. Older age was the strongest independent variable explaining a less positive attitude towards PA. Conclusion Patients seem to have an overall positive attitude towards PA after hip or knee replacement. Norwegian patients had a more positive attitude compared to Dutch patients, which could be the result of more formalized and extensive education of the benefits of PA as part of the “prehab” in Norway.

KW - Humans

KW - Norway

KW - Cross-Sectional Studies

KW - Arthroplasty, Replacement, Knee/psychology

KW - Netherlands

KW - Female

KW - Male

KW - Arthroplasty, Replacement, Hip/psychology

KW - Aged

KW - Middle Aged

KW - Surveys and Questionnaires

KW - Quality of Life

KW - Exercise

KW - Attitude to Health

KW - Motor Activity

KW - mensen

KW - noorwegen

KW - cross-sectionele studies

KW - artroplastiek, knievervanging/psychologie

KW - nederland

KW - vrouwelijk

KW - mannelijk

KW - artroplastiek, Heupvervanging/psychologie

KW - ouder

KW - middelbare leeftijd

KW - vragenlijsten en enquêtes

KW - kwaliteit van leven

KW - sporten

KW - houding ten opzichte van gezondheid

KW - motorische activiteit

U2 - 10.1371/journal.pone.0325746

DO - 10.1371/journal.pone.0325746

M3 - Article

C2 - 41575945

SN - 1932-6203

VL - 21

SP - 1

EP - 14

JO - PLOS ONE

JF - PLOS ONE

IS - 1 JANUARY

M1 - 0325746

ER -

Attitude toward physical activity after total hip or knee replacement: A cross-sectional survey study of Dutch and Norwegian patients

Samenvatting

Duurzame ontwikkelingsdoelstellingen van de VN

Keywords

Research Focus Areas Hanze University of Applied Sciences

Research Focus Areas Research Centre or Centre of Expertise

Publinova thema's

Toegang tot document

Andere bestanden en links

Vingerafdruk

Onderzoekersoutput

Attitudes towards physical activity after total knee or hip arthroplasty: an exploratory cross-sectional study of physical therapists in Germany, Norway, and the Netherlands

Effectiveness of rehabilitation for working-age patients after a total hip arthroplasty: a comparison of usual care in the Netherlands versus Germany

Effectiveness of a home-based rehabilitation program after total hip arthroplasty driven by a tablet app and remote coaching: nonrandomized controlled trial combining a single-arm intervention cohort with historical controls

Citeer dit