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

Johanne  Nordlund-Bjørnset; Gesine  Seeber; Håvard Østerås; Monica Unsgaard-Tøndel; Odd Magne Hals; Ann-Katrin Stensdotter; Geranda Slager; Inge van den Akker-Scheek; Martin stevens

doi:10.1080/21679169.2026.2659757

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

Johanne Nordlund-Bjørnset (First author)
, Gesine Seeber
, Håvard Østerås
, Monica Unsgaard-Tøndel
, Odd Magne Hals
, Ann-Katrin Stensdotter
, Geranda Slager
, Inge van den Akker-Scheek
, Martin stevens

University of Groningen, University Medical Center Groningen, Department of Orthopaedics
School of Medicine and Health Sciences, Division of Orthopaedics at Campus Pius-Hospital, Carl von Ossietzky Universität Oldenburg, Oldenburg,
Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway;

Onderzoeksoutput: Article › Academic › peer review

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Attitudes ten aanzien van fysieke activiteit na totale knie- of heupartroplastiek: een exploratieve cross-sectionele studie onder fysiotherapeuten in Duitsland, Noorwegen en Nederland

Achtergrond: Totale knie- en heupartroplastiek (TKA/THA) blijven standaardbehandelingen voor eindstadium artrose. Fysieke activiteit (PA) is van cruciaal belang voor optimale functionele uitkomsten tijdens en na de revalidatie. Het doel was om de attitudes en werkwijzen van fysiotherapeuten (PT’s) met betrekking tot PA bij TKA/THA-patiënten in Duitsland, Noorwegen en Nederland te beoordelen, en te onderzoeken hoe achtergrondfactoren, waaronder opleiding en nationale zorgsystemen, de werkwijzen en aanbevelingen beïnvloeden.

Methoden: Er werd een cross-sectionele enquête afgenomen onder fysiotherapeuten in Duitsland (n = 113), Noorwegen (n = 83) en Nederland (n = 156). Achtergrondkenmerken en antwoorden werden geanalyseerd met behulp van beschrijvende statistiek en chi-kwadraattoetsen.

Resultaten: Fysiotherapeuten uit alle drie de landen toonden positieve attitudes ten opzichte van PA na TKA/THA, met opvallende variaties in benadering. Noorse fysiotherapeuten, met het hoogste opleidingsniveau, legden de nadruk op de intensiteit van PA en spierversterking. Nederlandse fysiotherapeuten rapporteerden de hoogste beschikbaarheid van PA-programma’s binnen hun praktijken. Duitse fysiotherapeuten waren minder bekend met de richtlijnen van de World Health Organization, maar gaven wel gepersonaliseerd advies.

Conclusie: De attitudes van fysiotherapeuten waren positief, maar varieerden, mogelijk als gevolg van verschillen in opleiding en nationale zorgstructuur. De bevindingen onderstrepen de noodzaak van op maat gemaakte scholing en internationale kennisuitwisseling ter ondersteuning van een effectieve integratie van PA in de revalidatie na TKA/THA.

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
Originele taal-2	English
Pagina's (van-tot)	1-10
Aantal pagina's	10
Tijdschrift	European Journal of Physiotherapy
DOI's	https://doi.org/10.1080/21679169.2026.2659757
Status	E-pub ahead of print - 16 apr. 2026

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SDG 03 – Goede gezondheid en welzijn

Keywords

fysiotherapie
gezondheid
heup
knie
lichamelijke fitheid
oefening
prothese

Research Focus Areas Hanze University of Applied Sciences

Healthy Ageing

Research Focus Areas Research Centre or Centre of Expertise

Kwetsbaarheid en passende zorg
Gezonde leefstijl en leefomgeving

Publinova thema's

Gezondheid
Recreatie, Beweging & Sport

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10.1080/21679169.2026.2659757Licentie: CC BY

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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 patiëntenvan 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., 23 jan. 2026, In: PLOS ONE. 21, 1 JANUARY, blz. 1-14 14 blz., 0325746.
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Open Access
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).
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Open Access
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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.
Onderzoeksoutput: Article › Academic › peer review

Open Access

Citeer dit

Nordlund-Bjørnset, J., Seeber, G., Østerås, H., Unsgaard-Tøndel, M., Magne Hals, O., Stensdotter, A.-K., Slager, G., van den Akker-Scheek, I., & stevens, M. (2026). Attitudes towards physical activity after total knee or hip arthroplasty: an exploratory cross-sectional study of physical therapists in Germany, Norway, and the Netherlands. European Journal of Physiotherapy, 1-10. Online publicatie vooraf. https://doi.org/10.1080/21679169.2026.2659757

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abstract = "Background: Total knee and hip arthroplasty (TKA/THA) remain standard treatments for end-stage osteoarthritis. Physical activity (PA) is critical for optimal functional outcomes during and after rehabilitation. Objective was to assess attitudes and practices of physical therapists (PTs) regarding PA in TKA/THA patients across Germany, Norway, and the Netherlands, and explore how background factors, including education and national healthcare settings, influence practices and recommendations. Methods: A cross-sectional survey was administered to PTs in Germany (n = 113), Norway (n = 83), and the Netherlands (n = 156). Background characteristics and responses were analysed using descriptive and chi-square statistics. Results: PTs from all three countries showed positive attitudes towards PA post-TKA/THA, with notable variations in approach. Norwegian PTs, the highest-educated, emphasised PA intensity and muscle strengthening. Dutch PTs reported the highest availability of PA program services in their clinics. German PTs were less familiar with WHO guidelines but provided personalised advice. Conclusion: PTs{\textquoteright} attitudes were positive but varied, possibly due to differences in education and national healthcare structure. Findings highlight the need for tailored education and cross-national knowledge-sharing to support effective PA integration into TKA/THA rehabilitation.",

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Nordlund-Bjørnset, J, Seeber, G, Østerås, H, Unsgaard-Tøndel, M, Magne Hals, O, Stensdotter, A-K, Slager, G, van den Akker-Scheek, I & stevens, M 2026, 'Attitudes towards physical activity after total knee or hip arthroplasty: an exploratory cross-sectional study of physical therapists in Germany, Norway, and the Netherlands', European Journal of Physiotherapy, blz. 1-10. https://doi.org/10.1080/21679169.2026.2659757

Attitudes towards physical activity after total knee or hip arthroplasty: an exploratory cross-sectional study of physical therapists in Germany, Norway, and the Netherlands. / Nordlund-Bjørnset, Johanne (First author); Seeber, Gesine ; Østerås, Håvard et al.
In: European Journal of Physiotherapy, 16.04.2026, blz. 1-10.

Onderzoeksoutput: Article › Academic › peer review

TY - JOUR

T1 - Attitudes towards physical activity after total knee or hip arthroplasty

T2 - an exploratory cross-sectional study of physical therapists in Germany, Norway, and the Netherlands

AU - Nordlund-Bjørnset, Johanne

AU - Seeber, Gesine

AU - Østerås, Håvard

AU - Unsgaard-Tøndel, Monica

AU - Magne Hals, Odd

AU - Stensdotter, Ann-Katrin

AU - Slager, Geranda

AU - van den Akker-Scheek, Inge

AU - stevens, Martin

PY - 2026/4/16

Y1 - 2026/4/16

N2 - Background: Total knee and hip arthroplasty (TKA/THA) remain standard treatments for end-stage osteoarthritis. Physical activity (PA) is critical for optimal functional outcomes during and after rehabilitation. Objective was to assess attitudes and practices of physical therapists (PTs) regarding PA in TKA/THA patients across Germany, Norway, and the Netherlands, and explore how background factors, including education and national healthcare settings, influence practices and recommendations. Methods: A cross-sectional survey was administered to PTs in Germany (n = 113), Norway (n = 83), and the Netherlands (n = 156). Background characteristics and responses were analysed using descriptive and chi-square statistics. Results: PTs from all three countries showed positive attitudes towards PA post-TKA/THA, with notable variations in approach. Norwegian PTs, the highest-educated, emphasised PA intensity and muscle strengthening. Dutch PTs reported the highest availability of PA program services in their clinics. German PTs were less familiar with WHO guidelines but provided personalised advice. Conclusion: PTs’ attitudes were positive but varied, possibly due to differences in education and national healthcare structure. Findings highlight the need for tailored education and cross-national knowledge-sharing to support effective PA integration into TKA/THA rehabilitation.

AB - Background: Total knee and hip arthroplasty (TKA/THA) remain standard treatments for end-stage osteoarthritis. Physical activity (PA) is critical for optimal functional outcomes during and after rehabilitation. Objective was to assess attitudes and practices of physical therapists (PTs) regarding PA in TKA/THA patients across Germany, Norway, and the Netherlands, and explore how background factors, including education and national healthcare settings, influence practices and recommendations. Methods: A cross-sectional survey was administered to PTs in Germany (n = 113), Norway (n = 83), and the Netherlands (n = 156). Background characteristics and responses were analysed using descriptive and chi-square statistics. Results: PTs from all three countries showed positive attitudes towards PA post-TKA/THA, with notable variations in approach. Norwegian PTs, the highest-educated, emphasised PA intensity and muscle strengthening. Dutch PTs reported the highest availability of PA program services in their clinics. German PTs were less familiar with WHO guidelines but provided personalised advice. Conclusion: PTs’ attitudes were positive but varied, possibly due to differences in education and national healthcare structure. Findings highlight the need for tailored education and cross-national knowledge-sharing to support effective PA integration into TKA/THA rehabilitation.

KW - exercise

KW - fitness

KW - health

KW - hip

KW - knee

KW - physiotherapy

KW - prosthesis

KW - fysiotherapie

KW - gezondheid

KW - heup

KW - knie

KW - lichamelijke fitheid

KW - oefening

KW - prothese

U2 - 10.1080/21679169.2026.2659757

DO - 10.1080/21679169.2026.2659757

M3 - Article

SN - 2167-9169

SP - 1

EP - 10

JO - European Journal of Physiotherapy

JF - European Journal of Physiotherapy

ER -

Nordlund-Bjørnset J, Seeber G, Østerås H, Unsgaard-Tøndel M, Magne Hals O, Stensdotter AK et al. Attitudes towards physical activity after total knee or hip arthroplasty: an exploratory cross-sectional study of physical therapists in Germany, Norway, and the Netherlands. European Journal of Physiotherapy. 2026 apr. 16;1-10. Epub 2026 apr. 16. doi: 10.1080/21679169.2026.2659757

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

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

Vingerafdruk

Onderzoekersoutput

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

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