The influence of sociodemographic and health factors on adherence to home-based rehabilitation after fast-track total knee arthroplasty: secondary analysis of a randomized controlled trial
Creators: name: Nuevo, Montse
name: Modrego, Adriana
name: Rodríguez-Rodríguez, Daniel
name: Jauregui, Ricardo
name: Fabrellas, Núria
name: Zabalegui, Adelaida
name: Prat-Fabregat, Salvi
Publisher: name: Taylor & Francis
Year: 2025
Subjects: subject: Medicine
subject: Sociology
subject: FOS: Sociology
subject: Science Policy
subject: Mental Health

description: Adherence to home rehabilitation following total knee arthroplasty (TKA) is essential to reach optimal functional outcomes, especially in fast-track procedures. The aim of this study is to identify which sociodemographic and health factors significantly affect adherence in this context. This is a secondary analysis of a randomized controlled trial with 52 patients. Adherence was measured as the percentage of completed exercises. Two statistical analyses were performed, one on the entire population and another on the telerehabilitation group only, to study which factors significantly affects adherence. The analysis included the 42 patients with adherence data (23 TRH, 19 control). In Analysis I (<i>n</i> = 42), six variables were statistically significant: history of depression (<i>p</i> = 0.00026), educational level (<i>p</i> = 0.00151), social support (<i>p</i> = 0.00157), treatment group (<i>p</i> = 0.0081), history of diabetes (<i>p</i> = 0.01153), and ASA score (<i>p</i> = 0.02752). In Analysis II (TRH, <i>n</i> = 23), three variables were significant: history of depression (<i>p</i> = 0.003), educational level (<i>p</i> = 0.006), and history of hypertension (<i>p</i> = 0.047). There are sociodemographic and health factors affecting adherence to home rehabilitation post-TKA. Depression stands out as a negative factor, while high educational level and social support improve adherence. Telerehabilitation has positive effects and reduces the influence of social and economic factors. Physiotherapists should take into account demographic factors such as depression, educational level and social support when designing more personalized and effective interventions.Patients with a history of depression may benefit from the development and implementation of specific emotional or motivational support strategies, as well as additional psychological support.Tailored educational interventions based on patients’ educational levels should be enhanced to ensure a thorough understanding of the benefits of exercise and the proper integration of exercise into their daily routine.Telerehabilitation has proven effective in improving adherence to home physiotherapy.Promoting social support and encouraging the active involvement of family members, caregivers and/or friends in the rehabilitation process can significantly improve patient adherence to their exercise program. Physiotherapists should take into account demographic factors such as depression, educational level and social support when designing more personalized and effective interventions. Patients with a history of depression may benefit from the development and implementation of specific emotional or motivational support strategies, as well as additional psychological support. Tailored educational interventions based on patients’ educational levels should be enhanced to ensure a thorough understanding of the benefits of exercise and the proper integration of exercise into their daily routine. Telerehabilitation has proven effective in improving adherence to home physiotherapy. Promoting social support and encouraging the active involvement of family members, caregivers and/or friends in the rehabilitation process can significantly improve patient adherence to their exercise program.