Predictors of rehabilitation intention and behavior following anterior cruciate ligament surgery: an application of the Theory of Planned Behavior

Abstract

This study was guided by the Theory of Planned Behavior (TPB) to assess the predictors of rehabilitation intention and adherence following anterior cruciate ligament (ACL) reconstructive surgery in athletes. Participants (n=87; mean age=28.95 ±7.7 years) volunteered to participate following their first post-surgery physiotherapy session and completed the baseline measures of intention, attitudes, subjective norm, perceived behavioral control, self-efficacy,participation level, sport and age. At follow-up, 48 participants returned completed rehabilitation diaries detailing adherence behavior every 2 weeks during an 8-week period. Results indicatedthat there was no significant difference in rehabilitation behavior at weeks 2, 4, 6 or 8. A multivariate analysis of covariance indicated that sport type, sport level, intention and intention2 significantly predicted rehabilitation behavior, although the strength of relationship varied across the weeks. Self-efficacy was a significant predictor of intention. These findings suggest that adherence behavior is predicted by sport type, participation level and curvilinearly by intention to adhere. Intention to adhere can be positively associated with enhanced self-efficacy. The study has highlighted issues that practitioners should be aware of when encouraging rehabilitation adherence. However, the TPB provided a poor fit for understanding adherence behavior in this setting.