{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T22:33:32Z","timestamp":1788906812689,"version":"build-2803163510"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010790","name":"Erasmus+","doi-asserted-by":"publisher","award":["613008-EPP-1-2019-IT-SPO-SCP"],"award-info":[{"award-number":["613008-EPP-1-2019-IT-SPO-SCP"]}],"id":[{"id":"10.13039\/501100010790","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey study investigating attitude toward PA 6\u201312 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 \u2013 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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 \u201cprehab\u201d, while the participation in \u201crehab\u201d 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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 \u201cprehab\u201d in Norway.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0325746","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T18:23:05Z","timestamp":1769192585000},"page":"e0325746","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Attitude toward physical activity after total hip or knee replacement: A cross-sectional survey study of Dutch and Norwegian patients"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1614-8419","authenticated-orcid":true,"given":"Inge","family":"van den Akker-Scheek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid J.","family":"De Vries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marie","family":"Fenstad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ove Nord","family":"Furnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5vard","family":"\u00d8ster\u00e5s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bregje E.","family":"Raap \u2013 van Sleuwen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5661-3197","authenticated-orcid":true,"given":"Katja","family":"Saris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geranda E.C.","family":"Slager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Unsgaard-T\u00f8ndel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odd Magne","family":"Hals","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Katrin","family":"Stensdotter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"issue":"6","key":"pone.0325746.ref001","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1001\/jama.2020.22171","article-title":"Diagnosis and treatment of hip and knee osteoarthritis: a review","volume":"325","author":"JN Katz","year":"2021","journal-title":"JAMA"},{"issue":"2","key":"pone.0325746.ref002","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.mcna.2019.10.007","article-title":"Osteoarthritis: pathology, diagnosis, and treatment options","volume":"104","author":"B Abramoff","year":"2020","journal-title":"Med Clin North Am"},{"key":"pone.0325746.ref003","unstructured":"OECD. 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