Ways of understanding the regulation of physical activity among persons with knee osteoarthritis in digital rehabilitation: a phenomenographic study.

OBJECTIVES: To explore how patients in digital rehabilitation for knee osteoarthritis understand the regulation of physical activity. DESIGN: A qualitative, exploratory study with a phenomenographic approach. SETTING: A digital rehabilitation programme for knee osteoarthritis in Sweden. PARTICIPANTS: 20 adults with knee osteoarthritis were recruited using purposive sampling to maximise variation in sex, pain intensity, body mass index and fear avoidance. RESULTS: Five qualitatively different ways of understanding the regulation of physical activity were identified, represented by: avoidance of physical activity, need for expert guidance, navigating symptoms and daily activity, adaptation to remain active and development through physical activity. The descriptive categories were related through shared dimensions concerning perceptions of physical activity, interpretation of pain, purpose of regulation and perception of the body. The categories differed in aspects considered important when regulating physical activity and in the range of actions perceived as possible. CONCLUSIONS: Different ways of understanding the regulation of physical activity shape the range of possible actions among patients in digital rehabilitation for knee osteoarthritis. Some ways of understanding appear to constrain regulatory options, whereas others support a wider range of strategies to remain physically active. These findings contribute to the understanding of why similar health information and recommendations may be interpreted differently and could lead to varying approaches to physical activity. TRIAL REGISTRATION NUMBER: https://doi.org/10.17605/OSF.IO/N3UBQ.