Aim Based on Cognitive Dissonance Theory and the Lewin’s Change Model, this longitudinal study examines the developmental trajectory of exercise phobia in patients following total knee arthroplasty, aiming to provide evidence-based support for formulating rehabilitation strategies tailored to different stages. Method To use purposive sampling, from December 2024 to June 2025, eight patients who underwent total knee arthroplasty at a Grade III Class A hospital in Zhejiang Province were selected as research subjects. To track the trajectory of kinesiophobia symptoms within 3 months post-surgery and complete data analysis with thematic analysis, we conducted a thematic analysis. Results The trajectory of kinesiophobia in patients following total knee arthroplasty primarily manifests in two key aspects: cognitive assessment dysfunction (self-objectification and health literacy bias) and impaired behavioral control (pain central sensitization and rehabilitation motivation disorder). Conclusion Following total knee arthroplasty, patients undergo a dynamic progression of kinesiophobia, characterized by a shift from cognitive appraisal imbalance to behavioral control impairment, driven by the persistent conflict between rehabilitation needs and fear-based cognition. To optimize postoperative quality of life, healthcare professionals should implement targeted interventions tailored to the phased characteristics of kinesiophobia.
Ren et al. (Wed,) studied this question.