Long-term hyperglycaemia induces qualitative and quantitative changes in rat ultrasonic vocalizations.

Knee arthroplasty (KA) is a crucial procedure for treating severe knee diseases. By replacing the damaged joint with an artificial prosthesis, KA effectively restores joint function, relieves pain, corrects the lower limb mechanical axis, and improves patients’ quality of life. Although KA replaces the diseased joint and enhances joint function, postoperative functional exercise remains an indispensable and critical component. Effective rehabilitation exercise is a key factor in reducing postoperative complications, promoting joint reconstruction, and improving patients’ motor function and activities of daily living. However, studies indicate that adherence to rehabilitation exercise among KA patients is relatively low, at only approximately 60%, with full adherence reported in merely 10% to 20% of cases. Poor adherence can easily lead to joint stiffness, reduced muscle mass, and an increased risk of deep vein thrombosis, severely affecting patient prognosis and recovery, consequently prolonging the treatment cycle and increasing the financial burden on families. Therefore, it is of significant clinical value to conduct an in-depth exploration of the factors influencing rehabilitation exercise adherence in patients following KA. Health beliefs are defined as an individual’s subjective cognition and attitudes toward their health status, disease severity, treatment efficacy, and the perceived benefits of and barriers to adopting health-related behaviors. Health beliefs can influence adherence to healthy behaviors among various patient groups. For instance, research by LA S et al. indicated that the health belief model can affect self-identity, thereby enhancing adherence to iron supplementation among high school girls. Studies by M G et al. suggested that the health belief model may aid in developing interventions for behavior change in phosphate control. However, empirical research on the role of health beliefs in influencing adherence to rehabilitation exercise among patients after KA surgery remains scarce, and no studies have explored the role of exercise psychological needs satisfaction within this context. Psychological needs satisfaction refers to the extent to which an individual’s basic needs for autonomy, competence, and relatedness are fulfilled. In the context of exercise, this is termed exercise psychological needs satisfaction. Health beliefs serve as a critical antecedent to the fulfillment of these needs. First, positive health beliefs encourage patients to autonomously engage in rehabilitation exercise. By reframing rehabilitation as a challenge rather than a burden, patients are more likely to internalize the value of the activity, thereby facilitating satisfaction of their need for autonomy. Second, satisfaction of the need for competence is progressively enhanced as patients gain an understanding of rehabilitation principles and witness tangible improvements in their joint function, daily activities, and quality of life. Third, the formation of health beliefs often depends on education and guidance from healthcare providers. When medical staff not only convey relevant information but also offer emotional support and encouragement, patients feel genuinely cared for and understood, which directly addresses the need for relatedness. Furthermore, rehabilitation exercise following KA is a prolonged process, and adherence driven solely by health beliefs may be insufficient to sustain long-term engagement. When the basic psychological needs for autonomy, competence, and relatedness are adequately met, rehabilitation exercise can be transformed into a persistently internally motivated behavior. Therefore, this study hypothesized that exercise psychological needs satisfaction may serve as a mediating variable in the relationship between health beliefs and rehabilitation exercise adherence. This study aimed to investigate the psychological mechanism through which health beliefs influence rehabilitation exercise adherence, specifically focusing on the mediating role of exercise psychological needs satisfaction, thereby providing empirical evidence to enhance exercise adherence and improve the quality of life of patients following KA surgery.