Does kinesiophobia affect the early functional outcomes following total knee arthroplasty?

Abstract

The purpose of this study was to investigate the effects of kinesiophobia on early functional outcomes in patients following total knee arthroplasty (TKA) and how kinesiophobia is related to functional outcomes and pain. The Tampa Scale for Kinesiophobia (TSK), 2-minute walk test (2-MWT), and the timed up and go test (TUG) were used to assess 46 TKA patients on discharge day. The pain levels and active knee flexion range of motion (ROM) were recorded. Patients were divided into two groups as high kinesiophobia (Group I, n = 22) and low kinesiophobia (Group II, n = 24) based on the TSK levels. The TUG results were similar between groups (p = 0.826). 2-MWT results (p < 0.001), pain levels (p = 0.003), and knee flexion ROM (p = 0.025) scores were better in Group II when compared to Group I. The TSK scores were significantly correlated with 2-MWT results (r = -0.40; p = 0.003), pain levels (r = 0.80; p < 0.001), and knee flexion ROM (r = -0.47; p = 0.001). The regression analysis revealed that 41% of 2-MWT score, 47% of knee flexion ROM, and 60% of pain level changes could be explained by kinesiophobia level. The results suggest that early outcomes following TKA were affected by the pain-related fear of movement. The clinicians need to consider the interrelationships between fear of movement and functional outcomes when designing, implementing, and monitoring daily therapeutic exercise programs.

High Levels of Kinesiophobia at Discharge from the Hospital May Negatively Affect the Short-Term Functional Outcome of Patients Who Have Undergone Knee Replacement Surgery

“…Findings of this study add body to the current evidence that demonstrates that kinesiophobia, among other psychological factors, can delay or hinder functional recovery in patients who have undergone orthopedic surgery [6,8,9]. Especially since 60% of the increase in pain score could be related to the presence of kinesiophobia [21].…”

“…Kinesiophobia or fear of movement (FOM) is a well-known psychological factor that can influence patient outcome and recovery after trauma or surgery at the knee [6][7][8]. Patients with FOM are more likely to be physically inactive and depressed [9].…”

“…Female sex, lower levels of education, negative coping styles, and older age were all associated with the development of postoperative kinesiophobia [20]. For instance, kinesiophobia has already been associated with a reduced knee flexion range of motion among knee replacement patients [8,14]. Previous research has also highlighted that 60% of the increase in pain score could be related to the presence of kinesiophobia [21,22].…”

Predictors of Fear of Movement in Patients With Rheumatoid Arthritis

“…The present result of lower extremity pain and avoidance of physical activity in patients with RA can be explained by the fear avoidance. According to this model fear may lead to the avoidance of functional behaviors such as walking which results in disability (25,26).…”

Is kinesiophobia a predictor of early functional performance after total hip replacement? A prospective prognostic cohort study

“…Kinesiophobia is defined as the fear and refusal of movement [ 17 ], based on the fear-avoidance model introduced by Vlaeyen et al [ 18 ]. In patients undergoing knee replacement, authors showed a negative correlation between high levels of kinesiophobia and reduced knee flexion [ 19 , 20 ], ambulatory performance [ 21 , 22 ], pain [ 20 , 22 ] and length of hospital stay [ 23 ]. In literature, Kinesiophobia was measured using the Tampa Scale and patients with high levels of Kinesiophobia were identified for scores greater than 40 [ 21 ].…”