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

Association of high kinesiophobia and pain catastrophizing with quality of life in severe hip osteoarthritis: a cross-sectional study

BACKGROUND

While fear of movement is an important predictor of pain and disability in osteoarthritis (OA), its impact on patients with hip OA remains uncertain. This study aimed to determine whether fear of movement, evaluated by the Tampa Scale for Kinesiophobia (TSK)-11, and pain catastrophizing, evaluated by the Pain Catastrophizing Scale (PCS), were associated with quality of life (QOL) in patients with hip OA.

METHODS

This cross-sectional study was conducted between November 2017 and December 2018. Ninety-one consecutively enrolled patients with severe hip OA were scheduled for primary unilateral total hip arthroplasty. The EuroQOL-5 Dimensions questionnaire was used to measure general QOL. The Japanese Orthopedic Association Hip Disease Evaluation Questionnaire was used to assess disease-specific QOL. The covariates included age, sex, body mass index (BMI), pain intensity, high pain catastrophizing (PCS ≥ 30), and high kinesiophobia (TSK-11 ≥ 25). Variables were subjected to multivariate analysis using each QOL scale.

RESULTS

In multiple regression analysis, pain intensity, high pain catastrophizing, and BMI were independently correlated with the disease-specific QOL scale. High pain catastrophizing, pain intensity, and high kinesiophobia were independently correlated with the general QOL scale.

CONCLUSIONS

High pain catastrophizing (PCS ≥ 30) was independently associated with disease and general QOL scales. High kinesiophobia (TSK-11 ≥ 25) was independently associated with the general QOL scale in preoperative patients with severe hip OA.

Are contextual factors associated with activities and participation after total hip arthroplasty? A systematic review

OBJECTIVES

After total hip arthroplasty (THA), over 30% of individuals report activity limitations and participation restrictions. This systematic review aimed to determine the association between contextual factors and outcomes in the activity and participation domain after THA for hip osteoarthritis (OA).

METHODS

This systematic review was developed according to the PRISMA guidelines for systematic reviews. PubMed, Web of Science, Embase and Scopus were searched until August 2022. Risk of bias was assessed with the Quality in Prognosis Studies tool (QUIPS).

RESULTS

Twenty-nine articles were included. Eighteen had a high risk of bias, 3 had a low risk of bias, and 8 had a moderate risk of bias. Anxiety was only investigated in studies with high risk of bias but showed a consistent negative association with activities and participation after THA across multiple studies. Evidence was inconsistent regarding the associations between depression, trait anxiety, sense of coherence, big 5 personality traits, educational level, marital status, employment status, job position, expectations and social support, and the activity and participation domain. Optimism, general self-efficacy, cognitive appraisal processes, illness perception, ethnicity, and positive life events were associated with activities and participation but were only investigated in 1 study. No associations were identified across multiple studies for living or smoking status. Control beliefs, kinesiophobia, race, discharge location, level of poverty in neighbourhood, negative life events and occupational factors, were not associated with the activity and participation domain but were only investigated in 1 study.

CONCLUSION

Methodological quality of the included studies was low. Anxiety was the only factor consistently associated with worse outcomes in the activity and participation domain after THA but was only investigated in studies with high risk of bias. Further research is needed to confirm relationships between other contextual factors and activities and participation after THA.

REGISTRATION

PROSPERO CRD42020199070.

Overcoming fear of movement resulting from knee replacement; strategies used by patients: An interview study

BACKGROUND AND AIMS

Fear of movement is among the main concerns of patients following knee replacement surgery and a determining factor in the success of surgery. The strategies adopted by patients to overcome this fear have not yet been identified, but once pin pointed, these strategies can be strengthened and modified through intervention. The aim of the present study was to explore the personal strategies adopted by patients following knee replacement to overcome fear of movement.

MATERIALS AND METHODS

Interviews were conducted with 15 patients who had undergone knee replacement, selected by purposive sampling. Data were collected through in-depth semi-structured interviews and analyzed using inductive content analysis.

RESULTS

The patients' strategies as depicted in their narratives were classified into three categories: 1) Movement based on awareness; 2) Movement based on support; and 3) Movement based on hope. These three categories are described in eight subcategories and show what strategies the patients used to overcome their fear of movement.

CONCLUSION

These findings can help to increase awareness about strategies to overcome fear of movement in patients following knee replacement and to develop and support tailored treatment strategies with the aim of reducing such fear of movement and increasing physical activity among the patients.

Kinesiophobia Post Total Hip Arthroplasty: A Retrospective Study

Introduction

One of the major psychological factors that can affect the outcome of hip arthroplasty is postoperative kinesiophobia, which is defined as a fear of movement. The effect of kinesiophobia and excruciating pain has not been widely explored in hip arthroplasty literature especially in Saudi Arabia.

Aim

This study aimed to investigate kinesiophobia and pain catastrophizing after total hip arthroplasty (THA) in King Fahad Hospital, Hofuf, Saudi Arabia.

Materials and methods

This is a retrospective cross-sectional study conducted at King Fahad Hospital, Hofuf, Saudi Arabia. Using a validated self-administered questionnaire, participants were questioned telephonically. Questionnaires included basic demographic characteristics, Tampa Scale of Kinesiophobia (TSK), and Numerical Analogue Scale (NAS). Data were tabulated in MS Excel and all statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY).

Results

Seventy-four patients were recruited (60.8% females vs 39.2% males). The TSK mean score was 40.7 (SD 8.88) while the mean NAS score was 5.45 (SD 2.79). The prevalence of kinesiophobia was 62.2%. The statistical test revealed that there was a statistically significant positive correlation between TSK score and NAS score (r=460; p<0.001). Furthermore, kinesiophobia was widely prevalent among patients who had avascular necrosis (p<0.001) and among those who underwent physiotherapy (p=0.044).

Conclusion

There was a high prevalence of kinesiophobia among patients who underwent THA. Pain intensity directly correlated with the presence of kinesophobia.

Influence of Frailty Syndrome on Kinesiophobia According to the Gender of Patients after Coronary Artery Bypass Surgery

(1) Background: Kinesiophobia is associated with fear of movement, general fitness exercises, and physical or mental discomfort. In patients with frailty syndrome, in addition to coexisting conditions, the postoperative recovery period may be longer than in patients without frailty; (2) Methods: The study included 108 people over 60 years of age, qualified for CABG (coronary artery bypass grafting). The Tilburg Frailty Index was used to assess frailty syndrome and the kinesiophobia scale was to assess fear of physical activity; (3) Results: Frailty syndrome was diagnosed among 19.44% of respondents. The social components of frailty were more intense in the group of women p = 0.009. The mean results for the biological and psychological domain on the scale of kinesiophobia were 1.94 and 1.6. The level of kinesiophobia was higher among women than among men taking into account the psychological domain (p = 0.006) and the subdomains: motor skills self-assessment (p = 0.042) and body care (p = 0.011); (4) Conclusions: Frailty syndrome does not affect kinesiophobia among patients after CABG. The level of kinesiophobia was higher among women than among men, taking into account the psychological domain. The greater the energy resources, the lower the level of frailty and its physical components in the group of women.