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

Abstract

Background Considerable attention has been paid to the role of kinesiophobia with respect to knee prosthesis but it has not yet been studied as a prognostic factor of short-term functional performance following total hip replacement. The main purpose of the present study is to examine the possible predictors of early functional performance of patients undergoing total primary hip arthroplasty, including demographics as age, sex and body mass index, preoperative functional ability, type of anaesthesia, level of haemoglobin, pain and level of kinesiophobia before surgery. Secondly, we want to describe the main characteristics of the population with the highest levels of kinesiophobia. Methods A prospective, prognostic cohort study was carried out. Patients undergoing primary hip replacement were recruited consecutively. The main outcome is the early functional performance achieved by patients after surgery and measured using the Iowa Level of Assistance (ILOA) scale on the fifth postoperative day. Preoperative kinesiophobia was measured by the Tampa Scale and the preoperative functional ability by the Western Ontario and McMaster Osteoarthritis Index (WOMAC). The multivariate analysis was performed by the General Linear Model. The analysis of the population with high levels of kinesiophobia was conducted by identifying a cut-off of 40 compared to the Tampa Scale. Results Statistical analysis was performed on 269 patients. The average ILOA score recorded was 19.5 (DS 8.3). The levels of kinesiophobia, showed an average score of 35.1 (7.8) and it was not associated with early functional performance. The independent predictive factors include age, sex and body mass index. Kinesiophobia high levels were recorded in 30% of the population and this population had a higher level of pre-operative WOMAC score. Conclusions Early functional performance after hip replacement surgery was not correlated with the level of kinesiophobia. Three significant factors that describe a population most at risk of not achieving optimal functional performance are increased age, being female and increase in body mass index. In the preoperative phase, high levels of kinesiophobia were associated with more impaired preoperative functional ability. Trial registration Current Controlled Trials NCT02786121, May 2016. Retrospectively registered.

Kinesiophobia Post Total Hip Arthroplasty: A Retrospective Study

“…However, the prevalence of kinesophobia were similar across the socio-demographic characteristics of the patients and that includes age, gender, level of education, BMI level, and occupation. These reports are not consistent with the study of Morri et al [12], based on their accounts, age, sex, and BMI were the significant factors associated with kinesophobia. Similarly, Manali et al [11] accounted that age was observed to have a positive correlation with TSK score which coincided with the study done in Italy but differed from our study.…”

“…Their findings showed that there was a strong positive correlation between pain and the TSK score. However, in a study by Morri et al [12], they documented that there was no significant correlation between numerical rating scale score and kinesiophobia score postoperatively which were not in accordance with our report.…”

“…Their study involved 52 subjects aged range from 18 to 75 years old. Based on their accounts, 69.2% of the patients had a low level of kinesiophobia which corroborates the study done in Italy [12].…”

“…Moreover, the findings of this study will contribute to the current evidence that demonstrates kinesiophobia, along with other psychological factors, can prolong or hinder functional improvement in patients who have undergone hip surgery [2,10,12]. In this study, the mean score of NAS was 5.45 (SD 2.79) with a positive highly statistically significant correlation with TSK score (r=460; p<0.001) which generally indicates that the increase in the score of TSK will also increase NAS score.…”

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

“…The influence of sociodemographic factors on the occurrence of kinesiophobia was also noted by Morri et al As in the authors' own research, female sex may affect a higher level of perioperative anxiety. The researchers also included age and body weight as unfavorable factors influencing kinesiophobia [19].…”