Abstract
Background
Kinesiophobia is simply defined as a fear of movement and physical activity. It can be seen in patients as a result of any injury, which results in pain or a fear of injury recurrence. It leads to decreased motion and disuse that may result in a chronic pain syndrome and decreased physical function. High levels of fear-avoidance have been found in subjects with total knee arthroplasty (TKA) and knee injuries, which predisposes them to the development of chronic pain conditions and seriously affect functional outcomes and their return to previous activity levels. However, the relationship between pain, kinesiophobia and performance-based outcomes in assessment of patients with TKA is unclear.
Purpose
The aim of our study was to investigate relationship between pain, kinesiophobia and performance-based tests in assessment of patients with TKA.
Methods
Twenty-eight patients (10 males, 18 females) were included in the study with mean age 63.6±9.8 years. Patients performed 2 performance tests (Timed “Up & Go” Test (TUG), 10 Meter Walk Test (10-MWT)) and one self-report measurement (TAMPA Scale) which measure the kinesiophobia were preferred to assess patients. Also the activity pain level was evaluated by The Numeric Pain Rating Scale (NPRS). Patients were evaluated preoperatively and at discharge.
Results
While there was a moderate significant correlation in preoperatively between activity NPRS and 10-MWT score (r=0.432, p=0.022), there was no correlation between activity NPRS and TUG (p>0.05). Also there were no correlations between TAMPA scale and 2 performance-based tests in preoperatively (p>0.05). There were high significant correlations between TAMPA scale and 2 performance-based tests (TUG, 10-MWT) in the evaluation of patients with TKA (respectively; r=0.899, p<0.001; r=0.608, p=0.001). However, there were no correlations between activity NPRS and 2 performance-based tests in postoperatively in patients with TKA.
Conclusion
While there were high significant correlations between TAMPA scale and 2 performance-based tests, there were no correlations between activity NPRS and 2 performance-based tests in postoperatively in patients with TKA. The functional level at early stage after TKA may be more related with the kinesiophobia level than the activity pain level. Given these results suggest that the rehabilitation after TKA focused on reducing kinesiophobia level could be important to enhance the potential benefits of the patients' functional outcomes at early stage after TKA.
