Preoperative Video-Based Education in Total Hip Arthroplasty

The Effect of Preoperative Video-Based Education on Fear of Mobilization in Patients Undergoing Total Hip Arthroplasty: A Randomized Controlled Trial

This single-center, prospective, randomized controlled trial aims to evaluate the effect of preoperative video-based mobilization education on postoperative fear of movement (kinesiophobia), pain during first mobilization, and early mobilization characteristics in patients undergoing total hip arthroplasty. Ninety-six participants were randomized to receive either routine verbal education plus video-based education or routine verbal education alone. Postoperative outcomes were assessed using the Tampa Scale of Kinesiophobia (TSK), Numerical Pain Rating Scale (NPRS), and standardized mobilization observation forms.

Study Overview

• Status: Completed
• Conditions: Postoperative Pain; Hip Osteoarthritis; Kinesiophobia; Early Mobilization; Total Hip Arthroplasty (THA); Musculoskeletal Rehabilitation
• Intervention / Treatment: Behavioral: Video-Based Mobilization Education; Behavioral: Standard Verbal Education

Detailed Description

Total hip arthroplasty (THA) is a common orthopedic procedure in which early postoperative mobilization plays a key role in preventing complications, reducing pain, and accelerating functional recovery. However, fear of movement (kinesiophobia), insufficient preoperative preparation, and uncertainty regarding mobility expectations may negatively affect patients' early rehabilitation performance. Providing structured, standardized education before surgery has been shown to improve postoperative participation and enhance patient confidence, yet the most effective format of such education remains unclear.

This randomized controlled trial was designed to evaluate the impact of a preoperative video-based mobilization education program on postoperative kinesiophobia, pain during the first mobilization, and early mobilization characteristics among patients undergoing primary THA. A total of 96 participants were randomly assigned to an intervention group or a control group using a simple randomization method. Both groups received routine preoperative verbal education, while the intervention group additionally viewed a structured mobilization training video developed by a multidisciplinary team of orthopedic surgeons, physiatrists, physiotherapists, and orthopedic nurses.

The educational video included demonstrations of bed exercises, safe ambulation techniques with assistive devices, chair transfer mechanics, toilet use, stair negotiation, and postoperative precautions. All postoperative outcomes were measured on the first postoperative day following each patient's initial mobilization session. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia (TSK); pain intensity was measured using the Numerical Pain Rating Scale (NPRS) immediately before and after the first mobilization; and mobilization characteristics (duration, number of steps, activity level, and level of assistance required) were recorded using a standardized observation form.

The aim of the study was to determine whether video-based preoperative education provides measurable benefits compared with routine verbal instruction alone. By focusing on both psychological (kinesiophobia) and physical (pain and mobilization performance) outcomes, this trial seeks to contribute new evidence to the field of musculoskeletal rehabilitation and to support more effective perioperative education strategies in THA care. No adverse events related to the intervention were reported.

• Study Type: Interventional
• Enrollment (Actual): 96
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye), 34752
    • Acibadem Healthcare Group Hospital - Orthopedic Clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Age 18 years or older

Able to communicate verbally

Scheduled for primary total hip arthroplasty

No major neurological disease

No major psychiatric disease

Able to participate in postoperative mobilization

Provided written informed consent

Exclusion Criteria:

Scheduled for revision total hip arthroplasty

Comorbidities that prevent safe mobilization (e.g., severe cardiopulmonary limitations, severe balance disorders)

Severe cognitive impairment affecting comprehension or cooperation

Any condition preventing participation in the mobilization protocol

Declining to provide informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Group; Participants in this arm receive routine preoperative verbal education plus a structured video-based mobilization training. The video includes demonstrations of bed exercises, mobilization with assistive devices, chair transfer techniques, toilet use, stair negotiation, and postoperative precautions.	Behavioral: Video-Based Mobilization Education; A structured preoperative video-based mobilization training including demonstrations of bed exercises, mobilization with assistive devices, chair transfer, toilet use, stair negotiation, and postoperative precautions.
Active Comparator: Control Group; Participants in this arm receive only routine preoperative verbal education provided by ward nurses. No video-based training is given.	Behavioral: Standard Verbal Education; Routine preoperative verbal instruction provided by ward nurses.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Kinesiophobia (TSK Score)	Kinesiophobia will be measured using the Tampa Scale of Kinesiophobia (TSK), a 17-item scale scored on a 4-point Likert system (1-4). Total scores range from 17 to 68, with higher scores indicating greater fear of movement. The Turkish validated version will be used.	First postoperative day, after first mobilization

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity Before First Mobilization	Pain intensity will be assessed using the Numerical Pain Rating Scale (NPRS), in which patients rate their pain on a scale from 1 to 10. Higher scores represent greater pain intensity.	Immediately before first mobilization
Pain Intensity After First Mobilization	Pain intensity will be assessed using the Numerical Pain Rating Scale (NPRS), recorded on a scale from 1 to 10, where higher scores indicate more severe pain.	Immediately after first mobilization
Mobilization Duration	The total duration (in minutes) of the patient's first mobilization session will be recorded by the researcher using a standardized observation form.	First postoperative day
Number of Steps During First Mobilization	The number of steps taken during the first mobilization session will be counted using the standardized mobilization observation form.	First postoperative day
Activity Level During First Mobilization	Activity level will be evaluated using the standardized mobilization observation form, which records walking distance, device use, and functional quality of ambulation.	First postoperative day
Level of Assistance Required During First Mobilization	The required level of assistance (independent, minimal assistance, moderate assistance, or full assistance) will be assessed during the first mobilization session using a standardized observation form.	First postoperative day

Collaborators and Investigators

• Sponsor: Acibadem University
• Investigators: Principal Investigator: Nermin Ocaktan, Acıbadem Mehmet Ali Aydınlar University

Study record dates

Study Major Dates

• Study Start (Actual): November 15, 2023
• Primary Completion (Actual): July 30, 2024
• Study Completion (Actual): July 30, 2024

Study Registration Dates

• First Submitted: December 1, 2025
• First Submitted That Met QC Criteria: December 1, 2025
• First Posted (Actual): December 12, 2025

Study Record Updates

• Last Update Posted (Actual): December 12, 2025
• Last Update Submitted That Met QC Criteria: December 1, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Postoperative Pain; Kinesiophobia; Total Hip Arthroplasty; Mobilization; Orthopedic Surgery; Rehabilitation Nursing; Early Mobilization; Preoperative Education; Fear of Movement; Video-Based Training
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Mental Disorders; Postoperative Complications; Pathologic Processes; Arthritis; Joint Diseases; Rheumatic Diseases; Osteoarthritis; Phobic Disorders; Anxiety Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Kinesiophobia; Pain, Postoperative; Osteoarthritis, Hip
• Other Study ID Numbers: 2022-17-46

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The individual participant data (IPD) will not be shared because the study does not include a data sharing provision in the ethics approval and the collected data contain potentially identifiable clinical information.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No