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

M Morri, E Venturini, N Franchini, R Ruisi, A Culcasi, A Ruggiero, C Govoni, M G Benedetti, M Morri, E Venturini, N Franchini, R Ruisi, A Culcasi, A Ruggiero, C Govoni, M G Benedetti

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.

Keywords: Arthroplasty; Osteoarthritis; Psychology; Recovery of function.

Conflict of interest statement

The Authors declare that they have no competing interest.

Figures

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Enrollment process

References

    1. Marx RG, Jones EC, Atwan NC, Closkey RF, Salvati EA, Sculco TP. Measuring improvement following total hip and knee arthroplasty using patient-based measures of outcome. J Bone Joint Surg Am. 2005;87(9):1999–2005. doi: 10.2106/00004623-200509000-00013.
    1. Bruyère O, Ethgen O, Neuprez A, Zégels B, Gillet P, Huskin JP, Reginster JY. Health-related quality of life after total knee or hip replacement for osteoarthritis: a 7-year prospective study. Arch Orthop Trauma Surg. 2012;132(11):1583–1587. doi: 10.1007/s00402-012-1583-7.
    1. Judge A, Cooper C, Williams S, Dreinhoefer K, Dieppe P. Patient-reported outcomes one year after primary hip replacement in a European collaborative cohort. Arthritis Care Res. 2010;62(4):480–488. doi: 10.1002/acr.20038.
    1. Hawker GA, Badley EM, Borkhoff CM, Croxford R, Davis AM, Dunn S, Gignac MA, Jaglal SB, Kreder HJ, Sale JE. Which patients are most likely to benefit from total joint arthroplasty? Arthritis Rheum. 2013;65(5):1243–1252. doi: 10.1002/art.37901.
    1. Vincent HK, Alfano AP, Lee L, Vincent KR. Sex and age effects on outcomes of total hip arthroplasty after inpatient rehabilitation. Arch Phys Med Rehabil. 2006;87(4):461–467. doi: 10.1016/j.apmr.2006.01.002.
    1. Morri M, Franchini N, Gerini G, Morabito R, Pignotti E, Benedetti MG, Marchese O, Zanotti E. Measuring functional performance at discharge from hospital after total joint arthroplasty as a pre-requisite for planning early rehabilitation: a prognostic study. Orthop Nurs. 2015;34(2):95–100. doi: 10.1097/NOR.0000000000000126.
    1. Buirs LD, VanBeers LWAH, Scholtes VAB, et al. Predictors of physical functioning after total hip arthroplasty: a systematic review. BMJ Open. 2016;6:e010725. doi: 10.1136/bmjopen-2015-010725.
    1. Lungu E, Vendittoli PA, Desmeules F. Identification of patients with suboptimal results after hip arthroplasty: development of a preliminary prediction algorithm. BMC Musculoskelet Disord. 2015;16(1):279. doi: 10.1186/s12891-015-0720-1.
    1. Oosting E, Hoogeboom TJ, Appelman-de Vries SA, Swets A, Dronkers JJ, van Meeteren NL. Preoperative prediction of inpatient recovery of function after total hip arthroplasty using performance-based tests: a prospective cohort study. Disabil Rehabil. 2016;38(13):1243–1249. doi: 10.3109/09638288.2015.1076074.
    1. Landers MR, Creger RV, Baker CV, Stutelberg KS. The use of fear avoidance beliefs and nonorganic signs in predicting prolonged disability in patients with neck pain. Man Ther. 2008;13(3):239–248. doi: 10.1016/j.math.2007.01.010.
    1. Mansfield M, Thacker M, Spahr N, Smith T. Factors associated with physical activity participation in adults with chronic cervical spine pain: a systematic review. Physiotherapy. 2018;104(1):54–60. doi: 10.1016/j.physio.2017.01.004.
    1. Nieto R, Miró J, Huguet A. Pain-related fear of movement and catastrophizing in whiplash-associated disorders. Rehabil Psychol. 2013;58(4):361–368. doi: 10.1037/a0034267.
    1. Das De S, Vranceanu AM, Ring DC. Contribution of Kinesophobia and catastrophic thinking to upper-extremity-specific disability. J Bone Joint Surg Am. 2013;95:76–81. doi: 10.2106/JBJS.L.00064.
    1. Miedema HS, Feleus A, Bierma-Zeinstra SM, Hoekstra T, Burdorf A, Koes BW. Disability trajectories in patients with complaints of arm, neck, and shoulder (CANS) in primary care: prospective cohort study. Phys Ther. 2016;96(7):972–984. doi: 10.2522/ptj.20150226.
    1. Helminen EE, Sinikallio SH, Valjakka AL, Väisänen-Rouvali RH, Arokoski JP. Determinants of pain and functioning in knee osteoarthritis: a one-year prospective study. Clin Rehabil. 2016;30(9):890–900. doi: 10.1177/0269215515619660.
    1. Gunn AH, Schwartz TA, Arbeeva LS, et al. Fear of movement and associated factors among adults with symptomatic knee osteoarthritis. Arthritis Care Res. 2017;69(12):1826–1833. doi: 10.1002/acr.23226.
    1. Knapik A, Saulicz E, Gnat R. Kinesiophobia - Introducing a New Diagnostic Tool. J of Hum Kinet. 2011;28(−1):25–31. doi: 10.2478/v10078-011-0019-8.
    1. Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85(3):317–332. doi: 10.1016/S0304-3959(99)00242-0.
    1. Brown ML, Plate JF, Von Thaer S, et al. Decreased range of motion following Total knee Arthroplasty is predicted by the Tampa scale of Kinesiophobia. J Arthroplast. 2016;31(4):793–797. doi: 10.1016/j.arth.2015.10.037.
    1. Güney-Deniz H, Irem Kınıklı G, Çağlar Ö, Atilla B, Yüksel İ. Does kinesiophobia affect the early functional outcomes following total knee arthroplasty? Physiother Theory Pract. 2017;33(6):448–453. doi: 10.1080/09593985.2017.1318988.
    1. Doury-Panchout F, Metivier JC, Fouquet B. Kinesiophobia negatively influences recovery of joint function following total knee arthroplasty. Eur J Phys Rehabil Med. 2015;51(2):155–161.
    1. Sullivan M, Tanzer M, Reardon G, Amirault D, Dunbar M, Stanish W. The role of presurgical expectancies in predicting pain and function one year following total knee arthroplasty. Pain. 2011;152(10):2287–2293. doi: 10.1016/j.pain.2011.06.014.
    1. Witvrouw E, Pattyn E, Almqvist KF, et al. Catastrophic thinking about pain as a predictor of length of hospital stay after total knee arthroplasty: a prospective study. Knee Surg Sports Traumatol Arthrosc. 2009;17(10):1189–1194. doi: 10.1007/s00167-009-0817-x.
    1. Shields RK, Enloe LJ, Evans RE, Smith KB, Steckel SD. Reliability, validity, and responsiveness of functional tests in patients with total joint replacement. Phys Ther. 1995;75(3):169–176. doi: 10.1093/ptj/75.3.169.
    1. Lawlor M, Humphreys P, Morrow E, Ogonda L, Bennet D, Elliot D, Beverland D. Comparison of early postoperative functional levels following total hip replacement using minimally invasive versus standard incisions. A prospective randomized blinded trial. Clin Rehabil. 2005;19:465–474. doi: 10.1191/0269215505cr890oa.
    1. Stockton KA. Mengersen. Effect of multiple physiotherapy sessions on functional outcomes in the initial postoperative period after primary total hip replacement: a randomized controlled trial. Arch Phys Med Rehabil. 2009;90(10):1652–1657. doi: 10.1016/j.apmr.2009.04.012.
    1. Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798–804. doi: 10.1111/j.1365-2702.2005.01121.x.
    1. Salaffi F, Leardini G, Canesi B, Mannoni A, Fioravanti A, Caporali R, Lapadula G, Punzi L. Western Ontario and McMaster universities (WOMAC) OsteoarthritisIndex in Italian patients with osteoarthritis of the knee. Osteoarthr Cartil. 2003;11(8):551–560. doi: 10.1016/S1063-4584(03)00089-X.
    1. Monticone M, Giorgi I, Baiardi P, et al. Development of the Italian version of the Tampa scale of Kinesiophobia (TSK-I): cross-cultural adaptation, factor analysis, reliability, and validity. Spine. 2010;35:1241–1246. doi: 10.1097/BRS.0b013e3181bfcbf6.
    1. Filardo G, Merli G, Roffi A, Marcacci T, Berti CF, Raboni D, Bortolotti B, Kon E, Marcacci M M. Kinesiophobia and depression affect total knee arthroplastyoutcome in a multivariate analysis of psychological and physical factors on 200 patients. Knee Surg Sports Traumatol Arthrosc. 2016;24(10):3322–3328. doi: 10.1007/s00167-015-3898-8.
    1. Archer KR, Seebach CL, Mathis SL, Riley LH, 3rd, Wegener ST. Early postoperative fear of movement predicts pain, disability, and physical health six months after spinal surgery for degenerative conditions. Spine J. 2014;14(5):759–767. doi: 10.1016/j.spinee.2013.06.087.
    1. Smith GH, Johnson S, Ballantyne JA, Dunstan E, Brenkel IJ. Predictors of excellent early outcome after total hip arthroplasty. J Orthop Surg Res. 2012;25(7):13. doi: 10.1186/1749-799X-7-13.
    1. Schneider M, Kawahara I, Ballantyne G, McAuley C, Macgregor K, Garvie R, McKenzie A, Macdonald D, Breusch SJ. Predictive factors influencing fast track rehabilitation following primary total hip and knee arthroplasty. Arch Orthop Trauma Surg. 2009;129(12):1585–1591. doi: 10.1007/s00402-009-0825-9.
    1. Elings J, Hoogeboom TJ, van der Sluis G, van Meeteren NLU. What preoperative patient-related factors predict inpatient recovery of physical functioning and length of stay after total hip arthroplasty? A systematic review. Clin Rehabil. 2015;29(5):477–492. doi: 10.1177/0269215514545349.
    1. Liu W, Wahafu T, Cheng M, Cheng T, Zhang Y, Zhang X. The influence of obesity on primary total hip arthroplasty outcomes: a meta-analysis of prospective cohort studies. Orthop Traumatol Surg Res. 2015;101(3):289–296. doi: 10.1016/j.otsr.2015.01.011.
    1. Mak JC, Fransen M, Jennings M, March L, Mittal R. Harris IA; National Health and Medical Research Council (NHMRC) of Australia. Evidence-based review for patients undergoing elective hip and knee replacement. ANZ J Surg. 2014;84(1–2):17–24. doi: 10.1111/ans.12109.
    1. Ibrahim MS, Twaij H, Giebaly DE, Nizam I, Haddad FS. Enhanced recovery in total hip replacement: a clinical review. Bone Joint J. 2013;95-B(12):1587–1594. doi: 10.1302/0301-620X.95B12.31303.

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