Predictors of kinesiophobia in patients with total knee arthroplasty

Aiming to examine the factors that predict kinesiophobia in individuals with total knee arthroplasty (TKA) at the preoperative and postoperative 3rd month. Forty-five volunteers (33 females, 12 males) with a mean age of 64.16±7.50 years who were hospitalized for unilateral TKA surgery were included in this study. To assess kinesiophobia, the Tampa Scale of Kinesiophobia (TSK) (questions no. 1,2,9,10,14 and 15), which is valid for individuals with knee OA, was used. Knee pain and functionality of individuals were measured by Oxford Knee Score, psychological status by Hospital Anxiety and Depression Scale (HADS), physical performance by 2-Minute Walk Test (2-MWT) and Timed Up and Go Test (TUG) and knee joint range of motion goniometric measurement was done with. Positive intermediate level correlation was found between postoperative kinesiophobia and postoperative fear of falling, postoperative extension limitation, preoperative and postoperative ODS scores (rs=0.336, p=0.024; rs=0.418, p=0.004; rs=0.300, p=0.045; rs=0.529, p= 0.000), a moderate negative correlation (rs= -0.409 , p= 0.005; rs=-0.384 , p=0.009) was found between height and postoperative active flexion ROM. No significant correlation was found between TSK and age, weight, BMI, TUG, postoperative passive knee flexion degree, postoperative active and passive knee extension degree, HAD-Anxiety and HAD-Depression and 2-MWT. According to the results of our study, the fact that kinesiophobia after surgery is higher in men than women, the presence of knee joint extension limitation before surgery, the short distance walked with 2-MWT after surgery and the low degree of active knee flexion are the most effective factors explaining the occurrence of kinesiophobia at a rate of 70% found (R2=0.70; p<0.001). In conclusion, considering the factors that will trigger kinesiophobia by physiotherapists in the perioperative period and creating individual physiotherapy programs suitable for risk factors may reduce the development of kinesiophobia in TKA patients and contribute to their functionality in the postoperative period.