Güney-Deniz Hande, Irem Kınıklı Gizem, Çağlar Ömür, Atilla Bülent, Yüksel İnci
a Department of Physiotherapy and Rehabilitation , Hacettepe University , Ankara , Turkey.
b Department of Orthopedics and Traumatology , Hacettepe University , Ankara , Turkey.
Physiother Theory Pract. 2017 Jun;33(6):448-453. doi: 10.1080/09593985.2017.1318988. Epub 2017 May 8.
The purpose of this study was to investigate the effects of kinesiophobia on early functional outcomes in patients following total knee arthroplasty (TKA) and how kinesiophobia is related to functional outcomes and pain. The Tampa Scale for Kinesiophobia (TSK), 2-minute walk test (2-MWT), and the timed up and go test (TUG) were used to assess 46 TKA patients on discharge day. The pain levels and active knee flexion range of motion (ROM) were recorded. Patients were divided into two groups as high kinesiophobia (Group I, n = 22) and low kinesiophobia (Group II, n = 24) based on the TSK levels. The TUG results were similar between groups (p = 0.826). 2-MWT results (p < 0.001), pain levels (p = 0.003), and knee flexion ROM (p = 0.025) scores were better in Group II when compared to Group I. The TSK scores were significantly correlated with 2-MWT results (r = -0.40; p = 0.003), pain levels (r = 0.80; p < 0.001), and knee flexion ROM (r = -0.47; p = 0.001). The regression analysis revealed that 41% of 2-MWT score, 47% of knee flexion ROM, and 60% of pain level changes could be explained by kinesiophobia level. The results suggest that early outcomes following TKA were affected by the pain-related fear of movement. The clinicians need to consider the interrelationships between fear of movement and functional outcomes when designing, implementing, and monitoring daily therapeutic exercise programs.
本研究的目的是调查运动恐惧对全膝关节置换术（TKA）患者早期功能结局的影响，以及运动恐惧与功能结局和疼痛之间的关系。采用坦帕运动恐惧量表（TSK）、2分钟步行试验（2-MWT）和计时起立行走测试（TUG）对46例TKA患者出院当天进行评估。记录疼痛水平和膝关节主动屈曲活动范围（ROM）。根据TSK水平将患者分为高运动恐惧组（I组，n = 22）和低运动恐惧组（II组，n = 24）。两组间TUG结果相似（p = 0.826）。与I组相比，II组的2-MWT结果（p < 0.001）、疼痛水平（p = 0.003）和膝关节屈曲ROM（p = 0.025）得分更好。TSK得分与2-MWT结果（r = -0.40；p = 0.003）、疼痛水平（r = 0.80；p < 0.001）和膝关节屈曲ROM（r = -0.47；p = 0.001）显著相关。回归分析显示，运动恐惧水平可解释2-MWT得分变化的41%、膝关节屈曲ROM变化的47%和疼痛水平变化的60%。结果表明，TKA后的早期结局受与疼痛相关的运动恐惧影响。临床医生在设计、实施和监测日常治疗性运动计划时，需要考虑运动恐惧与功能结局之间的相互关系。
