全髋关节置换术后 6-8 年后的运动恐惧症及其与功能结果和生活质量的关系。
Kinesiophobia and its association with functional outcome and quality of life 6-8 years after total hip arthroplasty.
机构信息
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Sweden.
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Sweden.
出版信息
Acta Orthop Traumatol Turc. 2022 Jul;56(4):252-255. doi: 10.5152/j.aott.2022.21318.
OBJECTIVE
The aim of this study was to assess the incidence and severity of kinesiophobia, and to determine the relationship between Tampa Scale of Kinesiophobia (TSK) scores, functional outcome and quality of life (QoL) 6-8 years after Total Hip Arthroplasty (THA).
METHODS
161 patients (78 male and 83 female) with unilateral primary osteoarthritis (OA) treated with THA between September 2010 and December 2013 were included in this study. Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and EQ-5D scores were measured preoperatively. At 6-8 years follow-up, these scores were repeated and TSK scores were also measured. According to the TSK, patients were divided into two groups for further comparisons and analysis: without kinesiophobia (TSK-score ≤ 36) and with kinesiophobia (TSK-score >36).
RESULTS
There were 99 patients (61.5%) with no kinesiophobia (TSK score ≤ 36, TSK mean 28.4, SD 4.7) and 62 patients (38.5%) with kinesiophobia (TSK score > 36, TSK mean 42.8, SD 5.3). Patients with and without kinesiophobia were not statistically different regarding age, sex or body mass index. (P = 0.20, P = 0.99, P = 0.22, respectively). In the group with no kinesiophobia, the mean 6-8 years WOMAC was 12.4 (SD 15.6), while the absolute delta (Δ) value between preoperative and 6-8 years WOMAC was 46.2 (SD 20.4), compared to the group with kinesiophobia where the mean 6-8 years WOMAC was 32.2 (SD 23.4), while the absolute delta (Δ) value between preoperative and 6-8 years WOMAC was 32.3 (SD 25.5): both P < 0.001. The group with no kinesiophobia had a mean 6-8 years EQ-5D of 0.81 (SD 0.22), while the absolute delta (Δ) value between preoperative and 6-8 years EQ-5D was 0.44 (SD 0.26), compared to the group with kinesiophobia where the mean 6-8 years EQ-5D was 0.57 (SD 0.23), while the absolute delta (Δ) value between preoperative and 6-8 years EQ-5D was 0.33 (SD 0.26): P < 0.001 and P = 0.03, respectively. TSK scores were associated with worse WOMAC and EQ-5D scores, higher proportion of dependence on walking aids and increased THArelated adverse events (all P < 0.05).
CONCLUSION
This study has shown us that there is a high incidence of kinesiophobia 6-8 years after surgery and treating kinesiophobia early after THA might improve the outcome.
LEVEL OF EVIDENCE
Level IV, Therapeutic Study.
目的
本研究旨在评估髋关节置换术后 6-8 年的运动恐惧发生率和严重程度，并确定坦帕运动恐惧量表（TSK）评分与功能结果和生活质量（QoL）之间的关系。
方法
纳入了 2010 年 9 月至 2013 年 12 月接受单侧原发性骨关节炎（OA）髋关节置换术的 161 例患者（78 名男性和 83 名女性）。在术前测量 Western Ontario 和麦克马斯特大学骨关节炎（WOMAC）和 EQ-5D 评分，在 6-8 年随访时重复这些评分，并测量 TSK 评分。根据 TSK，将患者分为两组进行进一步比较和分析：无运动恐惧（TSK 评分≤36）和有运动恐惧（TSK 评分>36）。
结果
99 例患者（61.5%）无运动恐惧（TSK 评分≤36，TSK 平均 28.4，SD 4.7），62 例患者（38.5%）有运动恐惧（TSK 评分>36，TSK 平均 42.8，SD 5.3）。有运动恐惧和无运动恐惧的患者在年龄、性别或体重指数方面无统计学差异（P=0.20，P=0.99，P=0.22）。在无运动恐惧组中，6-8 年 WOMAC 的平均分数为 12.4（SD 15.6），而术前与 6-8 年 WOMAC 的绝对差值（Δ）为 46.2（SD 20.4），相比之下，有运动恐惧组的 6-8 年 WOMAC 的平均分数为 32.2（SD 23.4），而术前与 6-8 年 WOMAC 的绝对差值（Δ）为 32.3（SD 25.5）：均 P<0.001。无运动恐惧组的 6-8 年 EQ-5D 平均得分为 0.81（SD 0.22），而术前与 6-8 年 EQ-5D 的绝对差值（Δ）为 0.44（SD 0.26），相比之下，有运动恐惧组的 6-8 年 EQ-5D 平均得分为 0.57（SD 0.23），而术前与 6-8 年 EQ-5D 的绝对差值（Δ）为 0.33（SD 0.26）：均 P<0.001 和 P=0.03。TSK 评分与 WOMAC 和 EQ-5D 评分较差、对助行器的依赖程度较高以及与 THA 相关的不良事件发生率增加有关（均 P<0.05）。
结论
本研究表明，髋关节置换术后 6-8 年存在较高的运动恐惧发生率，早期治疗运动恐惧可能会改善预后。
证据等级
IV 级，治疗性研究。
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