Güney Yılmaz Güleser, Akel Burcu Semin, Sevimli Saitoğlu Yeliz, Akı Esra
Kütahya Health Sciences University, Department of Therapy and Rehabilitation, Kütahya, Turkey.
Istanbul Kültür University, Department of Physiotherapy, İstanbul, Turkey.
J Orthop. 2023 Jul 18;42:80-86. doi: 10.1016/j.jor.2023.07.020. eCollection 2023 Aug.
The development of kinesiophobia after Total Knee Arthroplasty (TKA) has been one of the important issues. However, the early results and the presence of kinesiophobia before surgery have not been adequately investigated. In addition, the effects of factors such as pain perception, postoperative pain level, and demographic characteristics were mentioned. However, occupational factors such as occupational expectations and occupational self-perception level have not been adequately investigated.
Each assessment tool was administered three times: once on the first day of the preoperative period and then again at the third and sixth weeks after the surgery. The assessment tools employed were the Knee Injury and Osteoarthritis Outcome Score, Tampa Scale for Kinesiophobia, Occupational Self Assessment, and Timed Up and Go test. To analyze the differences in Tampa Scale for Kinesiophobia scores, a one-way ANOVA was conducted. Subsequently, the patients were categorized into two groups based on their level of kinesiophobia: high and low. Independent sample t-tests were employed to compare continuous and normally distributed data between the two groups, while the Mann-Whitney test was used for non-normally distributed data. The Pearson correlation coefficient was utilized to assess the relationship between continuous data, whereas the Spearman rank-order correlation was employed for non-normally distributed data.
High levels of kinesiophobia were identified in individuals both prior to and following surgery. Significant differences were observed between the high and low kinesiophobia groups in terms of the mean OSA Competency (p < 0.05). However, no statistically significant differences were found between the groups in relation to the other evaluation scores during the follow-up periods. Furthermore, a negative correlation was observed between TSK score and OSA Competence results (p < 0.05).
Occupational self-perception levels effect the level of kinesiophobia in individuals with TKA and high rates of kinesiophobia observed before the surgery intensified after the surgery, especially in the early period. It may be necessary to focus more on factors such as individual factors, individuals' values, habits, and beliefs.
全膝关节置换术（TKA）后运动恐惧的发展一直是重要问题之一。然而，早期结果以及术前运动恐惧的存在尚未得到充分研究。此外，提到了疼痛感知、术后疼痛程度和人口统计学特征等因素的影响。然而，职业期望和职业自我认知水平等职业因素尚未得到充分研究。
每种评估工具使用三次：一次在术前第一天，然后在术后第三周和第六周各使用一次。所采用的评估工具包括膝关节损伤和骨关节炎疗效评分、坦帕运动恐惧量表、职业自我评估以及定时起立行走测试。为分析坦帕运动恐惧量表评分的差异，进行了单因素方差分析。随后，根据运动恐惧水平将患者分为两组：高和低。采用独立样本t检验比较两组间连续且呈正态分布的数据，而对于非正态分布的数据则使用曼-惠特尼检验。利用皮尔逊相关系数评估连续数据之间的关系，而非正态分布的数据则采用斯皮尔曼等级相关。
术前和术后个体均存在高水平的运动恐惧。高运动恐惧组和低运动恐惧组在平均职业自我评估能力方面存在显著差异（p < 0.05）。然而，在随访期间，两组在其他评估分数方面未发现统计学上的显著差异。此外，观察到TSK评分与职业自我评估能力结果之间存在负相关（p < 0.05）。
职业自我认知水平影响TKA患者的运动恐惧水平，术前观察到的高运动恐惧发生率在术后尤其是早期有所加剧。可能有必要更多地关注个体因素、个人价值观、习惯和信念等因素。
