Potential categories and influencing factors of kinesiophobia trajectories in patients after total hip arthroplasty_West China Medical Journal

Authors：

LAI Ting ^1,2,3 ,  WU Minglong ^1,2 , HU Kaili ^1,2 , HU Jiaxin ^2,3 , ZHOU Xinke ³

1. Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P. R. China;
2. Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P. R. China;
3. School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P. R. China;

Corresponding author：

WU Minglong, Email: 1924212533@qq.com

Keywords：

Total hip arthroplasty; kinesiophobia; longitudinal study; trajectory; latent category growth model; influencing factors

DOI：

10.7507/1002-0179.202406050

Video：

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Objective To investigate the development trajectories of kinesiophobia and their influencing factors in patients after total hip arthroplasty (THA). Methods Patients after THA from three tertiary hospitals in Wuhan from February to June 2023 were selected by convenience sampling method. The general situation questionnaire, Tampa Scale for Kinesiophobia, Self-Efficacy for Exercise Scale (SEE), Groningen Orthopaedic Social Support Scale, Generalized Anxiety Disorder, Patient Health Questionnaire, and Visual Analogue Scale (VAS) were distributed 1-2 d after surgery (T1), which were used again 1 week (T2), 1 month (T3), and 3 months (T4) after surgery, to evaluate the level of kinesiophobia and the physical and psychological conditions of the patients. The latent category growth model was used to classify the kinesiophobia trajectories of patients after THA, and the influencing factors of different categories of kinesiophobia trajectories were analyzed. Results A total of 263 patients after THA were included. The kinesiophobia trajectories of patients after THA were divided into four potential categories, including 29 cases in the C1 high kinesiophobia persistent group, 41 cases in the C2 medium kinesiophobia improvement group, 131 cases in the C3 low kinesiophobia improvement group, and 62 cases in the C4 no kinesiophobia group. Multicategorical logistic regression analysis showed that compared to the C4 no kinesiophobia group, the influencing factors for the kinesiophobia trajectory in THA patients to develop into the C1 high kinesiophobia persistent group were age [odds ratio (OR)=1.081, 95% confidence interval (CI) (1.025, 1.140)], chronic comorbidities [OR=6.471, 95%CI (1.831, 22.872)], the average SEE score at T1-T4 time points [OR=0.867, 95%CI (0.808, 0.931)], and the average VAS score at T1-T4 time points [OR=7.981, 95%CI (1.718, 37.074)], the influencing factors for the kinesiophobia trajectory to develop into the C2 medium kinesiophobia improvement group were age [OR=1.049, 95%CI (1.010, 1.089)], education level [OR=0.244, 95%CI (0.085, 0.703)], and the average VAS score at T1-T4 time points [OR=8.357, 95%CI (2.300, 30.368)], and the influencing factors for the kinesiophobia trajectory to develop into the C3 low kinesiophobia improvement group were the average SEE score [OR=0.871, 95%CI (0.825, 0.920)] and the average VAS score at T1-T4 time points [OR=4.167, 95%CI (1.544, 11.245)] . Conclusion Kinesiophobia in patients after THA presents different trajectories, and nurses should pay attention to the assessment and intervention of kinesiophobia in patients with advanced age, low education level, chronic diseases, low exercise self-efficacy, and high pain level.

Citation： LAI Ting, WU Minglong, HU Kaili, HU Jiaxin, ZHOU Xinke. Potential categories and influencing factors of kinesiophobia trajectories in patients after total hip arthroplasty. West China Medical Journal, 2024, 39(10): 1571-1578. doi: 10.7507/1002-0179.202406050 Copy

1.	李川, 钱东阳, 王斌, 等. 中国髋关节置换入路选择临床实践指南. 中华关节外科杂志, 2021, 15(6): 651-659.
2.	边焱焱, 程开源, 常晓, 等. 2011 至 2019 年中国人工髋膝关节置换手术量的初步统计与分析. 中华骨科杂志, 2020, 40(21): 1453-1460.
3.	童培建. 髋膝关节置换围手术期加速康复专家共识. 实用骨科杂志, 2021, 27(11): 961-965.
4.	Chua MJ, Hart AJ, Mittal R, et al. Early mobilisation after total hip or knee arthroplasty: a multicentre prospective observational study. PLoS One, 2017, 12(6): e0179820.
5.	Güney H, Kinikli G, Karaha S, et al. The relationship between kinesiophobia and early functional and physiological outcomes in patients with total hip and knee arthroplasty. Occup Ther Rehabil, 2016, 4(2): 97-101.
6.	Kori S, Miller R, Todd DD. Kinesiophobia: a new view of chronic pain behavior. Pain Manag, 1990(3): 35-43.
7.	Alsaleem MK, Alkhars AM, Alalwan HA, et al. Kinesiophobia post total hip arthroplasty: a retrospective study. Cureus, 2021, 13(6): e15991.
8.	Hidaka R, Tanaka T, Hashikura K, et al. Association of high kinesiophobia and pain catastrophizing with quality of life in severe hip osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord, 2023, 24(1): 388.
9.	何沁芮, 云洁, 毛雨婷, 等. 髋关节置换术后患者恐动症影响因素的 Meta 分析. 中国疗养医学, 2024, 33(1): 73-76.
10.	黄莉, 杨旭, 李芳芳, 等. 髋、膝关节置换术后患者恐动症发生现状及影响因素分析. 中华骨与关节外科杂志, 2023, 16(11): 1001-1007.
11.	胡文. 简体中文版 TSK 和 FABQ 量表的文化调适及其在退行性腰腿痛中的应用研究. 上海: 第二军医大学, 2012.
12.	Resnick B, Jenkins LS. Testing the reliability and validity of the Self-Efficacy for Exercise scale. Nurs Res, 2000, 49(3): 154-159.
13.	Lee LL, Perng SJ, Ho CC, et al. A preliminary reliability and validity study of the Chinese version of the self-efficacy for exercise scale for older adults. Int J Nurs Stud, 2009, 46(2): 230-238.
14.	van den Akker-Scheek I, Stevens M, Spriensma A, et al. Groningen Orthopaedic Social Support Scale: validity and reliability. J Adv Nurs, 2004, 47(1): 57-63.
15.	Plummer F, Manea L, Trepel D, et al. Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis. Gen Hosp Psychiatry, 2016, 39: 24-31.
16.	Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care, 2003, 41(11): 1284-1292.
17.	王红霞, 唐霖, 张萍. 骨科术后患者 4 种疼痛评估方法适用性研究. 护理学杂志, 2013, 28(6): 5-7.
18.	关烨, 张光铂. 中国骨科康复学. 北京: 人民军医出版社, 2011: 5-6.
19.	王文慧, 张利峰, 李信欣, 等. 髋关节置换术后患者不同时期关节功能变化及其影响因素研究. 中华护理杂志, 2017, 52(6): 649-653.
20.	王孟成, 邓俏文, 毕向阳, 等. 分类精确性指数 Entropy 在潜剖面分析中的表现: 一项蒙特卡罗模拟研究. 心理学报, 2017, 49(11): 1473-1482.
21.	Yan Z, Wu Y, Liu M, et al. Heterogeneous trajectories of kinesiophobia and their effects on rehabilitation outcomes after total knee arthroplasty: a prospective cohort study. J Orthop Surg Res, 2023, 18(1): 449.
22.	Zhou Y, Ma L. Intrinsic capacity in older adults: recent advances. Aging Dis, 2022, 13(2): 353-359.
23.	马远征, 王以朋, 刘强, 等. 中国老年骨质疏松诊疗指南(2018). 中国老年学杂志, 2019, 39(11): 2557-2575.
24.	闫江涛, 李纯, 冯凯, 等. 影响老年股骨粗隆间骨折患者术后髋关节功能评分的相关因素探讨. 中国临床保健杂志, 2021, 24(5): 667-670.
25.	李沪生, 吴静, 董凤伟, 等. 心房颤动患者射频消融术后运动恐惧的潜在剖面分析. 护理学杂志, 2023, 38(10): 43-46, 64.
26.	Cetinkaya Eren O, Buker N, Tonak HA, et al. The effect of video-assisted discharge education after total hip replacement surgery: a randomized controlled study. Sci Rep, 2022, 12(1): 3067.
27.	Wu WW, Yu TH, Jou ST, et al. Physical activity self-efficacy mediates the effect of symptom distress on exercise involvement among adolescents undergoing cancer treatment. Eur J Cancer Care (Engl), 2019, 28(4): e13045.
28.	Alavijeh MS, Zandiyeh Z, Moeini M. The effect of self-care self-efficacy program on life satisfaction of the Iranian elderly. J Educ Health Promot, 2021, 10(1): 167.
29.	Zhou Y, Gao W, Gao S, et al. Pain catastrophizing, kinesiophobia and exercise adherence in patients after total knee arthroplasty: the mediating role of exercise self-efficacy. J Pain Res, 2023, 16: 3993-4004.
30.	郦杭婷, 沈娇妮, 万昕瑞, 等. 髋膝关节置换术患者康复自我效能感在正念与恐动症间的中介效应研究. 中华护理杂志, 2022, 57(10): 1177-1183.
31.	叶菁菁, 张咏梅, 谢倩倩, 等. 基于行为改变轮理论的健康教育与康复锻炼对全髋关节置换术后患者髋关节功能恢复的影响. 现代预防医学, 2021, 48(6): 1132-1135, 1148.
32.	梁飞燕, 王富珍. 成人下肢创伤性骨折病人术后恐动症的影响因素及路径分析. 护理研究, 2022, 36(7): 1170-1174.
33.	Kurien T, Arendt-Nielsen L, Petersen KK, et al. Preoperative neuropathic pain-like symptoms and central pain mechanisms in knee osteoarthritis predicts poor outcome 6 months after total knee replacement surgery. J Pain, 2018, 19(11): 1329-1341.
34.	Goff AJ, Jones LE, Lim CJ, et al. A cross sectional study exploring the relationship of self-reported physical activity with function, kinesiophobia, self-efficacy and quality of life in an Asian population seeking care for knee osteoarthritis. BMC Musculoskelet Disord, 2024, 25(1): 74.
35.	Duport A, Pelletier R, Martel M, et al. The influence of kinesiophobia and pain catastrophizing on pain-induced corticomotor modulation in healthy participants: a cross sectional study. Neurophysiol Clin, 2022, 52(5): 375-383.

1. 李川, 钱东阳, 王斌, 等. 中国髋关节置换入路选择临床实践指南. 中华关节外科杂志, 2021, 15(6): 651-659.
2. 边焱焱, 程开源, 常晓, 等. 2011 至 2019 年中国人工髋膝关节置换手术量的初步统计与分析. 中华骨科杂志, 2020, 40(21): 1453-1460.
3. 童培建. 髋膝关节置换围手术期加速康复专家共识. 实用骨科杂志, 2021, 27(11): 961-965.
4. Chua MJ, Hart AJ, Mittal R, et al. Early mobilisation after total hip or knee arthroplasty: a multicentre prospective observational study. PLoS One, 2017, 12(6): e0179820.
5. Güney H, Kinikli G, Karaha S, et al. The relationship between kinesiophobia and early functional and physiological outcomes in patients with total hip and knee arthroplasty. Occup Ther Rehabil, 2016, 4(2): 97-101.
6. Kori S, Miller R, Todd DD. Kinesiophobia: a new view of chronic pain behavior. Pain Manag, 1990(3): 35-43.
7. Alsaleem MK, Alkhars AM, Alalwan HA, et al. Kinesiophobia post total hip arthroplasty: a retrospective study. Cureus, 2021, 13(6): e15991.
8. Hidaka R, Tanaka T, Hashikura K, et al. Association of high kinesiophobia and pain catastrophizing with quality of life in severe hip osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord, 2023, 24(1): 388.
9. 何沁芮, 云洁, 毛雨婷, 等. 髋关节置换术后患者恐动症影响因素的 Meta 分析. 中国疗养医学, 2024, 33(1): 73-76.
10. 黄莉, 杨旭, 李芳芳, 等. 髋、膝关节置换术后患者恐动症发生现状及影响因素分析. 中华骨与关节外科杂志, 2023, 16(11): 1001-1007.
11. 胡文. 简体中文版 TSK 和 FABQ 量表的文化调适及其在退行性腰腿痛中的应用研究. 上海: 第二军医大学, 2012.
12. Resnick B, Jenkins LS. Testing the reliability and validity of the Self-Efficacy for Exercise scale. Nurs Res, 2000, 49(3): 154-159.
13. Lee LL, Perng SJ, Ho CC, et al. A preliminary reliability and validity study of the Chinese version of the self-efficacy for exercise scale for older adults. Int J Nurs Stud, 2009, 46(2): 230-238.
14. van den Akker-Scheek I, Stevens M, Spriensma A, et al. Groningen Orthopaedic Social Support Scale: validity and reliability. J Adv Nurs, 2004, 47(1): 57-63.
15. Plummer F, Manea L, Trepel D, et al. Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis. Gen Hosp Psychiatry, 2016, 39: 24-31.
16. Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care, 2003, 41(11): 1284-1292.
17. 王红霞, 唐霖, 张萍. 骨科术后患者 4 种疼痛评估方法适用性研究. 护理学杂志, 2013, 28(6): 5-7.
18. 关烨, 张光铂. 中国骨科康复学. 北京: 人民军医出版社, 2011: 5-6.
19. 王文慧, 张利峰, 李信欣, 等. 髋关节置换术后患者不同时期关节功能变化及其影响因素研究. 中华护理杂志, 2017, 52(6): 649-653.
20. 王孟成, 邓俏文, 毕向阳, 等. 分类精确性指数 Entropy 在潜剖面分析中的表现: 一项蒙特卡罗模拟研究. 心理学报, 2017, 49(11): 1473-1482.
21. Yan Z, Wu Y, Liu M, et al. Heterogeneous trajectories of kinesiophobia and their effects on rehabilitation outcomes after total knee arthroplasty: a prospective cohort study. J Orthop Surg Res, 2023, 18(1): 449.
22. Zhou Y, Ma L. Intrinsic capacity in older adults: recent advances. Aging Dis, 2022, 13(2): 353-359.
23. 马远征, 王以朋, 刘强, 等. 中国老年骨质疏松诊疗指南(2018). 中国老年学杂志, 2019, 39(11): 2557-2575.
24. 闫江涛, 李纯, 冯凯, 等. 影响老年股骨粗隆间骨折患者术后髋关节功能评分的相关因素探讨. 中国临床保健杂志, 2021, 24(5): 667-670.
25. 李沪生, 吴静, 董凤伟, 等. 心房颤动患者射频消融术后运动恐惧的潜在剖面分析. 护理学杂志, 2023, 38(10): 43-46, 64.
26. Cetinkaya Eren O, Buker N, Tonak HA, et al. The effect of video-assisted discharge education after total hip replacement surgery: a randomized controlled study. Sci Rep, 2022, 12(1): 3067.
27. Wu WW, Yu TH, Jou ST, et al. Physical activity self-efficacy mediates the effect of symptom distress on exercise involvement among adolescents undergoing cancer treatment. Eur J Cancer Care (Engl), 2019, 28(4): e13045.
28. Alavijeh MS, Zandiyeh Z, Moeini M. The effect of self-care self-efficacy program on life satisfaction of the Iranian elderly. J Educ Health Promot, 2021, 10(1): 167.
29. Zhou Y, Gao W, Gao S, et al. Pain catastrophizing, kinesiophobia and exercise adherence in patients after total knee arthroplasty: the mediating role of exercise self-efficacy. J Pain Res, 2023, 16: 3993-4004.
30. 郦杭婷, 沈娇妮, 万昕瑞, 等. 髋膝关节置换术患者康复自我效能感在正念与恐动症间的中介效应研究. 中华护理杂志, 2022, 57(10): 1177-1183.
31. 叶菁菁, 张咏梅, 谢倩倩, 等. 基于行为改变轮理论的健康教育与康复锻炼对全髋关节置换术后患者髋关节功能恢复的影响. 现代预防医学, 2021, 48(6): 1132-1135, 1148.
32. 梁飞燕, 王富珍. 成人下肢创伤性骨折病人术后恐动症的影响因素及路径分析. 护理研究, 2022, 36(7): 1170-1174.
33. Kurien T, Arendt-Nielsen L, Petersen KK, et al. Preoperative neuropathic pain-like symptoms and central pain mechanisms in knee osteoarthritis predicts poor outcome 6 months after total knee replacement surgery. J Pain, 2018, 19(11): 1329-1341.
34. Goff AJ, Jones LE, Lim CJ, et al. A cross sectional study exploring the relationship of self-reported physical activity with function, kinesiophobia, self-efficacy and quality of life in an Asian population seeking care for knee osteoarthritis. BMC Musculoskelet Disord, 2024, 25(1): 74.
35. Duport A, Pelletier R, Martel M, et al. The influence of kinesiophobia and pain catastrophizing on pain-induced corticomotor modulation in healthy participants: a cross sectional study. Neurophysiol Clin, 2022, 52(5): 375-383.

West China Medical Journal

Potential categories and influencing factors of kinesiophobia trajectories in patients after total hip arthroplasty

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