Study on the impact of kinesiophobia after Total knee replacement on the rehabilitation of patients during hospitalization

Abstract Objective:This study aims to investigate the influence of kinesiophobia on the rehabilitation outcomes of patients undergoing knee replacement surgery during their hospital stay. Methods:The study conveniently selected patients who underwent unilateral knee replacement at a tertiary hospital in Baoding City between June 2021 and December 2021.A self-designed questionnaire was utilized to gather data on the patients' general demographic and disease information, while the Tampa Scale for Kinesiophobia (TSK) was employed to identify postoperative kinesiophobia. Out of the total sample, 33 patients scored above 37 points on the TSK, while 35 patients scored 37 points or below.The Numerical Rating Scale (NRS) was utilized to assess pain levels in two groups of patients at various time points post-surgery: upon returning to the ward after surgery (T1), the first day after surgery (T2), the second day after surgery (T3), the third day after surgery (T4), resting pain in the knee joint on the fifth postoperative day (T5), and on the day of discharge (T6). The flexion of the knee joint was measured in two groups of patients on the first postoperative day (T1*), the third postoperative day (T2*), the fifth postoperative day (T3*), and the day of discharge (T4*).The first time out of bed activities of the two groups of patients were compared, along with the results of the 2-Minute Walk Test (2-MWT) on the day of discharge and the postoperative hospital stay. Results:The pain scores of patients in the kinesiophobia group were consistently higher than those in the non-kinesiphobia group at all time points (P<0.05). There were observed time effect, Between-group effects, and interaction effects (P<0.05). Additionally, the active knee flexion of patients in the kinesiphobia group was found to be smaller compared to the non-kinesiophobia group at each time point (P<0.05), There were observed time effect, Between-group effects, and interaction effects (P<0.05). Patients in the kinesiophobia group also exhibited delayed time to first get out of bed, shorter activity time and distance, as well as higher pain scores during activities, in comparison to those in the non-kinesiophobia group (P<0.05). Furthermore, patients with kinesiophobia walked shorter distances in the 2-minute walk test on the day of discharge and had longer hospitalization times than their non-kinesiophobia counterparts (P<0.05). Conclusion:Kinesiophobia following knee replacement surgery has a significant impact on the rehabilitation outcomes of patients while they are hospitalized. It is important for healthcare professionals to promptly recognize and address this issue in order to enhance the rehabilitation progress of these patients during their hospital stay.