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The effects of kinesiophobia on outcome following total knee replacement: a systematic review.

Brown, OS; Hu, L; Demetriou, C; Smith, TO; Hing, CB (2020) The effects of kinesiophobia on outcome following total knee replacement: a systematic review. Arch Orthop Trauma Surg, 140 (12). pp. 2057-2070. ISSN 1434-3916 https://doi.org/10.1007/s00402-020-03582-5
SGUL Authors: Hing, Caroline Blanca

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Abstract

INTRODUCTION: Kinesiophobia, the fear of physical movement and activity related to injury vulnerability, has been linked to sub-optimal outcomes following total knee replacement (TKR). This systematic review has two aims: to define the relationship between kinesiophobia and functional outcomes, pain and range of motion following TKR, and to evaluate published treatments for kinesiophobia following TKR. MATERIALS AND METHODS: A primary search of electronic databases, grey literature, and trial registries was performed in March 2020. English-language studies recruiting adult primary TKR patients, using the Tampa Scale of Kinesiophobia (TSK) were included. Outcome measures were grouped into short (< 6 months), medium (6-12 months), and long term (> 12 months). Study quality was assessed using the Newcastle Ottawa Scale for cohort or case control studies, and the Cochrane Collaboration Risk of Bias tool for randomised controlled trials. RESULTS: All thirteen included papers (82 identified) showed adequately low risk of methodological bias. TSK1 (activity avoidance) correlated with WOMAC functional score at 12 months in three studies (r = 0.20 p < 0.05, R = 0.317 p = 0.001, and correlation coefficient 0.197 p = 0.005). TSK score significantly correlated with mean active range of motion (ROM) at 2 weeks [65.98 (SD = 14.51) versus 47.35 (SD = 14.48) p = 0.000], 4 weeks [88.20 (SD = 15.11) versus 57.65 (SD = 14.80) p = 0.000], and 6 months [105.33 (SD = 12.34) versus 85.53 (SD = 14.77) p = 0.000] post-operation. Three post-operative interventions improved TSK score vs control following TKR: a home-based functional exercise programme [TSK - 14.30 (SD = 0.80) versus - 2.10 (SD = 0.80) p < 0.001], an outpatient cognitive behavioural therapy (CBT) programme [TSK 27.76 (SD = 4.56) versus 36.54 (SD = 3.58)], and video-based psychological treatment [TSK 24 (SD = 5) versus 29 (SD = 5) p < 0.01]. CONCLUSIONS: Kinesiophobia negatively affects functional outcomes up until 1 year post-operatively, while active ROM is reduced up to 6 months post-procedure. Post-operative functional and psychological interventions can improve kinesiophobia following TKR.

Item Type: Article
Additional Information: © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Keywords: Kinesiophobia, Outcomes, Systematic review, TKR, Treatments, Arthroplasty, Replacement, Knee, Case-Control Studies, Cognitive Behavioral Therapy, Cohort Studies, Exercise Therapy, Fear, Humans, Movement, Osteoarthritis, Knee, Pain, Pain Measurement, Phobic Disorders, Psychotherapy, Range of Motion, Articular, Humans, Osteoarthritis, Knee, Pain, Pain Measurement, Range of Motion, Articular, Exercise Therapy, Arthroplasty, Replacement, Knee, Case-Control Studies, Cohort Studies, Fear, Phobic Disorders, Psychotherapy, Movement, Cognitive Behavioral Therapy, Kinesiophobia, TKR, Outcomes, Treatments, Systematic review, Kinesiophobia, Outcomes, Systematic review, TKR, Treatments, 1103 Clinical Sciences, Orthopedics
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Arch Orthop Trauma Surg
ISSN: 1434-3916
Language: eng
Dates:
DateEvent
December 2020Published
24 August 2020Published Online
16 August 2020Accepted
Publisher License: Publisher's own licence
PubMed ID: 32839826
Web of Science ID: WOS:000562327000001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113157
Publisher's version: https://doi.org/10.1007/s00402-020-03582-5

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