Ruth L Chimenti1, Molly S Pacha1, Natalie A Glass2, Mathew Frazier3, Amy O Bowles4, Andrew D Valantine5, Kristin R Archer6, Jason M Wilken1. 1. Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa, USA. 2. Department of Orthopedics and Rehabilitation, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA. 3. Carl R. Darnall Army Medical Center, Department of Rehabilitation and Physical Therapy Clinic, Fort Hood, Texas, USA. 4. Brain Injury Rehabilitation Service, Department of Rehabilitation Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas, USA. 5. Intrepid Spirit TBI Clinic, NICoE Informatics Team, Fort Hood, Texas, USA. 6. Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Abstract
OBJECTIVE: The purpose of this study was to examine associations between level of kinesiophobia and improvement in physical function during recovery from lower extremity injury. METHODS: A total 430 adults (mean [SD]: age = 27.3 [6.4] years; sex = 70.5% men; body mass index = 27.6 [5.2] kg/m2) were included in the analyses. Using the Patient-Reported Outcomes Measurement Information System, physical function was evaluated in parallel with treatment from a physical therapist at the initial visit and every 3 weeks until final visit or up to 6 months. A Tampa Scale of Kinesiophobia (TSK-17) score of >41 indicated elevated TSK. Four TSK groups were identified: (1) TSK score improved from >41 at initial visit to <41 by final visit (TSK_I), (2) TSK score was <41 at initial and final visits (TSK-), (3) TSK score was >41 at initial and final visits (TSK+), and (4) TSK score worsened from <41 at initial visit to ≥41 by final visit (TSK_W). Linear mixed effects models were used to examine differences between groups in improved physical function over time, with adjustment for depression and self-efficacy. RESULTS: Groups with elevated kinesiophobia at the final visit had smaller positive improvements in physical function (mean change [95% CI]: TSK+ = 7.1 [4.8-9.4]; TSK_W: 6.0 [2.6-9.4]) compared with groups without elevated kinesiophobia at the final visit (TSK_I = 9.8 [6.4-13.3]; TSK- = 9.7 [8.1-11.3]) by 12 weeks. CONCLUSIONS: Elevated kinesiophobia that persists or develops over the course of care is associated with less improvement in physical function within military and civilian cohorts. IMPACT: The findings of this prospective longitudinal study support the need to assess for elevated kinesiophobia throughout the course of care because of its association with decreased improvement in physical function. LAY SUMMARY: To help improve your physical function, your physical therapist can monitor the interaction between fear of movement and your clinical outcomes over the course of treatment.
OBJECTIVE: The purpose of this study was to examine associations between level of kinesiophobia and improvement in physical function during recovery from lower extremity injury. METHODS: A total 430 adults (mean [SD]: age = 27.3 [6.4] years; sex = 70.5% men; body mass index = 27.6 [5.2] kg/m2) were included in the analyses. Using the Patient-Reported Outcomes Measurement Information System, physical function was evaluated in parallel with treatment from a physical therapist at the initial visit and every 3 weeks until final visit or up to 6 months. A Tampa Scale of Kinesiophobia (TSK-17) score of >41 indicated elevated TSK. Four TSK groups were identified: (1) TSK score improved from >41 at initial visit to <41 by final visit (TSK_I), (2) TSK score was <41 at initial and final visits (TSK-), (3) TSK score was >41 at initial and final visits (TSK+), and (4) TSK score worsened from <41 at initial visit to ≥41 by final visit (TSK_W). Linear mixed effects models were used to examine differences between groups in improved physical function over time, with adjustment for depression and self-efficacy. RESULTS: Groups with elevated kinesiophobia at the final visit had smaller positive improvements in physical function (mean change [95% CI]: TSK+ = 7.1 [4.8-9.4]; TSK_W: 6.0 [2.6-9.4]) compared with groups without elevated kinesiophobia at the final visit (TSK_I = 9.8 [6.4-13.3]; TSK- = 9.7 [8.1-11.3]) by 12 weeks. CONCLUSIONS: Elevated kinesiophobia that persists or develops over the course of care is associated with less improvement in physical function within military and civilian cohorts. IMPACT: The findings of this prospective longitudinal study support the need to assess for elevated kinesiophobia throughout the course of care because of its association with decreased improvement in physical function. LAY SUMMARY: To help improve your physical function, your physical therapist can monitor the interaction between fear of movement and your clinical outcomes over the course of treatment.
Authors: Ibai López-de-Uralde-Villanueva; Ricardo Notario-Pérez; Tamara Del Corral; Bernardo Ramos-Díaz; Mario Acuyo-Osorio; Roy La Touche Journal: Work Date: 2017
Authors: Petteri Koho; Tage Orenius; Hannu Kautiainen; Maija Haanpää; Timo Pohjolainen; Heikki Hurri Journal: J Rehabil Med Date: 2011-09 Impact factor: 2.912