Determining the Factors Affecting Fear of Movement in Patients Undergoing Total Knee Replacement
Abstract
Objective: Total knee replacement (TKR) negatively affects the recovery process because TKR patients avoid movement and have difficulty meeting their needs. Therefore, the aim of this study is to determine the level of fear of movement and affecting factors in patients undergoing total knee replacement surgery according to the surgery period.
Methods: The sample consisted of 150 TKR patients at a university hospital. Data were collected by using a questionnaire including sociodemographic characteristics developed by the researcher, Lysholm Knee Scoring Scale, Barthel Daily Living Activities Index, Numeric Rating Scale and Tampa Kinesiophobia Scale. Data were collected three times using the Tampa Scale of Kinesiophobia (TSK) (1) before surgery, (2) one day after surgery, and (3) three weeks after discharge. The data were analyzed using independent samples t-test, analysis of variance (ANOVA), Tukey, Tamhane, Mann-Whitney U, Kruskal-Wallis H tests, and Bonferroni correction. The statistical significance level of the study is indicated as p<0.05.
Results: Participants had a mean TSK score of 44.05±6.24, 45.54±7.05, and 42.79±8.15 before surgery, one day after surgery, and three weeks after discharge, respectively. Most participants needed help with their activities of daily living after surgery (89.3%). More than three-quarters of the participants avoided movement due to postoperative pain (78.7%). Participants who did not exercise after discharge (1,99±1,66) had higher pain levels (p=0,010) than those who did (1,32±1,38). Participants who exercised regularly (38,12±7,58) had less fear of movement (p=0,000) than those who did not (45,90±6,97).
Conclusion: Post-TKR pain and fear of movement cause patients to avoid moving, which negatively affects the recovery process. Patients who exercise regularly recover more quickly. Therefore, it is important to identify the factors affecting fear of movement in TKR patients.
Keywords
total knee replacement, movement, activities of daily living, pain, orthopedic nursing
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