Relationship between postoperative kinesiophobia and functional recovery in patients with lumbar disc herniation_West China Medical Journal

Authors：

PU Xingcui ¹ , CHEN Jiali ¹ ,  NING Ning ¹ , ZENG Jiancheng ² , SONG Yueming ² , LI Peifang ¹ , LI Ye ¹

1. Department of Orthopedics, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

NING Ning, Email: gkningning@126.cn

Keywords：

Lumbar disc herniation; postoperative; kinesiophobia; rehabilitation

DOI：

10.7507/1002-0179.202207128

Video：

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Objective To explore the correlation between postoperative kinesiophobia and rehabilitation outcome in patients with lumbar disc herniation (LDH). Methods This study was a cross-sectional survey. The patients who underwent lumbar discectomy due to LDH in West China Hospital of Sichuan University between June and October 2019 were included consecutively. According to the Tampa Scale for Kinesiophobia (TSK) score, patients were divided into two groups: the kinesiophobia group and the non-kinesiophobia group. The patients’ scores of the TSK, the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), and the Japanese Orthopaedic Association Scores (JOA) at different time points were collected. The relationship between postoperative kinesiophobia, pain, and lumbar function in patients was analyzed. Results A total of 201 patients were included. Among them, there were 128 cases in the kinesiophobia group and 73 cases in the non-kinesiophobia group. The incidence of kinesiophobia was 63.68%. Pearson correlation test analysis showed that TSK score was positively correlated with VAS score (r=0.218, P<0.01) and ODI score (r=0.263, P<0.01) at 24 h after surgery. At one month after surgery, there was a positive correlation with VAS score (r=0.296, P<0.01) and a negative correlation with JOA score (r=?0.182, P<0.05). The results of multiple linear regression showed that postoperative age, pain, lumbar function, and postoperative kinesiophobia were interrelated (P<0.05). Conclusions Patients with LDH had a higher incidence of kinesiophobia 24 h after surgery. Postoperative kinesiophobia was correlated with the recovery outcome of patients with LDH.

Citation： PU Xingcui, CHEN Jiali, NING Ning, ZENG Jiancheng, SONG Yueming, LI Peifang, LI Ye. Relationship between postoperative kinesiophobia and functional recovery in patients with lumbar disc herniation. West China Medical Journal, 2023, 38(6): 870-877. doi: 10.7507/1002-0179.202207128 Copy

1.	郭愛敏, 周蘭姝. 成人護理學. 3 版. 北京: 人民衛生出版社, 2017.
2.	Vialle LR, Wang JC, Lamartina C. 腰背痛. 海涵, 鄭召民, 譯. 濟南: 山東科學技術出版社, 2019: 3.
3.	王銀浩, 王翠. 腰椎間盤突出癥患者術后康復的研究進展. 中國康復理論與實踐, 2019, 25(4): 401-406.
4.	潘俊杰, 陳鈺琳, 王兵, 等. 經皮椎間孔鏡治療腰椎間盤突出癥的系統評價. 中國疼痛醫學雜志, 2019, 25(11): 866-870.
5.	唐沖, 劉正, 吳四軍, 等. 斜外側腰椎椎間融合術治療腰椎退行性疾病療效的 meta 分析. 中華骨科雜志, 2019, 39(21): 1320-1332.
6.	李星鳳, 熊鈺. 腰椎間盤突出癥患者疼痛相關心理與生活質量的研究進展. 國際護理學雜志, 2016, 35(6): 724-728.
7.	Kori SH, Miller RP, Todd DD. Kinesiophobia: a new view of chronic pain behavior. Pain Management, 1990, 3: 35-43.
8.	胡文. 簡體中文版 TSK 和 FABQ 量表的文化調適及其在退行性腰腿痛中的應用研究. 上海: 中國人民解放軍海軍軍醫大學, 2012.
9.	Gregg CD, McIntosh G, Hall H, et al. The relationship between the Tampa Scale of Kinesiophobia and low back pain rehabilitation outcomes. Spine J, 2015, 15(12): 2466-2471.
10.	中華醫學會骨科學分會脊柱外科學組, 中華醫學會骨科學分會骨科康復學組. 腰椎間盤突出癥診療指南. 中華骨科雜志, 2020, 40(8): 477-487.
11.	Jairath V, Feagan BG. Global burden of inflammatory bowel disease. Lancet Gastroenterol Hepatol, 2020, 5(1): 2-3.
12.	潘麗, 史寶欣. 慢性腰痛患者恐動癥現狀及其影響因素研究. 中國全科醫學, 2019, 22(8): 978-982.
13.	Svensson GL, Lundberg M, Ostgaard HC, et al. High degree of kinesiophobia after lumbar disc herniation surgery: a cross-sectional study of 84 patients. Acta Orthop, 2011, 82(6): 732-736.
14.	Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med, 2019, 53(9): 554-559.
15.	宋瑩瑩, 張嵐, 梁瑛琳, 等. 慢性下腰痛患者恐動癥的研究進展. 護理管理雜志, 2018, 18(8): 572-575.
16.	肖順貞. 臨床科研設計. 北京: 北京大學醫學出版社, 2008: 151.
17.	Roelofs J, van Breukelen G, Sluiter J, et al. Norming of the Tampa Scale for Kinesiophobia across pain diagnoses and various countries. Pain, 2011, 152(5): 1090-1095.
18.	汪敏, 吳建賢. 腰痛與心理社會因素的相關研究現狀. 中國康復醫學雜志, 2009, 24(5): 473-475.
19.	鄭光新, 趙曉鷗, 劉廣林, 等. Oswestry 功能障礙指數評定腰痛患者的可信性. 中國脊柱脊髓雜志, 2002(1): 13-15.
20.	劉綺, 麥明泉, 肖靈君, 等. 中文版 Oswestry 功能障礙指數評定慢性腰痛患者的反應度研究. 中國康復醫學雜志, 2010, 25(7): 621-624.
21.	Fujimori T, Okuda S, Iwasaki M, et al. Validity of the Japanese orthopaedic association scoring system based on patient-reported improvement after posterior lumbar interbody fusion. Spine J, 2016, 16(6): 728-736.
22.	宋瑩瑩, 張嵐, 梁瑛琳, 等. 腰椎間盤突出癥患者術后恐動癥現狀及影響因素分析. 東南國防醫藥, 2019, 21(2): 205-207.
23.	Stensland ML, Sanders S. Not so golden after all: the complexities of chronic low back pain in older adulthood. Gerontologist, 2018, 58(5): 923-931.
24.	Misterska E, Jankowski R, G?owacki J, et al. Kinesiophobia in pre-operative patients with cervical discopathy and coexisting degenerative changes in relation to pain-related variables, psychological state and sports activity. Med Sci Monit, 2015, 21: 181-194.
25.	Brunetti ND, Guerra A, Ieva R, et al. Scared for the scar: fearsome impact of acute cardiovascular disease on perceived kinesiophobia (fear of movement). Clin Cardiol, 2017, 40(7): 480-484.
26.	Cook AJ, Brawer PA, Vowles KE. The fear-avoidance model of chronic pain: validation and age analysis using structural equation modeling. Pain, 2006, 121(3): 195-206.
27.	Gunn AH, Schwartz TA, Arbeeva LS, et al. Fear of movement and associated factors among adults with symptomatic knee osteoarthritis. Arthritis Care Res (Hoboken), 2017, 69(12): 1826-1833.
28.	Esteve R, Marquina-Aponte V, Ramírez-Maestre C. Postoperative pain in children: association between anxiety sensitivity, pain catastrophizing, and female caregivers’ responses to children’s pain. J Pain, 2014, 15(2): 157-168.e1.
29.	劉禮鋒, 萬凌峰, 孟齊生, 等. 外科手術后疼痛與年齡、性別間的相關性分析. 浙江創傷外科, 2018, 23(2): 233-234.
30.	Ahlstrand I, Vaz S, Falkmer T, et al. Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis. Clin Rehabil, 2017, 31(6): 824-834.
31.	Fagevik Olsén M, Slobo M, Klarin L, et al. Physical function and pain after surgical or conservative management of multiple rib fractures-a follow-up study. Scand J Trauma Resusc Emerg Med, 2016, 24(1): 128.
32.	中國康復技術轉化及發展促進會骨科加速康復專業委員會脊柱微創加速康復學組. 經皮內鏡椎板間入路腰椎管減壓椎間盤切除術加速康復專家共識 (2020). 中國修復重建外科雜志, 2020, 34(12): 1497-1506.
33.	陳佳麗, 寧寧, 屈俊宏, 等. 骨科加速康復外科新視角. 華西醫學, 2018, 33(9): 1068-1072.
34.	郜鑫, 吳菁, 吳紅. 骨科術后患者恐動癥與疼痛災難化、情緒狀態的相關性研究. 華南國防醫學雜志, 2021, 35(8): 584-588.
35.	雷小平, 李勇, 晁建虎, 等. 腰椎穩定性與腰背肌退變的相關性分析. 中國綜合臨床, 2015, 35(11): 1029-1031.
36.	黃少敏, 龍仕杰, 李衛偉. 核心肌群穩定訓練與傳統腰背肌鍛煉治療腰椎間盤突出癥的療效對比研究. 中國實用醫藥, 2019, 14(35): 197-198.

1. 郭愛敏, 周蘭姝. 成人護理學. 3 版. 北京: 人民衛生出版社, 2017.
2. Vialle LR, Wang JC, Lamartina C. 腰背痛. 海涵, 鄭召民, 譯. 濟南: 山東科學技術出版社, 2019: 3.
3. 王銀浩, 王翠. 腰椎間盤突出癥患者術后康復的研究進展. 中國康復理論與實踐, 2019, 25(4): 401-406.
4. 潘俊杰, 陳鈺琳, 王兵, 等. 經皮椎間孔鏡治療腰椎間盤突出癥的系統評價. 中國疼痛醫學雜志, 2019, 25(11): 866-870.
5. 唐沖, 劉正, 吳四軍, 等. 斜外側腰椎椎間融合術治療腰椎退行性疾病療效的 meta 分析. 中華骨科雜志, 2019, 39(21): 1320-1332.
6. 李星鳳, 熊鈺. 腰椎間盤突出癥患者疼痛相關心理與生活質量的研究進展. 國際護理學雜志, 2016, 35(6): 724-728.
7. Kori SH, Miller RP, Todd DD. Kinesiophobia: a new view of chronic pain behavior. Pain Management, 1990, 3: 35-43.
8. 胡文. 簡體中文版 TSK 和 FABQ 量表的文化調適及其在退行性腰腿痛中的應用研究. 上海: 中國人民解放軍海軍軍醫大學, 2012.
9. Gregg CD, McIntosh G, Hall H, et al. The relationship between the Tampa Scale of Kinesiophobia and low back pain rehabilitation outcomes. Spine J, 2015, 15(12): 2466-2471.
10. 中華醫學會骨科學分會脊柱外科學組, 中華醫學會骨科學分會骨科康復學組. 腰椎間盤突出癥診療指南. 中華骨科雜志, 2020, 40(8): 477-487.
11. Jairath V, Feagan BG. Global burden of inflammatory bowel disease. Lancet Gastroenterol Hepatol, 2020, 5(1): 2-3.
12. 潘麗, 史寶欣. 慢性腰痛患者恐動癥現狀及其影響因素研究. 中國全科醫學, 2019, 22(8): 978-982.
13. Svensson GL, Lundberg M, Ostgaard HC, et al. High degree of kinesiophobia after lumbar disc herniation surgery: a cross-sectional study of 84 patients. Acta Orthop, 2011, 82(6): 732-736.
14. Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med, 2019, 53(9): 554-559.
15. 宋瑩瑩, 張嵐, 梁瑛琳, 等. 慢性下腰痛患者恐動癥的研究進展. 護理管理雜志, 2018, 18(8): 572-575.
16. 肖順貞. 臨床科研設計. 北京: 北京大學醫學出版社, 2008: 151.
17. Roelofs J, van Breukelen G, Sluiter J, et al. Norming of the Tampa Scale for Kinesiophobia across pain diagnoses and various countries. Pain, 2011, 152(5): 1090-1095.
18. 汪敏, 吳建賢. 腰痛與心理社會因素的相關研究現狀. 中國康復醫學雜志, 2009, 24(5): 473-475.
19. 鄭光新, 趙曉鷗, 劉廣林, 等. Oswestry 功能障礙指數評定腰痛患者的可信性. 中國脊柱脊髓雜志, 2002(1): 13-15.
20. 劉綺, 麥明泉, 肖靈君, 等. 中文版 Oswestry 功能障礙指數評定慢性腰痛患者的反應度研究. 中國康復醫學雜志, 2010, 25(7): 621-624.
21. Fujimori T, Okuda S, Iwasaki M, et al. Validity of the Japanese orthopaedic association scoring system based on patient-reported improvement after posterior lumbar interbody fusion. Spine J, 2016, 16(6): 728-736.
22. 宋瑩瑩, 張嵐, 梁瑛琳, 等. 腰椎間盤突出癥患者術后恐動癥現狀及影響因素分析. 東南國防醫藥, 2019, 21(2): 205-207.
23. Stensland ML, Sanders S. Not so golden after all: the complexities of chronic low back pain in older adulthood. Gerontologist, 2018, 58(5): 923-931.
24. Misterska E, Jankowski R, G?owacki J, et al. Kinesiophobia in pre-operative patients with cervical discopathy and coexisting degenerative changes in relation to pain-related variables, psychological state and sports activity. Med Sci Monit, 2015, 21: 181-194.
25. Brunetti ND, Guerra A, Ieva R, et al. Scared for the scar: fearsome impact of acute cardiovascular disease on perceived kinesiophobia (fear of movement). Clin Cardiol, 2017, 40(7): 480-484.
26. Cook AJ, Brawer PA, Vowles KE. The fear-avoidance model of chronic pain: validation and age analysis using structural equation modeling. Pain, 2006, 121(3): 195-206.
27. Gunn AH, Schwartz TA, Arbeeva LS, et al. Fear of movement and associated factors among adults with symptomatic knee osteoarthritis. Arthritis Care Res (Hoboken), 2017, 69(12): 1826-1833.
28. Esteve R, Marquina-Aponte V, Ramírez-Maestre C. Postoperative pain in children: association between anxiety sensitivity, pain catastrophizing, and female caregivers’ responses to children’s pain. J Pain, 2014, 15(2): 157-168.e1.
29. 劉禮鋒, 萬凌峰, 孟齊生, 等. 外科手術后疼痛與年齡、性別間的相關性分析. 浙江創傷外科, 2018, 23(2): 233-234.
30. Ahlstrand I, Vaz S, Falkmer T, et al. Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis. Clin Rehabil, 2017, 31(6): 824-834.
31. Fagevik Olsén M, Slobo M, Klarin L, et al. Physical function and pain after surgical or conservative management of multiple rib fractures-a follow-up study. Scand J Trauma Resusc Emerg Med, 2016, 24(1): 128.
32. 中國康復技術轉化及發展促進會骨科加速康復專業委員會脊柱微創加速康復學組. 經皮內鏡椎板間入路腰椎管減壓椎間盤切除術加速康復專家共識 (2020). 中國修復重建外科雜志, 2020, 34(12): 1497-1506.
33. 陳佳麗, 寧寧, 屈俊宏, 等. 骨科加速康復外科新視角. 華西醫學, 2018, 33(9): 1068-1072.
34. 郜鑫, 吳菁, 吳紅. 骨科術后患者恐動癥與疼痛災難化、情緒狀態的相關性研究. 華南國防醫學雜志, 2021, 35(8): 584-588.
35. 雷小平, 李勇, 晁建虎, 等. 腰椎穩定性與腰背肌退變的相關性分析. 中國綜合臨床, 2015, 35(11): 1029-1031.
36. 黃少敏, 龍仕杰, 李衛偉. 核心肌群穩定訓練與傳統腰背肌鍛煉治療腰椎間盤突出癥的療效對比研究. 中國實用醫藥, 2019, 14(35): 197-198.

West China Medical Journal

Relationship between postoperative kinesiophobia and functional recovery in patients with lumbar disc herniation

Abstract Full text Figures/Tables Video References Cited by

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