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：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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.	郭爱敏, 周兰姝. 成人护理学. 3 版. 北京: 人民卫生出版社, 2017.
2.	Vialle LR, Wang JC, Lamartina C. 腰背痛. 海涵, 郑召民, 译. 济南: 山东科学技术出版社, 2019: 3.
3.	王银浩, 王翠. 腰椎间盘突出症患者术后康复的研究进展. 中国康复理论与实践, 2019, 25(4): 401-406.
4.	潘俊杰, 陈钰琳, 王兵, 等. 经皮椎间孔镜治疗腰椎间盘突出症的系统评价. 中国疼痛医学杂志, 2019, 25(11): 866-870.
5.	唐冲, 刘正, 吴四军, 等. 斜外侧腰椎椎间融合术治疗腰椎退行性疾病疗效的 meta 分析. 中华骨科杂志, 2019, 39(21): 1320-1332.
6.	李星凤, 熊钰. 腰椎间盘突出症患者疼痛相关心理与生活质量的研究进展. 国际护理学杂志, 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. 简体中文版 TSK 和 FABQ 量表的文化调适及其在退行性腰腿痛中的应用研究. 上海: 中国人民解放军海军军医大学, 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.	中华医学会骨科学分会脊柱外科学组, 中华医学会骨科学分会骨科康复学组. 腰椎间盘突出症诊疗指南. 中华骨科杂志, 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.	潘丽, 史宝欣. 慢性腰痛患者恐动症现状及其影响因素研究. 中国全科医学, 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.	宋莹莹, 张岚, 梁瑛琳, 等. 慢性下腰痛患者恐动症的研究进展. 护理管理杂志, 2018, 18(8): 572-575.
16.	肖顺贞. 临床科研设计. 北京: 北京大学医学出版社, 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, 吴建贤. 腰痛与心理社会因素的相关研究现状. 中国康复医学杂志, 2009, 24(5): 473-475.
19.	郑光新, 赵晓鸥, 刘广林, 等. Oswestry 功能障碍指数评定腰痛患者的可信性. 中国脊柱脊髓杂志, 2002(1): 13-15.
20.	刘绮, 麦明泉, 肖灵君, 等. 中文版 Oswestry 功能障碍指数评定慢性腰痛患者的反应度研究. 中国康复医学杂志, 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.	宋莹莹, 张岚, 梁瑛琳, 等. 腰椎间盘突出症患者术后恐动症现状及影响因素分析. 东南国防医药, 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, Głowacki 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.	刘礼锋, 万凌峰, 孟齐生, 等. 外科手术后疼痛与年龄、性别间的相关性分析. 浙江创伤外科, 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.	中国康复技术转化及发展促进会骨科加速康复专业委员会脊柱微创加速康复学组. 经皮内镜椎板间入路腰椎管减压椎间盘切除术加速康复专家共识 (2020). 中国修复重建外科杂志, 2020, 34(12): 1497-1506.
33.	陈佳丽, 宁宁, 屈俊宏, 等. 骨科加速康复外科新视角. 华西医学, 2018, 33(9): 1068-1072.
34.	郜鑫, 吴菁, 吴红. 骨科术后患者恐动症与疼痛灾难化、情绪状态的相关性研究. 华南国防医学杂志, 2021, 35(8): 584-588.
35.	雷小平, 李勇, 晁建虎, 等. 腰椎稳定性与腰背肌退变的相关性分析. 中国综合临床, 2015, 35(11): 1029-1031.
36.	黄少敏, 龙仕杰, 李卫伟. 核心肌群稳定训练与传统腰背肌锻炼治疗腰椎间盘突出症的疗效对比研究. 中国实用医药, 2019, 14(35): 197-198.

1. 郭爱敏, 周兰姝. 成人护理学. 3 版. 北京: 人民卫生出版社, 2017.
2. Vialle LR, Wang JC, Lamartina C. 腰背痛. 海涵, 郑召民, 译. 济南: 山东科学技术出版社, 2019: 3.
3. 王银浩, 王翠. 腰椎间盘突出症患者术后康复的研究进展. 中国康复理论与实践, 2019, 25(4): 401-406.
4. 潘俊杰, 陈钰琳, 王兵, 等. 经皮椎间孔镜治疗腰椎间盘突出症的系统评价. 中国疼痛医学杂志, 2019, 25(11): 866-870.
5. 唐冲, 刘正, 吴四军, 等. 斜外侧腰椎椎间融合术治疗腰椎退行性疾病疗效的 meta 分析. 中华骨科杂志, 2019, 39(21): 1320-1332.
6. 李星凤, 熊钰. 腰椎间盘突出症患者疼痛相关心理与生活质量的研究进展. 国际护理学杂志, 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. 简体中文版 TSK 和 FABQ 量表的文化调适及其在退行性腰腿痛中的应用研究. 上海: 中国人民解放军海军军医大学, 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. 中华医学会骨科学分会脊柱外科学组, 中华医学会骨科学分会骨科康复学组. 腰椎间盘突出症诊疗指南. 中华骨科杂志, 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. 潘丽, 史宝欣. 慢性腰痛患者恐动症现状及其影响因素研究. 中国全科医学, 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. 宋莹莹, 张岚, 梁瑛琳, 等. 慢性下腰痛患者恐动症的研究进展. 护理管理杂志, 2018, 18(8): 572-575.
16. 肖顺贞. 临床科研设计. 北京: 北京大学医学出版社, 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, 吴建贤. 腰痛与心理社会因素的相关研究现状. 中国康复医学杂志, 2009, 24(5): 473-475.
19. 郑光新, 赵晓鸥, 刘广林, 等. Oswestry 功能障碍指数评定腰痛患者的可信性. 中国脊柱脊髓杂志, 2002(1): 13-15.
20. 刘绮, 麦明泉, 肖灵君, 等. 中文版 Oswestry 功能障碍指数评定慢性腰痛患者的反应度研究. 中国康复医学杂志, 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. 宋莹莹, 张岚, 梁瑛琳, 等. 腰椎间盘突出症患者术后恐动症现状及影响因素分析. 东南国防医药, 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, Głowacki 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. 刘礼锋, 万凌峰, 孟齐生, 等. 外科手术后疼痛与年龄、性别间的相关性分析. 浙江创伤外科, 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. 中国康复技术转化及发展促进会骨科加速康复专业委员会脊柱微创加速康复学组. 经皮内镜椎板间入路腰椎管减压椎间盘切除术加速康复专家共识 (2020). 中国修复重建外科杂志, 2020, 34(12): 1497-1506.
33. 陈佳丽, 宁宁, 屈俊宏, 等. 骨科加速康复外科新视角. 华西医学, 2018, 33(9): 1068-1072.
34. 郜鑫, 吴菁, 吴红. 骨科术后患者恐动症与疼痛灾难化、情绪状态的相关性研究. 华南国防医学杂志, 2021, 35(8): 584-588.
35. 雷小平, 李勇, 晁建虎, 等. 腰椎稳定性与腰背肌退变的相关性分析. 中国综合临床, 2015, 35(11): 1029-1031.
36. 黄少敏, 龙仕杰, 李卫伟. 核心肌群稳定训练与传统腰背肌锻炼治疗腰椎间盘突出症的疗效对比研究. 中国实用医药, 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

Previous Article

Next Article

Format

Content