Summary

Kinesiophobia results in poorer functional outcomes after ACL reconstruction in an Asian non-athlete population

Abstract

Introduction

Kinesiophobia is the irrational and excessive fear of movement. This study aims to investigate the prevalence of kinesiophobia and its effect on functional outcomes after ACLR in an Asian, non-athlete population. The secondary aims are to assess factors associated with high levels of kinesiophobia.

Methods

A retrospective database review of all patients who underwent ACLR from a single institution between January 2019 and June 2023. Professional athletes, patients with psychological illness, multi-ligamentous injuries or revision ACLR were excluded. Kinesiophobia was measured using the Tampa Scale of Kinesiophobia-17 questionnaire (TSK-17) at baseline, 1 and 2-years post-surgery. High levels of kinesiophobia were defined as a score ≥ 37. Functional outcomes were determined using the International Knee Documentation Committee (IKDC) score at the same time points. Patient demographics, physiotherapy session details and intra-operative concomitant injuries were collected.

Results

A total of 122 patients were included. There was a high prevalence (58%) of elevated kinesiophobia at baseline. Patients with high Kinesiophobia had significantly worse IKDC scores at 1 year (56.2±11.7 vs 67.1±9.6, p<0.05) and 2 years (60.2±12.6 vs 71.7±7.2, p<0.05) postoperatively. Concomitant injuries and compliance to physiotherapy did not affect kinesiophobia levels. Time post-ACLR was significantly associated with reduced kinesiophobia levels, with mean TSK-17 falling from 38.4±5.5 at baseline to 32.5 ±7.3 at 1 year and 30.5 ±8.3 at 2 years (P<0.001).

Conclusion

There is a high prevalence of elevated kinesiophobia in our non-athlete, Asian population after ACL injury. Persistence of elevated kinesiophobia significantly worsens post-ACLR functional outcome at 1 and 2-years post-surgery.