Unraveling the impact of kinesiophobia on proprioception and balance: Mediation by pain, mobility, and psychological wellbeing in post-total hip replacement recovery

• Published in: PloS one 2024-12, Vol.19 (12), p.e0314627
• Main Authors: Alshehri, Shaker Hassan S, Reddy, Ravi Shankar, Alshahrani, Mastour Saeed, Alnakhli, Hani Hassan, Gautam, Ajay Prashad, ALMohiza, Mohammad A, Alyami, Abdullah Mohammed, Al Adal, Saeed Y, Dixit, Snehil, Alyazedi, Faisal M
• Format: Article
• Language: English
• Subjects: Aged; Analysis; Arthroplasty, Replacement, Hip - psychology; Asymptomatic; Balance; Biology and Life Sciences; Biomedical materials; Cardiovascular disease; Care and treatment; Cognitive ability; Comorbidity; Complications and side effects; Cross-Sectional Studies; Diabetes; Fear - psychology; Female; Health aspects; Humans; Inclinometers; Injuries; Kinesiophobia; Male; Mediation; Medicine and Health Sciences; Middle Aged; Mobility; Observational studies; Older people; Orthopedics; Osteoarthritis; Outpatient care facilities; Pain; Pain - physiopathology; Pain - psychology; Phobic Disorders - physiopathology; Phobic Disorders - psychology; Postural Balance - physiology; Proprioception; Proprioception - physiology; Psychological factors; Quality of life; Recovery; Rehabilitation; Social Sciences; Stability analysis; Surgery; Total hip arthroplasty; Well being
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0314627

This study aimed to investigate the relationships between kinesiophobia, proprioception, and limits of stability in elderly individuals post-THR. Specifically, it sought to assess the direct and indirect effects of kinesiophobia on proprioception through mediating factors such as pain intensity, functional mobility, and psychological well-being. A cross-sectional observational study was conducted with 100 participants (50 post-THR patients and 50 asymptomatic elderly controls) at King Khalid University Hospital. Kinesiophobia was measured using the Tampa Scale for Kinesiophobia (TSK), proprioception was assessed via a digital inclinometer, and limits of stability were evaluated using computerized dynamic posturography. Post-THR patients exhibited significantly higher levels of kinesiophobia (p < 0.001) and impaired proprioception (p < 0.001) compared to controls. Mediation analyses revealed that pain intensity, functional mobility, and psychological well-being partially mediated the relationship between kinesiophobia and proprioception. The Sobel tests confirmed significant mediation effects for pain intensity (Z = 3.88, p = 0.021), functional mobility (Z = 2.96, p = 0.013), and psychological well-being (Z = 2.84, p = 0.015). Kinesiophobia significantly impairs proprioception and balance in elderly individuals post-THR, with these effects being partially mediated by pain intensity, functional mobility, and psychological well-being. These findings highlight the importance of addressing psychological factors in rehabilitation programs to enhance proprioceptive function and improve postural stability, thereby optimizing recovery outcomes in the post-THR population.