Is kinesiophobia associated with functional outcome measures in patients following medial patellofemoral ligament reconstruction?

BACKGROUND: This study aimed to investigate the potential relationship between kinesiophobia and functional outcomes in patients following medial patellofemoral ligament reconstruction (MPFLr). METHODS: Twenty-one patients (six males, 15 females) who underwent MPFLr between 2016 and 2020, (23.57 ± 9.49 years old) with a mean follow up period of 52.33 ± 24.82 months were included in the study. Following an assessment of patellar stability and alignment, kinesiophobia levels, function and balance were measured. The kinesiophobia was measured using the Tampa Scale of Kinesiophobia, while functional outcomes were assessed with the single-leg hop test, Y-Balance test and single-leg sway index. The self-reported function was measured by Kujala patellofemoral score and Lysholm knee score. RESULTS: The patients exhibited kinesiophobia scores of 43.10 ± 6.90. A negative correlation existed between kinesiophobia and both the Kujala scores (r = -0.75, P < 0.001) and the Lysholm scores (r = -0.79, P < 0.001). Moderate negative correlations were observed between kinesiophobia and the single-leg hop distance (r = -0.64, P < 0.01), as well as in Y-Balance test anterior reach distance (r = -0.51, P < 0.01) and posterolateral reach distance (r = -0.55, P < 0.01). Additionally, a low negative correlation was noted between kinesiophobia and Y-Balance test posteromedial reach distances (r = -0.43, P = 0.05), as well as the total sway index (r = -0.46, P = 0.04). CONCLUSIONS: A high level of kinesiophobia was strongly correlated with self-reported functional scores and moderately correlated with measured functional outcomes. The findings underscore a notable prevalence of kinesiophobia following biomechanically successful MPFLr. Investigating the impact of kinesiophobia on outcomes after MPFLr may provide a better understanding of patient recovery.

Relationship between Kinesiophobia and Dynamic Postural Stability after Anterior Cruciate Ligament Reconstruction: A Prospective Cohort Study.

Anterior cruciate ligament (ACL) injuries in young, active patients generally require ACL reconstruction (ACLR) to restore mechanical and postural stability. The fear of movement or reinjury (kinesiophobia) has become increasingly recognized in the post-ACLR population; however, the association between restoration of postural stability and kinesiophobia remains largely unknown. The purpose of this study was to investigate changes in mean Tampa Scale of Kinesiophobia-11 (TSK-11), dynamic motion analysis (DMA) scores, and time on the testing platform, as well as any correlation between TSK-11 and mean overall and individual translational and rotational DMA scores during the first 12 months following ACLR. Cohort study. Patients undergoing ACLR were prospectively enrolled and dynamic postural stability and kinesiophobia based on the TSK-11 were collected within 2 days prior to surgery and at 6 and 12 months following ACLR. Dynamic postural stability was quantified by calculating a DMA score, with score calculated in three translational (anterior/posterior [AP], up/down [UD], medial/lateral [ML]) and three rotational (left/right [LR], flexion/extension, and internal/external rotation) independent planes of motions. Correlations between DMA and TSK-11 scores at each time point were analyzed. A total of 25 patients meeting inclusion criteria were analyzed. Mean overall DMA and TSK-11 scores increased with each successive testing interval. At 6-month follow-up, a weakly positive association between TSK-11 and DMA scores was appreciated based on overall DMA, AP, UD, ML, and LR. At 12 months, a moderately positive correlation was appreciated between TSK-11 and the translational, but not rotational, planes of motion. Following ACLR, lower level of kinesiophobia were found to be moderately associated with improved dynamic stability, especially in the translation planes of motion.