Kinesiophobia on Proprioception and Balance: Mediation by Pain, Mobility, and Psychological Wellbeing following THR

The study analyzed the demographic and clinical characteristics of two groups: 50 total hip replacement (THR) patients and 50 asymptomatic elderly individuals. The THR group had a mean age of 68.43 years, slightly higher than the 67.83 years observed in the asymptomatic group. The THR group had a higher proportion of females (60%) compared to the asymptomatic group (55%). Body Mass Index (BMI) was slightly higher in the THR group, averaging 27.34 kg/m² versus 26.56 kg/m² in the asymptomatic group. The THR patients had experienced symptoms for an average of 12.66 months. Significant differences were observed between the groups in various clinical measures. The THR patients had substantially higher Kinesiophobia (TSK Score: 36.56 ± 5.27) and Pain Intensity (VAS Score: 6.23 ± 1.59) compared to the asymptomatic group (TSK Score: 19.85 ± 4.13, VAS Score: 1.05 ± 0.53). Functional mobility, measured by the Timed Up and Go (TUG) test, was poorer in the THR group (12.54 ± 2.09 seconds) than in the asymptomatic group (10.34 ± 1.54 seconds). Psychological well-being, as assessed by the Hospital Anxiety and Depression Scale (HADS), was also lower in the THR group (8.03 ± 3.23) compared to the asymptomatic group (4.34 ± 2.56).

Further analysis using independent samples t-tests revealed significant differences between the groups across all measured characteristics, including Joint Position Sense (JPS) in hip flexion and abduction, and various directions of Limits of Stability (LoS). The THR group exhibited greater impairment in proprioception and LoS, with Cohen's d values indicating large effect sizes, particularly in kinesiophobia, proprioception, and LoS in the forward and right-forward directions. These findings highlight the profound impact of THR on patients' physical and psychological well-being, emphasizing the need for targeted rehabilitation interventions.