M. Pazzinatto1,2, E. Rio2, K. Crossley2, S. Coburn2, R. Johnston2, D. Jones2, J. Kemp2
1Sao Paulo State University, Physiotherapy, Presidente Prudente, Brazil, 2La Trobe University, La Trobe Sports and Exercise Medicine Research Centre, Melbourne, Australia
Background: Femoroacetabular impingement (FAI) syndrome is a common cause of hip-related pain in adults. Impingement is associated with bony deformities of the femoral head-neck junction (cam morphology). Cam morphology might lead to aberrant joint forces during functional movements in the position of hip impingement (involving flexion and rotation), and subsequent pain and damage to the articular cartilage of the hip joint. Individuals with FAI syndrome may perceive pain as a threat of body damage, leading to kinesiophobia (fear of movement) during painful activities. The fear of carrying out certain movements may trigger a negative cycle, where people with FAI syndrome have greater levels of pain, disability, and as a result, poor quality of life.
Purpose: To explore the association of kinesiophobia with hip-related self-reported clinical outcomes and objective function in people with FAI syndrome
Methods: One-hundred-fifty participants with FAI syndrome (51% women, with a mean (SD) age of 35 (8) years and BMI of 25.56 (4.95) kg/m2) completed assessment of the following: (1) kinesiophobia with the TAMPA Scale for Kinesiophobia; (2) objective physical function (side bridge, hop for distance, one leg rise and star excursion balance test; (3) range of motion (hip flexion, hip external rotation, hip internal rotation); and (4) self-reported outcomes (pain, disability, health- and hip-related quality of life). The study was approved by the La Trobe University Human Ethics Committee (HEC 17-080). Spearman’s rank correlation coefficient (rho) was used to explore the association between all outcomes. When at least fair correlations were found, linear regression models were used to explore the percentage of variation of the dependent variables explained by the independent variable (kinesiophobia). The models were adjusted for age, sex and BMI.
Results: Greater kinesiophobia demonstrated a moderate correlation with lower hip-related quality of life (rho = -0.57; p-value < 0.001); fair correlation with lower self-reported physical function (rho = -0.41; p-value < 0.001) and lower health-related quality of life (rho = -0.46; p-value < 0.001); poor correlation with pain levels (rho = 0.27; p-value = 0.001). There was no correlation between kinesiophobia and objective physical function or range of motion. Kinesiophobia explained 35% of the variation of the hip-related quality of life, 20% of the health-related quality of life and 19% of the hip-related physical function.
Conclusion(s): In people with FAI syndrome, kinesiophobia is associated with poor self-reported outcomes, but not with objective function or range of motion. Future studies are needed to explore the effect of interventions targeting kinesiophobia for people with FAI syndrome.
Implications: Kinesiophobia is known to be a barrier to rehabilitation adherence in different chronic pain conditions. Its relationship to poor self-reported outcomes in people with FAI syndrome highlights the need to consider interventions targeting kinesiophobia in people with FAI syndrome.
Funding, acknowledgements: This work was supported by the Australian National Health and Medical Research Council (NHMRC); Early Career Fellowship (JLK): 1119971.
Keywords: Fear of movement, Hip pain
Topic: Musculoskeletal: lower limb
Did this work require ethics approval? Yes
Institution: La Trobe University
Committee: La Trobe University Human Ethics Committee
Ethics number: HEC 17-080
All authors, affiliations and abstracts have been published as submitted.
