Fear of movement and its effects on hand function after tendon repair

Z Tuna; D Oskay

doi:10.1016/j.hansur.2018.05.004

Fear of movement and its effects on hand function after tendon repair

Hand Surg Rehabil. 2018 Jun 7:S2468-1229(18)30092-6. doi: 10.1016/j.hansur.2018.05.004. Online ahead of print.

Authors

Z Tuna¹, D Oskay²

Affiliations

¹ Gazi University Faculty of Health Sciences Department of Physiotherapy and Rehabilitation, 06500 Ankara, Turkey. Electronic address: zeyneptuna6@yahoo.com.
² Gazi University Faculty of Health Sciences Department of Physiotherapy and Rehabilitation, 06500 Ankara, Turkey.

PMID: 29887493
DOI: 10.1016/j.hansur.2018.05.004

Abstract

After tendon injuries, it has been observed clinically that patient-reported disability is more severe than the patient's actual performance. This is thought to result from a fear of movement (kinesiophobia) after surgery. The aim of this study was to investigate the presence of kinesiophobia in this patient population and its effects on the clinical outcomes. Patients (n=118) with tendon repairs were included. All the participants received early passive mobilization and were assessed at the end of the 8^th week. Grip and pinch strengths were measured and the Nine-Hole Peg Test (9HPT) was conducted. Patients also filled out the Michigan Hand Outcomes Questionnaire (MHOQ) and Tampa Scale for Kinesiophobia (TSK). Patients were divided according to their kinesiophobia: Group 1 with low kinesiophobia (TSK<37) and Group 2 with high kinesiophobia (TSK≥37). The groups were compared on the assessed parameters. Fifty-nine percent of the patients had a high kinesiophobia level. The performance-based test results were similar between the groups (P>0.05). Patient-reported MHOQ and TSK scores were significantly lower in the high kinesiophobic group (P=0.001 and P=0.000, respectively). Patients with tendon repairs often develop kinesiophobia, which may contribute to difficulty when starting to re-use their hand in daily life. None of the objective results were affected by this fear of movement-only patient-reported disability. Clinicians should be aware that clinical outcomes may be affected by the patient's kinesiophobic thinking and must be cautious during treatment.

Keywords: Evaluation du résultat; Hand rehabilitation; Kinesiophobia; Kinésiophobie; Outcome measure; Réparation tendineuse; Rééducation de la main; Tendon repair.