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OBJECTIVE: The objectives of this study were to revise the Kinesiophobia Causes Scale (KCS) to make it suitable for Chinese cultural context and to verify its applicability in Chinese Total knee arthroplasty (TKA) patients. METHODS: TKA patients in Henan Province, China (N = 418, average age ≥64 years). Exploratory and confirmatory factor analysis was performed on two samples randomly selected from the population (each N = 208). Psychometric properties, including the content, construct, predictive and concurrent validity was evaluated for KCS. RESULTS: The KCS scale showed desirable internal consistency (Cronbach's alpha: 0.927), test-retest reliability (0.936), and content validity (0.958). A seven-factor structure was revealed and confirmed using exploratory and confirmatory factor analysis. The area under the curve was 0.852. The optimal cut-off score for KCS was 3.68. CONCLUSIONS: The developed Chinese version of KCS is both reliable and valid when applied in Chinese setting of TKA patients.
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To evaluate the effects of robot-assisted rehabilitation training on knee function and the daily activity ability of older adults following total knee arthroplasty (TKA). Eighty-eight patients who underwent TKA were randomly assigned to a robot-assisted rehabilitation or traditional therapy group. The patients in the control group were treated with traditional manual rehabilitation therapy, while the patients in the experimental group were subjected to the robot-assisted rehabilitation program. Range of motion of the knee joint, Hospital for Special Surgery Knee Rating Score, and the modified Barthel Index were assessed on the first or second day after TKA (preintervention) and the discharge day (postintervention). Additionally, the length of hospital stay and related hospitalization expenses of the two groups were collected on the discharge day. Improvements in the active range of motion (p < 0.001), passive range of motion (p = 0.001), Hospital for Special Surgery Knee Rating Score (p < 0.001), and modified Barthel Index score (p = 0.004) were significantly better in the robot-assisted rehabilitation group than in the traditional therapy group. Interestingly, the length of hospital stay in the experimental group (9 days) was shorter than that in the control group (13 days), and the total cost of hospitalization was lower (p = 0.002). The robot-assisted rehabilitation training program is an effective intervention that significantly improves the daily activity ability and knee function of older adults following TKA.
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Artroplastia do Joelho , Osteoartrite do Joelho , Robótica , Humanos , Idoso , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/reabilitação , Articulação do Joelho/cirurgia , Atividades Cotidianas , Terapia por Exercício , Resultado do Tratamento , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/cirurgiaRESUMO
BACKGROUND: The shortened version of the Tampa Scale for Kinesiophobia (TSK-11) has been well characterized in the literature. However, to the best of our knowledge, no previous studies have evaluated the reliability and validity of the TSK-11 for Chinese-speaking patients who have undergone total knee arthroplasty (TKA). Thus, the objectives of this study were to translate and adapt the TSK-11 cross-culturally into Chinese and to evaluate its reliability and validity in a sample of Chinese TKA patients. METHODS: The TSK-11 was translated and cross-culturally adapted into Chinese according to the international guidelines for the cross-cultural adaptation of self-report measures. The Chinese version of TSK-11 was administered to 254 patients following their TKA, along with the Fear-Avoidance Beliefs Questionnaire, Pain Catastrophizing Scale, Numerical Rating Scale, and 12-Item Short Form Health Survey. Psychometric testing included internal consistency, test-retest reliability, floor and ceiling effects, construct validity, and convergent validity. RESULTS: A high completion rate of 95.8% with no floor or ceiling effects was noted in the Chinese version of the TSK-11. The questionnaire also showed good internal consistency (Cronbach's α = 0.883) and test-retest reliability (intraclass correlation coefficient = 0.798). Construct validity was assessed by exploratory factor analysis, and 3 factors were extracted that accounted for 65.2% of the variance. Convergent validity was confirmed by significant Pearson correlations between the Chinese version of the TSK-11 and the Pain Catastrophizing Scale (r = 0.751), Fear-Avoidance Beliefs Questionnaire (r = 0.719) and VAS (r = 0.450), as well as the 12-Item Short Form Health Survey subdomains Bodily Pain (r = -0.391), Mental Health (r = -0.356), Physical Functioning (r = -0.339), Role-Emotional (r = -0.317), and Role-Physical (r = -0.277). CONCLUSION: The Chinese version of the TSK-11 demonstrated satisfactory acceptability, reliability, and validity; therefore, it can be used in clinical practice and research for assessing kinesiophobia in Chinese patients after TKA.
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Artroplastia do Joelho , Medição da Dor , Transtornos Fóbicos/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/psicologia , Adulto , Idoso , Aprendizagem da Esquiva , China , Comparação Transcultural , Características Culturais , Medo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ortopedia/métodos , Dor , Psicometria/métodos , Reprodutibilidade dos Testes , Autorrelato , Inquéritos e Questionários , Resultado do TratamentoRESUMO
BACKGROUND: The incidence of and risk factors for kinesiophobia after total knee arthroplasty (TKA) have not been well characterized in the literature. Thus, the aim of this study was to investigate the incidence of postoperative kinesiophobia among patients undergoing TKA and to identify the associated risk factors. METHODS: The simplified Chinese version of the Tampa Scale for Kinesiophobia, Knee Self-Efficacy Scale, Numerical Rating Scale, Simplified Coping Style Questionnaire, and Social Support Rating Scale were used to measure kinesiophobia, self-efficacy, pain intensity, coping styles and social support, respectively. Multivariate logistic regression analyses were utilized to identify the risk factors for postoperative kinesiophobia among TKAs. RESULTS: A total of 862 participants were included in this study. Among all participants, 210 (24.4%) were identified as having kinesiophobia according the Tampa Scale for Kinesiophobia (TSK>37), with a mean score of 32.5 (standard deviation 13.1). A multivariate regression analysis showed that older age (odds ratio [OR] = 2.8, confidence interval [CI] = 2.0-3.7), lower education level (OR = 1.7, CI = 1.3-2.4), negative coping styles (OR = 1.6, CI = 1.0-2.2), less social support (OR = 3.5, CI = 3.1-4.1), lower self-efficacy (OR = 1.4, CI = 1.1-1.7), and greater pain intensity (OR = 2.8, CI = 1.5-5.3) are independent risk factors for kinesiophobia. CONCLUSION: A 24.4% incidence rate of postoperative kinesiophobia was noted in patients following TKA. Older age (most notably ≥76 years old), lower education levels, negative coping styles, greater pain intensity, lower self-efficacy, and less social support were associated with odds of developing postoperative kinesiophobia.
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Artroplastia do Joelho/efeitos adversos , Articulação do Joelho/cirurgia , Transtornos dos Movimentos/etiologia , Transtornos dos Movimentos/psicologia , Dor Pós-Operatória/psicologia , Transtornos Fóbicos/psicologia , Adaptação Psicológica , Adolescente , Adulto , Fatores Etários , Idoso , Ansiedade/psicologia , Criança , China , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Movimento , Análise Multivariada , Medição da Dor , Período Pós-Operatório , Fatores de Risco , Autoeficácia , Índice de Gravidade de Doença , Apoio Social , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: To evaluate the effects of a cognitive behavioral therapy (CBT) program on kinesiophobia, knee function, pain and pain catastrophizing in patients following total knee arthroplasty (TKA). METHODS: This was a parallel-group, randomized, controlled pilot study in which 100 patients who exhibited kinesiophobia after TKA were randomly assigned to participate in a CBT (experimental group) or standard care (control group) program. Each group included 50 patients. Before intervention (preintervention), 4 weeks after intervention (postintervention), and 6 months after the end of intervention (follow-up), patients were assessed via the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a numerical rating scale, and the Hospital for Special Surgery knee rating scale. Repeated-measures analysis of variance was used to test the significance of each outcome measure. RESULTS: The CBT program had significant group (P < .001), time (P < .001), and group-by-time interaction (P < .001) effects on kinesiophobia, pain catastrophizing, and knee function, and these effects lasted for at least 6 months after the end of the intervention. Pain was reduced in both groups after the intervention, but there were significant time and group effects (P = .003) in favor of the experimental group. CONCLUSION: The CBT program was superior to standard care in reducing kinesiophobia, pain catastrophizing, and knee pain and in enhancing knee function in patients who have a high level of kinesiophobia following TKA. The treatment effect was clinically significant and lasted for at least 6 months after the end of the intervention.
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Artroplastia do Joelho/psicologia , Terapia Cognitivo-Comportamental , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/psicologia , Transtornos Fóbicos/terapia , Idoso , Catastrofização , China , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/complicações , Avaliação de Resultados em Cuidados de Saúde , Medição da Dor/métodos , Transtornos Fóbicos/complicações , Projetos Piloto , Projetos de PesquisaRESUMO
The birth and development of oocyte donation technology have brought hope for women with poor ovarian reserve and repeated failure for in vitro fertilization, as well as for those with chromosomal abnormalities, premature ovarian failure, or at perimenopausal or menopausal stages. It has not only preserved their reproductive right, but also stabilized their families and increased social harmony. However, this technology does not only involve infertile couples themselves, but also social and ethical issues concerning their families and the society. This paper has reviewed and discussed the hot issues concerning oocyte donation, e.g., source of eggs, compensation for donors, prerequisites for recipients and donors, privacy of donors, and made suggestions for further improvement for the administration of oocyte donation.