Relationship of Kinesiophobia and Pain Catastrophizing with Physical Performance in Patients Following Total Knee Replacement Surgery on Post-operative Days 14–17

Abstract

Background: Total knee replacement is a commonly performed surgical procedure for patients with
advanced knee joint pathology, especially osteoarthritis. Although surgery helps reduce pain and
improve joint function, early post-operative recovery may be influenced by both physical and
psychological factors. Kinesiophobia (fear of movement) and pain catastrophizing may reduce
participation in rehabilitation and negatively affect physical performance during the early recovery
phase.
Objective: To assess the relationship of kinesiophobia and pain catastrophizing with physical
performance in patients following total knee replacement surgery on post-operative days 14 to 17.
Methods: Sixty-two subjects who had undergone total knee replacement surgery and were on post-
operative days 14 to 17 were included in this cross-sectional study. Subjects were selected according to
inclusion and exclusion criteria using purposive sampling. Kinesiophobia was assessed using the Tampa
Scale of Kinesiophobia, pain catastrophizing using the Pain Catastrophizing Scale, pain intensity using
the Visual Analogue Scale, and physical performance using the Timed Up and Go test. Descriptive
statistics were used to summarize demographic and outcome variables. Normality was assessed using
the Shapiro–Wilk test, and the Spearman rank correlation was used to determine the relationships
between variables.
Results: Higher levels of kinesiophobia and pain catastrophizing were associated with poorer physical
performance, indicating that psychological factors may influence early functional recovery. Pain
intensity also showed an association with physical performance during the post-operative period.
Conclusion: Kinesiophobia and pain catastrophizing are important psychological factors associated with
physical performance in patients following total knee replacement on post-operative days 14 to 17. Early
identification of these factors may help physiotherapists plan individualized rehabilitation strategies,
improve patient confidence, enhance participation in exercises, and promote better functional recovery.