Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (2): 317-322. doi: 10.19723/j.issn.1671-167X.2025.02.015

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Current status and influencing factors of kinesiophobia in patients with lumbar disc herniation after lumbar fusion surgery

Lianlian CHEN, Zhangying CAI, Linna YE, Jie LI*()   

  1. Department of Spinal Surgery, the 2nd Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China
  • Received:2024-01-16 Online:2025-04-18 Published:2025-04-12
  • Contact: Jie LI E-mail:jianjian20002@163.com
  • Supported by:
    the Basic Scientific Research Project of Wenzhou City in 2022(Y20220518)

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Abstract:

Objective: To investigate the current status of kinesiophobia after lumbar fusion surgery in patients with lumbar disc herniation (LDH) and to analyze its influencing factors. Methods: A total of 489 LDH patients who underwent lumbar fusion surgery in our hospital from January 2021 to December 2022 and effectively filled out the tampa scale for kinesiophobia (TSK) and other questionnaires on the first day after surgery were collected as the study subjects, the current status of kinesiophobia in LDH patients after lumbar fusion surgery were investigated using the TSK. The LDH patients were grouped into a kinesiophobia group (n=221) and a non kinesiophobia group (n=268) based on whether there was kinesiophobia after lumbar fusion surgery. The self-designed general data questionnaires were used to collect data, and Logistic regression was applied to analyze independent risk factors for kinesiophobia after lumbar fusion surgery in the LDH patients. Results: In the study, 221 out of the 489 LDH patients (45.19%) had kinesiophobia after lumbar fusion surgery. Univariate analysis showed that there were statistically significant differences between the phobic group and the non phobic group in terms of gender, education level, course of disease, whether there was hypoproteinemia, pain level, self-efficacy, social support, whether there was anxiety, and whether there was depression (P < 0.05). There were no statistically significant differences in terms of age, body mass index, monthly family income, marital status, residence, medical expense payment form, whether there was hypertension, whether there was diabetes, whether there was cardiovascular and cerebrovascular disease, whether there was respiratory disease, whether there was surgery experience, whether there was anemia, work conditions, and responsibility segments (P>0.05). Male (95%CI: 3.289-10.586, P < 0.001), education level below undergraduate level (95%CI: 6.533-45.162, P < 0.001), severe pain (95%CI: 10.348-72.025, P < 0.001), moderate pain (95%CI: 6.247-37.787, P < 0.001), low self-efficacy (95%CI: 4.238-15.095, P < 0.001), and medium self-efficacy (95%CI: 2.804-8.643, P < 0.001) were influencing factors for kinesiophobia after lumbar fusion surgery in the patients with LDH (P < 0.05). Conclusion: The incidence of kinesiophobia after lumbar fusion surgery in patients with LDH is high, and its influencing factors include gender, education level, pain level, and self-efficacy.

Key words: Kinesiophobia, Lumbar disc herniation, Lumbar fusion surgery, Present situation, Influence factor

CLC Number: 

  • R687.3

Table 1

Single factor analysis of movement in lumber disc herniation (LDH) patients after lumbar fusion surgery"

General information Number of survey participants Anxiety disorder, n(%) χ2 P
Gender 26.859 <0.001
  Male 363 189 (52.07)
  Female 126 32 (25.40)
Age/years 0.891 0.828
  18-<30 5 2 (40.00)
  30-<45 30 12 (40.00)
  45-<60 146 70 (47.95)
  ≥60 308 137 (44.48)
Body mass index/(kg/m2) 0.975 0.807
  Thin(<18.5) 46 23 (50.00)
  Normal weight(18.5-<24.0) 319 140 (43.89)
  Overweight(24.0-<28.0) 114 54 (47.37)
  Obesity(≥28.0) 10 4 (40.00)
Degree of education 65.323 <0.001
  Undergraduate or below 390 212 (54.36)
  Bachelor degree or above 99 9 (9.09)
Monthly household income/yuan 2.372 0.305
  <2 000 113 54 (47.79)
  2 000-<4 000 277 129 (46.57)
  ≥4 000 99 38 (38.38)
Marital status 1.253 0.740
  Unmarried 22 12 (54.55)
  Married 424 188 (44.34)
  Divorce 36 18 (50.00)
  Bereave 7 3 (42.86)
Place of residence 0.608 0.436
  Rural area 305 142 (46.56)
  Town center 184 79 (42.93)
Payment form of medical expenses 2.001 0.572
  Medical insurance 171 79 (46.20)
  Cooperative medical care 225 106 (47.11)
  Commercial insurance 24 9 (37.50)
  Self funded 69 27 (39.13)
Course of disease/years 21.665 <0.001
  <1 51 16 (31.37)
  1-<5 225 84 (37.33)
  5-<10 94 56 (59.57)
  ≥10 119 65 (54.62)
Hypertension 1.214 0.271
  Yes 160 78 (48.75)
  No 329 143 (43.47)
Diabetes 0.842 0.359
  Yes 108 53 (49.07)
  No 381 168 (44.09)
Cerebrovascular disease 2.898 0.089
  Yes 86 46 (53.49)
  No 403 175 (43.42)
Respiratory disease 0.595 0.441
  Yes 155 74 (47.74)
  No 334 147 (44.01)
Surgical experience 0.696 0.404
  Yes 108 45 (41.67)
  No 381 176 (46.19)
Anemia 0.964 0.326
  Yes 157 76 (48.41)
  No 332 145 (43.67)
Hypoproteinemia 15.684 <0.001
  Yes 134 80 (59.70)
  No 355 141 (39.72)
Pain level 59.148 <0.001
  Mild 84 7 (8.33)
  Moderate 274 136 (49.64)
  Severe 131 78 (59.54)
Efficacy 41.043 <0.001
  Low 133 79 (59.40)
  Medium 183 97 (53.01)
  High 173 45 (26.01)
Social support 29.552 <0.001
  Low 142 90 (63.38)
  Medium 186 78 (41.94)
  High 161 53 (32.92)
Anxiety 11.746 0.001
  Yes 198 108 (54.55)
  No 291 113 (38.83)
Depressed 10.850 0.001
  Yes 206 111 (53.88)
  No 283 110 (38.87)
Work situation 2.056 0.358
  Unemployed 59 23 (38.98)
  Retire 103 43 (41.75)
  Be on the job 327 155 (47.40)
Responsibility section 0.896 0.639
  L3-L4 51 21 (41.18)
  L4-L5 236 104 (44.07)
  L5-S1 202 96 (47.52)

Table 2

Multivariate analysis of fear of movement in lumber disc herniation (LDH) patients after lumbar fusion surgery"

Factor β S.E. Wald P OR 95% confidence interval
Lower limit Upper limit
Gender (Male) 1.775 0.298 35.441 <0.001 5.901 3.289 10.586
Degree of education (Undergraduate or below) 2.844 0.493 33.236 <0.001 17.176 6.533 45.162
Pain level
  Severe 3.307 0.495 44.639 <0.001 27.301 10.348 72.025
  Moderate 2.732 0.459 35.400 <0.001 15.363 6.247 37.787
Efficacy
  Low 2.079 0.324 41.165 <0.001 7.998 4.238 15.095
  Medium 1.594 0.287 30.796 <0.001 4.922 2.804 8.643
  Constant -7.910 0.764 107.201 <0.001 <0.001
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