Article

OBJECTIVES: To assess the presence of fear-induced activity limitation (FIAL) in
a sample of patients 1 year after total knee arthroplasty (TKA), and to develop a
preliminary prediction model to predict the risk of FIAL. DESIGN: Prospective
cohort study. SETTING: A tertiary teaching hospital. PARTICIPANTS: Patients
(N=72; mean age, 70+/-6y) undergoing primary, unilateral TKA participated.
INTERVENTIONS: Not applicable. OUTCOME MEASURES: Preoperative candidate
predictors were age, sex, body mass index, previous falls history, number of
comorbidities, self-report physical function, gait speed, knee range of motion,
knee pain, and standing balance. Outcome measure at 1-year follow-up was the
level of FIAL, measured by the Survey of Activities and Fear of Falling in the
Elderly. RESULTS: Thirty-one patients (41%; 95% confidence interval, .31-.55) had
FIAL, of whom 15 had moderate to severe FIAL. Multivariable predictors of FIAL
included preoperative habitual gait speed and velocity of postural sway in the
anterior-posterior axis. A 2-variable nomogram-based prediction model was
constructed, and this model showed moderately good discrimination
(optimism-corrected c-index, .76) and adequate calibration. CONCLUSIONS: In our
sample of patients with TKA, FIAL is common, and early identification of patients
at risk of FIAL would bring them into appropriate modes of preventive care. Our
prediction model shows some promise in identifying patients with FIAL, but
prospective validation studies are needed.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS