ORIGINAL RESEARCH article
Front. Psychol.
Sec. Movement Science
This article is part of the Research TopicHarnessing Physical Activity for Cognitive Enhancement and Mental Health PromotionView all 9 articles
Investigating the Dynamic Relationship between Joint Function Outcomes and Kinesiophobia following Total Knee Arthroplasty
Provisionally accepted
- Chuanbei Medical College, Sichuan, China
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[Abstract] Objective To investigate the temporal trends and bidirectional predictive relationships between joint function outcomes and kinesiophobia in patients following total knee arthroplasty (TKA). Methods Using a convenience sampling method, 242 patients who underwent TKA in the orthopedics departments of two Grade A Tertiary hospitals in Panzhihua City between October 2024 and March 2025 were selected as study participants. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Tampa Scale for Kinesiophobia-11 (TSK-11) were used to assess joint function and kinesiophobia at 1 month (T1), 3 months (T2), and 6 months (T3) postoperatively. A Cross-lagged analysis was employed to analyze the causal relationships between the variables.Results Joint function in TKA patients improved significantly over time, while kinesiophobia levels gradually decreased, with statistically significant differences in scores across all time points (P < 0.05). By six months post-surgery, the excellent and good outcome rate reached 72.31%, indicating that joint function still retained potential for further improvement. Cross-lagged analysis revealed a bidirectional causal relationship between joint function and kinesiophobia. In the early rehabilitation phase (T1–T2), kinesiophobia was a stronger predictor of joint function (β = 0.368, P < 0.001). Conversely, in the middle to late rehabilitation phase (T2–T3), joint function became a more prominent predictor of kinesiophobia (β = 0.218, P < 0.001). Conclusion We found a bidirectional relationship between joint function and kinesiophobia during TKA recovery, with the dominant influence shifting from kinesiophobia early on to joint function later. This suggests that rehabilitation strategies should be phased, initially addressing fear and later focusing on functional training to optimize outcomes.
Keywords: Cross-lagged model, Joint function, Kinesiophobia, longitudinal study, Total knee arthroplasty
Received: 11 Dec 2025; Accepted: 30 Jan 2026.
Copyright: © 2026 Wen, Wu, Qin, Luo, Wei and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jing Zhang
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