Clinical Application of a Functional Exercise Program for Patients with Kinesiophobia after Total Hip Arthroplasty Based on the Health Action Process Approach (HAPA) Theory
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i2.4059
Abstract
Objective: To explore the clinical application effect of a functional exercise program for patients with kinesiophobia after total hip arthroplasty based on the Health Action Process Approach (HAPA) theory on the functional recovery of patients with kinesiophobia after total hip arthroplasty. Methods: A total of 46 patients with kinesiophobia after total hip arthroplasty in the Department of Traumatic Hip Surgery of Tianjin Hospital from February to May 2024 were selected and randomly divided into a control group and an experimental group, with 23 patients in each group. The control group received the conventional functional exercise program for hip arthroplasty, while the experimental group received a functional exercise program for patients with kinesiophobia after hip arthroplasty based on the HAPA theory. The kinesiophobia scores and hip joint function scores of the two groups were compared before surgery, at discharge, and at 1 and 3 months after surgery to explore the clinical application effect of the functional exercise program for patients with kinesiophobia after hip arthroplasty based on the HAPA theory. Results: The longitudinal analysis of the experimental group (n=23) and the control group (n=23) showed that the kinesiophobia scores of the experimental group were significantly lower than those of the control group after surgery (at discharge: 26.91±2.37 vs. 36.04±2.35; at three months: 20.09±1.12 vs. 28.04±2.84, with P values all <0.001), and the interaction effect of time×group was significant (F=289.54, P<0.001, partial η²=0.768), indicating that the intervention accelerated symptom relief. Meanwhile, the hip joint function scores of the experimental group were significantly higher than those of the control group (at discharge: 48.65±4.12 vs. 40.52±3.85; at three months: 87.78±5.76 vs. 66.57±5.02, all P<0.001), with a strong interaction effect (F=498.26, P<0.001, partial η²=0.847), suggesting that the intervention effectively promoted functional recovery. The time, group, and interaction effects were all highly significant (P<0.001, partial η²>0.76), confirming that the intervention could significantly reduce the level of kinesiophobia and accelerate hip joint rehabilitation, with the effect continuously increasing over time. Conclusion: Compared with the conventional functional exercise program for hip arthroplasty, the functional exercise program for patients with kinesiophobia after hip arthroplasty based on the HAPA theory can more effectively reduce the perception of movement fear in patients with kinesiophobia after hip arthroplasty and improve hip joint function.
Keywords
HAPA Theory, Total Hip Arthroplasty, Kinesiophobia, Functional Exercise, Hip Joint Function
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[15]Zhou Xingtian, Luo Jian, Peng Chaohua, et al. Systematic review and re-evaluation of rehabilitation exercise after total hip arthroplasty [J]. General Nursing Journal, 2021, 19(25): 3471-3475.
[2]Wang Yuan. Gait analysis after total hip arthroplasty with different approaches [D]. Qingdao University, 2022.
[3]Sun Qianqian. Construction and validation of a risk prediction model for kinesiophobia in patients after total hip arthroplasty [D]. Yan'an University, 2024.
[4]Xu Sihui. Construction and application of a self-management program for COPD patients based on the HAPA theory [D]. Henan University, 2023.
[5]Bai Mengjiao, Zang Yuantong. Impact of health education based on the HAPA theory on self-efficacy in patients with spinal cord injury [J]. Inner Mongolia Medical Journal, 2024, 56(02): 253-255.
[6]He Hongyan, Lin Yuan, Liang QiXuan, et al. Research progress on early rehabilitation exercise in patients with kinesiophobia after total hip arthroplasty [J]. China Modern Medicine, 2024, 31(31): 188-194.
[7]Swinkels-Meewisse E J C M, Swinkels R A H M, Verbeek A L M, et al. Psychometric properties of the Tampa Scale for kinesiophobia and the fear-avoidance beliefs questionnaire in acute low back pain [J]. Man Ther, 2003, 8(1): 29-36.
[8]Xia Zhenlan, He Bing, Fan Meixia, et al. Evaluation of the reliability and validity of the Chinese version of the Oxford Hip Score [J]. Nursing Journal of China, 2012, 19(05): 23-25.
[9]Cao Diansheng, Xie Guangrong. From behavioral intention to health behavior - an overview of the Health Action Process Approach (HAPA) model [J]. Chinese Journal of Clinical Psychology, 2010, 18(06): 809-812.
[10]Yang Ruipeng. Health behavior promotion theory: A review of the HAPA model [J]. Biotechnology World, 2013(12): 149.
[11]Kou Xiaoping, Pan WeiYu, Wang Xiaoyu, et al. Application of stage-based rehabilitation nursing based on the HAPA model in patients after total hip arthroplasty for femoral neck fracture [J]. Nursing Journal of Qilu, 2023, 29(14): 1-3.
[12]Ling Hong. Application of the Health Action Process Approach (HAPA) theory in knee function rehabilitation intervention after total knee arthroplasty [J]. Nursing Management Journal, 2015, 15(09): 663-664.
[13]Wang Fengping, Chen Lei, Feng Wei, et al. Impact of "Internet +" follow-up on postoperative rehabilitation after total hip arthroplasty [J]. International Journal of Gerontology, 2022, 43(04): 442-445.
[14]Zhang Yaqin, Li Yanting, Dan DanShan, et al. Application of collaborative care model in patients with kinesiophobia after total hip arthroplasty [J]. Chinese Journal of Nursing, 2021, 56(04): 515-520.
[15]Zhou Xingtian, Luo Jian, Peng Chaohua, et al. Systematic review and re-evaluation of rehabilitation exercise after total hip arthroplasty [J]. General Nursing Journal, 2021, 19(25): 3471-3475.
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