Low Self-Efficacy and High Kinesiophobia Are Associated With Worse Function in Patients With Femoroacetabular Impingement Syndrome
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Context: Femoroacetabular impingement syndrome (FAIS) is a painfully debilitating hip condition disproportionately affecting active individuals. Mental health disorders are an important determinant of treatment outcomes for individuals with FAIS. Self-efficacy, kinesiophobia, and pain catastrophizing are psychosocial factors that have been linked to inferior outcomes for a variety of orthopedic conditions. However, these psychosocial factors and their relationships with mental health disorders, pain, and function have not been examined in individuals with FAIS. Objective: (1) To examine relationships between self-efficacy, kinesiophobia, pain catastrophizing, pain, and function in patients with FAIS and (2) to determine if these variables differ between patients with and without a self-reported depression and/or anxiety. Design: Cross-sectional. Setting: University health center. Participants: Fifty-one individuals with FAIS (42 females/9 males; age 35.7 [11.6] y; body mass index 27.1 [4.9] kg/m2). Main Outcome Measures: Participants completed the Pain Self-Efficacy Questionnaire, Tampa Scale for Kinesiophobia, Pain Catastrophizing Scale, visual analog scale for hip pain at rest and during activity, and the 12-item International Hip Outcome Tool. Self-reported depression and/or anxiety were recorded. The relationships between psychosocial factors, pain, and function were examined using Spearman rank-order correlations. Independent t tests and Mann–Whitney U tests were used to evaluate the effect of self-reported depression and/or anxiety on psychosocial factors, pain and function. Results: The 12-item International Hip Outcome Tool was correlated with pain during activity (ρ = −.57, P ≤ .001), Tampa Scale for Kinesiophobia (ρ = −.52, P ≤ .001), and Pain Self-Efficacy Questionnaire (ρ = .71, P ≤ .001). The Pain Self-Efficacy Questionnaire was also correlated with pain at rest (ρ = −.43, P = .002) and pain during activity (ρ = −.46, P = .001). Individuals with self-reported depression and/or anxiety (18/51; 35.3%) had worse self-efficacy and pain catastrophizing (P ≤ .01). Conclusion: Self-reported depression and/or anxiety, low self-efficacy, and high kinesiophobia were associated with more hip pain and worse function for patients with FAIS. These findings warrant further examination including psychosocial treatment strategies to improve the likelihood of a successful clinical outcome for this at-risk population.
Jochimsen was with the Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA; and is now with the Division of Athletic Training, West Virginia University, Morgantown, WV, USA. Mattacola is with the School of Health and Human Sciences, The University of North Carolina Greensboro, Greensboro, NC, USA. Noehren is with the Division of Physical Therapy, University of Kentucky, Lexington, KY, USA. Picha is with Clinical Anatomy, Department of Health Sciences, A.T. Still University, Mesa, AZ, USA. Duncan is with Adult Reconstruction, Hip Resurfacing, and Hip Preservation, Department of Orthopedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, USA. Jacobs is with Orthopedic Research, Department of Orthopedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, USA.
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