The Effect of Preoperative Video-Based Education on Fear of Mobilization in Patients Undergoing Total Hip Arthroplasty: A Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Acibadem University
- Enrollment
- 96
- Locations
- 1
- Primary Endpoint
- Kinesiophobia (TSK Score)
Overview
Brief Summary
This single-center, prospective, randomized controlled trial aims to evaluate the effect of preoperative video-based mobilization education on postoperative fear of movement (kinesiophobia), pain during first mobilization, and early mobilization characteristics in patients undergoing total hip arthroplasty. Ninety-six participants were randomized to receive either routine verbal education plus video-based education or routine verbal education alone. Postoperative outcomes were assessed using the Tampa Scale of Kinesiophobia (TSK), Numerical Pain Rating Scale (NPRS), and standardized mobilization observation forms.
Detailed Description
Total hip arthroplasty (THA) is a common orthopedic procedure in which early postoperative mobilization plays a key role in preventing complications, reducing pain, and accelerating functional recovery. However, fear of movement (kinesiophobia), insufficient preoperative preparation, and uncertainty regarding mobility expectations may negatively affect patients' early rehabilitation performance. Providing structured, standardized education before surgery has been shown to improve postoperative participation and enhance patient confidence, yet the most effective format of such education remains unclear.
This randomized controlled trial was designed to evaluate the impact of a preoperative video-based mobilization education program on postoperative kinesiophobia, pain during the first mobilization, and early mobilization characteristics among patients undergoing primary THA. A total of 96 participants were randomly assigned to an intervention group or a control group using a simple randomization method. Both groups received routine preoperative verbal education, while the intervention group additionally viewed a structured mobilization training video developed by a multidisciplinary team of orthopedic surgeons, physiatrists, physiotherapists, and orthopedic nurses.
The educational video included demonstrations of bed exercises, safe ambulation techniques with assistive devices, chair transfer mechanics, toilet use, stair negotiation, and postoperative precautions. All postoperative outcomes were measured on the first postoperative day following each patient's initial mobilization session. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia (TSK); pain intensity was measured using the Numerical Pain Rating Scale (NPRS) immediately before and after the first mobilization; and mobilization characteristics (duration, number of steps, activity level, and level of assistance required) were recorded using a standardized observation form.
The aim of the study was to determine whether video-based preoperative education provides measurable benefits compared with routine verbal instruction alone. By focusing on both psychological (kinesiophobia) and physical (pain and mobilization performance) outcomes, this trial seeks to contribute new evidence to the field of musculoskeletal rehabilitation and to support more effective perioperative education strategies in THA care. No adverse events related to the intervention were reported.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- None
Masking Description
Due to the nature of the intervention (video-based education), neither participants nor care providers could be blinded. Outcome assessment was conducted by a researcher who was not involved in randomization; however, full blinding was not feasible.
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age 18 years or older
- •Able to communicate verbally
- •Scheduled for primary total hip arthroplasty
- •No major neurological disease
- •No major psychiatric disease
- •Able to participate in postoperative mobilization
- •Provided written informed consent
Exclusion Criteria
- •Scheduled for revision total hip arthroplasty
- •Comorbidities that prevent safe mobilization (e.g., severe cardiopulmonary limitations, severe balance disorders)
- •Severe cognitive impairment affecting comprehension or cooperation
- •Any condition preventing participation in the mobilization protocol
- •Declining to provide informed consent
Outcomes
Primary Outcomes
Kinesiophobia (TSK Score)
Time Frame: First postoperative day, after first mobilization
Kinesiophobia will be measured using the Tampa Scale of Kinesiophobia (TSK), a 17-item scale scored on a 4-point Likert system (1-4). Total scores range from 17 to 68, with higher scores indicating greater fear of movement. The Turkish validated version will be used.
Secondary Outcomes
- Pain Intensity Before First Mobilization(Immediately before first mobilization)
- Pain Intensity After First Mobilization(Immediately after first mobilization)
- Mobilization Duration(First postoperative day)
- Number of Steps During First Mobilization(First postoperative day)
- Activity Level During First Mobilization(First postoperative day)
- Level of Assistance Required During First Mobilization(First postoperative day)
Investigators
Nermin Ocaktan
assistant professor
Acibadem University