Brain activity related to kinesiophobia before and after total hip arthroplasty in patients with hip osteoarthritis: a pilot task-related functional MRI study
Bibliographic record
Abstract
OBJECTIVE: Kinesiophobia that persists in some patients after total hip arthroplasty (THA) is a significant factor hindering functional recovery. Its neural basis is not well understood. This exploratory prospective cohort study aimed to investigate changes in kinesiophobia-related brain activity before and after THA in patients with hip osteoarthritis (HOA) using task-related functional MRI (fMRI) during a motor task. METHODS: Six women (70.8 ± 13.1 years) who underwent THA for left HOA were assessed before and 2 weeks after surgery. Brain activity was measured using block-design fMRI during an active left hip flexion motor task. Clinical assessments included the Tampa Scale for Kinesiophobia short version (TSK-11), Visual Analog Scales (VAS) for kinesiophobia and pain, and gluteus medius muscle activity (% maximum voluntary contraction, %MVC) during the gait stance phase. Brain image analysis was performed using the General Linear Model in MATLAB R2024b and SPM25, with activation regions identified using Montreal Neurological Institute coordinates. RESULTS: fMRI analysis revealed activity in the anterior cingulate cortex (ACC) and middle cingulate cortex (MCC), both pre- and postoperatively. Postoperatively, TSK-11, kinesiophobia VAS, and pain VAS scores significantly decreased (P < 0.05), while %MVC increased (P < 0.01). Changes in ACC activity showed a positive correlation with changes in TSK-11 and kinesiophobia VAS. Changes in MCC activity showed a negative correlation with changes in pain VAS and %MVC. CONCLUSION: These findings suggest that postoperative psychological improvements are associated with neuroplastic changes in the cingulate gyrus, which are associated with functional recovery. This suggests a potential neural mechanism involved in the recovery from kinesiophobia.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".