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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".