Construction and evaluation of a model to identify early postoperative kinesiophobia in patients with lumbar degenerative diseases: a cross-sectional study.

The study was cross-sectional, so it cannot show whether fear of movement came before or after anxiety, depression, pain, self-efficacy or social support. Predictors and fear were measured at the same time by patient report, so shared reporting bias and bidirectional relationships are possible. Participants were recruited by convenience sampling from two hospitals, so the model may not apply to other settings or populations. The model requires several questionnaires plus age, sex and pain scores, which the authors say may be unviable in busy hospital practice. It did not include possible factors such as number of lumbar levels, pathology distribution, perioperative analgesia, mobilization or rehabilitation pathway, early complications, or ICU transfer. No intervention was tested, so the paper does not show whether acting on the model improves rehabilitation.

The authors declared financial support for the work or publication. The study was supported by Science and Technology Projects of Quanzhou city, Fujian Provincial Natural and Scientific Foundation, and Joint Funds for the Innovation of Science and Technology, Fujian Province.

Do not read the model as proof that anxiety, depression, pain, self-efficacy or social support cause fear of movement. The study measured these factors and fear at the same time after surgery, and it did not test whether treating any of them changes outcomes.