OBJECTIVE: To compare the improvement in disability, kinesiophobia, pain and quality of life obtained by means of home-based functional exercises aimed at managing kinesiophobia with that obtained by giving subjects undergoing total knee arthroplasty (TKA) advice to stay active after discharge from a rehabilitation unit. DESIGN: Randomised, controlled trial with six months' follow-up. SETTING: Home. PARTICIPANTS: Patients (n = 110, 40 males; mean age 67 years) at the end of a 15-day period of in-hospital rehabilitation after undergoing primary TKA. INTERVENTIONS: Experimental group: before returning home, the patients were asked to continue the functional exercises learned during hospitalisation in twice-weekly 60-minute sessions for six months, and given a book containing theoretical information about the management of kinesiophobia. Control group: the patients were advised to stay active and gradually recover their usual activities. MAIN OUTCOME MEASURES: Repeated-measures analysis of covariance 26 with baseline values as the covariates (p < 0.05) was used to assess the effect of treatment on disability, fear-avoidance beliefs, pain intensity, and the quality of life. RESULTS: The analysis revealed a significant time by group interaction in all the variables in favour of the experimental group. Post hoc analysis showed that the effect of group was statistically significant at the end of home training and at follow33 up. The treatment effect was clinically tangible in terms of disability and the quality of life, and persisted for six months after the intervention ended. CONCLUSIONS: A home-based programme based on functional exercises and the management of kinesiophobia was useful in changing the course of disability, fear38 avoidance beliefs, pain, and the quality of life in patients with TKA.

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