Strengths and limitations
The primary strength of the study is that accelerometers were used to measure physical activity, as they yield more objective data than patient-reported outcome measures of physical activity [A limitation of the study is that 25 and 30 patients did not have any accelerometer data at 6 and 12 months, respectively. Although the characteristics of the excluded patients did not deviate notably from those included in the analysis, this limitation could have impacted the robustness of the findings.Another limitation to consider in our findings relates to their predictive capability. While we found an association between preoperative fear of movement and postoperative movement behaviour, this must not be mistaken for genuine predictive capability. Building a robust predictive model demands a more rigorous research design, encompassing elements such as validation datasets and larger sample sizes [