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Exercise therapy and education are recommended from several guidelines for managing symptoms in chronic nonspecific spinal pain (CNSP) patients. However, no systematic reviews have previously analyzed the effectiveness of pain science education (PSE) plus exercise therapy for managing CNSP related symptoms. Systematic searches were conducted on 10 databases looking for randomized control trials (RCTs) aimed to evaluate the effectiveness on pain, disability, kinesiophobia, and catastrophizing. Data were analyzed using random-effects meta-analyses and studies were appraised using the Cochrane ROB tool and GRADE. A total of eight RCTs (n = 622) were included in the qualitative-analysis and five were selected for meta-analysis. PSE plus exercise therapy showed improvements in pain (5RCTs: short-term: SMD: -0.53 [-0.86,-0.2]; 4RCTs: intermediate-term: SMD: -0.57 [-1.01,-0.14]; low quality), disability (4RCTs: short-term: SMD: -0.24 [-0.53,0.05]; 4RCTs: intermediate-term: SMD: -0.93 [-1.08,-0.03]; low-to-very-low quality), kinesiophobia (3RCTs: short-term: SMD: -0.7 [-1.51,0.11]; 4RCTs: intermediate-term: SMD: -0.93 [-1.57,-0.30]; moderate-to-very-low quality), and catastrophizing (2RCTs: short-term: MD: -3.26 points [-6.15,-0.37]; 3RCTs: intermediate-term: MD: -4.94 points [-8.08,-1.81]; low-to-very-low quality) compared to exercise alone. A qualitative-analysis showed improvements in the experimental group compared to multimodal physiotherapy (1RCT; low-to-very-low quality), whereas no clear benefits were reported compared to PSE alone (1RCT; very-low quality) or no intervention (1RCT; very-low quality). There is low to very-low certainty of the evidence suggesting that PSE plus exercise therapy reduces CNSP related-symptoms. Perspective Based on low-quality data from small samples, PSE plus exercise therapy reduces CNSP related symptoms. The evidence requires further investigation due to the limited number of studies with short follow-up periods (CRD42020168968).

OBJECTIVES To examine kinesiophobia (i.e. fear of movement) among adolescent athletes with concussion compared to controls, and correlations of kinesiophobia with symptoms and reaction time. DESIGN Prospective cohort study. METHODS We evaluated 49 adolescent athletes twice. The concussion group was assessed within 14 days of injury and at return-to-play clearance. The control group was tested initially and approximately 28 days later. Participants completed Tampa Scale of Kinesiophobia, Post-Concussion Symptom Inventory, and clinical reaction time assessments. RESULTS We included 32 concussion participants (15 ± 2 years; 50% female) and 17 controls (16 ± 1 years; 47% female). Acutely (

Objectives Previous studies in a high-income country have demonstrated that people with and without low back pain (LBP) have an implicit bias that bending and lifting with a flexed lumbar spine is dangerous. These studies present two key limitations: use of a single group per study; people who recovered from back pain were not studied. Our aims were to evaluate: implicit biases between back posture and safety related to bending and lifting in people who are pain-free, have a history of LBP or have current LBP in a middle-income country, and to explore correlations between implicit and explicit measures within groups. Methods Exploratory cross-sectional study including 174 participants (63 pain-free, 57 with history of LBP and 54 with current LBP). Implicit biases between back posture and safety related to bending and lifting were assessed with the Implicit Association Test (IAT). Participants completed paper-based (Bending Safety Belief [BSB]) and online questionnaires (Tampa Scale of Kinesiophobia; Back Pain Attitudes Questionnaire). Results Participants displayed significant implicit bias between images of round-back bending and lifting and words representing “danger” (IATD-SCORE: Pain-free group: 0.56 (IQR=0.31–0.91; 95% CI [0.47, 0.68]); history of LBP group: 0.57 (IQR=0.34–0.84; 95% CI [0.47, 0.67]); current LBP group: 0.56 (IQR=0.24–0.80; 95% CI [0.39, 0.64])). Explicit measures revealed participants hold unhelpful beliefs about the back, perceiving round-back bending and lifting as dangerous (BSBthermometer: Pain-free group: 8 (IQR=7–10; 95% CI [7.5, 8.5]); history of LBP group: 8 (IQR=7–10; 95% CI [7.5, 9.0]); current LBP group: 8.5 (IQR=6.75–10; [7.5, 9.0])). There was no correlation between implicit and explicit measures within the groups. Conclusions In a middle-income country, people with and without LBP, and those who recovered from LBP have an implicit bias that round-back bending and lifting is dangerous.

The study aimed to examine the effects of vestibular rehabilitation on kinesiophobia, quality of life, dynamic visual acuity, and balance. Thirty vestibular hypofunction patients aged 18–65 years who were diagnosed by videonystagmography (VNG) voluntarily participated in the study. Before and after treatment Tampa Kinesiophobia Scale, World Health Organization Quality of Life Scale-Turkish Short Form, Tandem Stance Test, Dynamic Visual Acuity, Visual Analog Scale to measure dizziness, Subjective Visual Vertical and Subjective for verticality and horizontality perception Visual Horizontal tests were applied. The exercise program was applied for 8 weeks. Patients were observed in the hospital every two weeks. The exercises given in the session were given as home exercises, 3 times a day, for 10 repetitions. As a result of the study, statistical correlations were found tandem stance test, subjective visual vertical and subjective visual horizontal tests for the perception of verticality and horizontality, visual analog scale to measure the severity of dizziness, dynamic visual acuity, quality of life and tampa kinesiophobia scales (p

Background: Further data on the causes of functional independence or disability after surgery are needed to explain the clinical decision-making process for older patients, their families, and policy-makers. There are a limited number of studies showing the relationship between kinesiophobia, functional status, pain and mobility in older adults after surgery. Aims: The study aims to investigate relationships among kinesiophobia, pain, mobility, and functional status in older adults after surgery. Methods: A comparative–descriptive and cross-sectional study. The research was conducted with 99 older adults in the general surgery clinic after surgery. A Visual Analogue Scale was used to evaluate pain levels, the Standardized Mini-Mental State Examination to evaluate mental function status, the Functional Independence Measure to assess functional independence in daily activities, the Rivermead Mobility Index to evaluate basic mobility in daily life, and the Tampa Scale for Kinesiophobia to assess fear of mobility. Results: Regression analysis revealed a significant negative correlation between social security and kinesiophobia, and also between functional level and type of anesthesia and mental status in older women (R2 = ? 0.185, p = 0.005; R2 = ? 0.167, p = 0.011 and p = 0.005, respectively). Discussion: In the literature, there are no standardized procedures during the evaluation and rehabilitation of older adults after abdominal or thoracic surgery, etc. operations. This study will contribute to the current literature by attracting interest in this field and increasing the evaluations performed. Conclusions: The study findings emphasize the importance of evaluating the functional, mobility, mental and kinesiophobic status of older adults after surgery in clinics, rehabilitation centers, or research. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.

INTRODUCTION Kinesiophobia is a common symptom associated with high disability, and has been observed in patients with migraine. However, the association between kinesiophobia and clinical factors in this population is unknown. OBJECTIVE To assess the fear of falling, dizziness disability, and migraine disability in patients with migraine, considering the presence of kinesiophobia. METHODS Eighty patients with migraine completed the Tampa Scale for Kinesiophobia and were divided into two groups according to the questionnaire cutoff point: migraine without kinesiophobia (MoK, n = 39) and migraine with kinesiophobia (MK, n = 41). Fear of falling, dizziness disability, and migraine disability were assessed in both groups using validated questionnaires. RESULTS The MK group presented higher scores on dizziness disability, fear of falling, and migraine disability compared to the MoK (p

Kinesiophobia is defined as "an irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury" by those who coined the term. Pain catastrophizing and kinesiophobia (fear of movement and re-injury) magnify somatosensory perceptions, overstating this perception in terms of a pain-related exaggeration of fearful anticipation of the pain getting worse and worse. Fear of pain has a high prognostic value when it comes to the development of chronic musculoskeletal pain and impairment. Kinesiophobia is most closely linked to higher order brain mechanisms linked to anxiety. The Fear-Avoidance Model of Exaggerated Pain Perception, suggested by Lethem et al, represented the impact of fear on outcomes. They proposed that the sensory and emotional aspects of pain can contribute to the development of chronic musculoskeletal pain syndromes by inducing a fear of pain. The Tampa Scale is used to assess kinesiophobia, and patients with scores higher than 40 are considered to have a high degree of kinesiophobia “Psychological therapy” was the therapy include (1) psychological education; (2) cognition-behavior therapy; (3) perceptive stimulation in non-injured body areas such as virtual reality equipment, laser, and relaxation; (4) therapeutic milieu involves interpersonal communication such as group session and feedback session. One of the main reason of kinesiophobia is fear avoidance, sensory and emotional both factors are responsible. Depending on the cause of kinesiophobia the treatment will differ and different approaches should be considered.

Background: The spinal column is a highly complex system of bones and connective tissues that provide support for the body and protect the delicate spinal cord and nerves. Back surgery carries higher risks than some other types of surgery because it is done closer to the nervous system. The most serious of these risks include paralysis and infections. Fear of movement/(re)injury is described as “a specific fear of movement and physical activity that is (wrongfully) assumed to cause reinjury”. In the extreme situation of fear of movement, the expression “kinesiophobia” is used. Tampa Scale for Kinesiophobia (TSK) was developed by Miller, Kori and Todd 1990 in order to assess fear of movement/(re)injury. It is a valid, reliable tool is used to assess Kinesiophobia.(1) Aim: The present study was done to Assess Prevalence of Kinesiophobia In patients undergone Spinal Surgery using Tampa Scale (6- 10 weeks post surgery). Method: In this study a total of 100 patients answered Tampa scale of kinesiophobia and were evaluated according to their level of kinesiophobia after post spinal surgical period 6- 10 weeks, that is after the healing period. Result: There was a high degree of kinesiophobia which was observed after post spinal surgical period 6-10 weeks in 61% of the participants. Conclusion: This study showed Prevalence of High Degree of Kinesiophobia noted after 6-10 weeks in 61% of the Post- Spinal Surgery patients even after 4-6 weeks of healing period. Key words: Kinesiophobia, Fear-avoidance, Spinal surgery, Tampa scale.

Introduction Physical exercise improves physical fitness and health, helping to reduce pain and prevent low back pain. This study aims to compare the intensity of low back pain (LBP), behavioral habits, and the level of disability and kinesiophobia among exercising and non-exercising subjects with LBP. Methods Consecutive sample of 102 individuals was divided into exercising group (EG) and non-exercising group (NEG). The data was extracted from the answers to the questionnaires Back Pain and Body Posture Evaluation Instrument (BackPEI-A), Oswestry Disability Index (ODI) and Fear-avoidance Beliefs Questionnaire (FABQ-Brazil). For statistical analysis, the chi-square test was used, α ≤ 0.05. Results Both groups presented predominance of mild to moderate pain intensity and absence of kinesiophobia in the practice of physical activity, with no statistically significant difference. However, there was significant difference between the groups for the risk of occurrence of LBP and for levels of incapacity and kinesiophobia related to work. Conclusion Exercising individuals appear to present with a lower risk for occurrence of LBP, lower level of disability, and absence of work-related kinesiophobia.

Background: Low back pain is one of the most common conditions encountered by a physical therapist in their clinical practice. Chronic low back pain is difficult to treat due to various environmental and psychological factors such as kinesiophobia, which may possibly lead to altered or reduced physical activity level producing various effects on musculoskeletal system. In addition to this, little is known about the relation between these factors, especially in Indian population. Therefore, it is important to find out if any correlation exists between these factors. Methods: This Correlational study included 53 patients of both gender suffering from chronic low back pain. Numerical Pain Rating Scale (NPRS), Marathi version of Tampa Scale of Kinesiophobia (TSK) and short version of International Physical Activity Questionnaire (IPAQ) were administered in the patients after obtaining their consent. The responses were collected and then analyzed using Pearson’s coefficient. Results: The mean pain intensity was found to be 3.11±2.24 and 6.86±1.91 at rest and on activity respectively. Mean score of kinesiophobia was 29.11±5.00. Mean score of physical activity level was 5466.62±5362. Significant correlation was found between pain during activity and kinesiophobia (p

PurposeThe aims of this study were to (1) investigate the effect of hydrodilatation in frozen shoulder patients on objective indices of shoulder functionality and subjective outcomes of pain, mobility, kinesiophobia, depression, and anxiety, and (2) progress knowledge about the reciprocal temporal relationship between psychological parameters at baseline and objective and subjective outcomes at 3-month follow-up.MethodsWe evaluated the clinical and psychological status of 72 patients with a frozen shoulder before and after hydrodilatation, using the Constant Murley score, the Visual Analogue score, the Tampa Scale for Kinesiophobia, the Hospital Anxiety and Depression Scale, and the Shoulder Pain And Disability Index.ResultsWe noted a significant improvement in functionality, pain and disability (p p ConclusionHydrodilatation followed by physiotherapy is an excellent way to treat patients with recalcitrant frozen shoulder, resulting in a continuous improvement of ROM and pain. Physiotherapists and physicians should be aware that psychological factors might have an impact on the treatment outcome.

Tam Metin / Full Text WOS:000680831400005 ESCI To investigate level of kinesiophobia and related factors in postmenopausal women with osteoporosis (OP) and osteopenia (OPN).Materials and Methods: A total of 60 female patients with postmenopausal OP, 60 female patients with postmenopausal OPN and60 age- and gender-matched controls were enrolled in this study. Demographic data (age, weight, height, body mass index, educationallevel, employment status, disease duration and menopause duration) of the participants were recorded. In all participants, the level ofkinesiophobia, fear of falling, psychological status, health-related quality of life and osteoporosis self-efficacy were evaluated using the Tampascale of kinesiophobia (TSK), falls efficacy scale-international (FES-I), hospital anxiety and depression scale (HADS), quality of life questionnaireof the European Foundation for Osteoporosis-41 (QUALEFFO-41) and osteoporosis self-efficacy scale (OSES), respectively.Results: Postmenopausal patients with OP and OPN had higher levels of kinesiophobia than controls (p0.05). In addition, a positive correlation was found betweenTSK score and FES-I, HADS, QUALEFFO-41 scores and duration of menopause, and a negative correlation between OSES scores in patientswith OP and OPN (p0,05). OP ve OPN’li hastalarda TKÖ skoru ile UDES, HADÖ, QUALEFFO-41 skorları, menopoz süresi arasında pozitif, OEYÖ skorları arasında negatif korelasyon vardı (p

Objective: To find the short-term psychological and hormonal effects of virtual reality training on chronic low back pain in American soccer players. Design, Setting, Participants: The 3-block random sampling method was used on 54 university American soccer players with chronic low back pain, and they were allocated into 3 groups: virtual reality training (VRT; n = 18), combined physical rehabilitation (n = 18), and control (n = 18) groups at University Hospital. They underwent different balance training exercises for 4 weeks. The participants and the therapist who is assessing the outcomes were blinded. Psychological (pain intensity and kinesiophobia) and hormonal (glucose, insulin, Homeostatic Model Assessment of Insulin Resistance, growth hormone, prolactin, adrenocorticotropic hormone, and cortisol) values were measured at baseline, after 4 weeks, and after 6 months. Results: The baseline demographic, psychological, and hormonal data between the VRT, combined physical rehabilitation, and control groups show no statistical difference (P ≥ .05). Four weeks following training, the VRT group shows more significant changes in pain intensity and kinesiophobia than the combined physical rehabilitation and control groups (P P P = .075) between the 3 groups. At 6-month follow-up glucose, prolactin, adrenocorticotropic hormone, and cortisol show more significant difference in the VRT group than the other 2 groups (P P = .694), Homeostatic Model Assessment of Insulin Resistance (P = .272), and growth hormone (P = .145) failed to show significant changes between the groups. Conclusion: Training through virtual reality is an effective treatment program when compared with conventional exercise training programs from a psychological and hormonal analysis perspective in American soccer players with chronic low back pain.

Introdução: A dor lombar crônica inespecífica (DLCI) é uma sintomatologia dolorosa comum na região inferior da coluna por período superior a doze semanas, podendo ser acompanhada de sintomas neurológicos em membros inferiores. A DLCI apresenta alta prevalência mundial, pode conduzir a limitações de função e o tratamento enfatiza terapias ativas, tais como exercícios de Pilates. Objetivo: Avaliar o efeito de exercícios de Pilates na percepção dolorosa, qualidade de vida, incapacidade funcional e cinesiofobia de indivíduos com DLCI, classificados com baixo e médio riscos de mau prognóstico conforme a versão brasileira do Start Back Screening Tool (SBST-Brasil). Métodos: Ensaio clínico randomizado controlado com 59 pacientes diagnosticados clinicamente com DLCI, divididos em dois grupos: Controle (GC) e Pilates (GP). Durante 12 semanas, o GC recebeu intervenção medicamentosa enquanto o GP foi submetido a um protocolo de exercícios do método Pilates duas vezes na semana. Resultados: O treinamento com Pilates reduziu dor e cinesiofobia em ambos os subgrupos com SBST-Brasil Baixo e Médio. Contrariamente aos participantes de médio risco de mau prognóstico do GC, o GP com médio risco apresentou melhora significativa (P

Background: Osteoarthritis (OA) is one of the commonest forms of joint disease, and the knee is one of the most commonly affected joints. OA is clinically associated with pain, joint stiffness, joint deformity and swelling. Kinesiophobia is a condition in which a patient has an excessive, irritational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or reinjury. This study addresses the influence of biological (eg: X-ray changes) as well as severity of pain, kinesiophobia in individual physical functioning. The purpose of the study aims to know the prevalence of kinesiophobia in patients with OA knee. Methodology: A simple random sampling of 30 patients with diagnosed OA knee who visited Pravara Rural hospital (Loni) was included. The patients included were between the age group of 40 - 80 years and were screened according to inclusion and exclusion criteria. The data collection includes the application of scales (Tampa scale of Kinesiophobia-11) which includes 11 items, WOMAC (3 components), VAS to all the 30 subjects and was taken by the principal investigator. The total scores of each scale were analyzed mean and standard deviation were taken. Pearson correlation test was performed to know the correlation between each component. Result: Pearson correlation test was performed which showed a positive correlation between all the four variables i.e. stage of OA, VAS, TSK 11, WOMAC with r= 0.0312. Conclusion: The present study concluded that as there is progression in level or stage of OA there is increase in severity of pain which leads to further increase in level of kinesiophobia in individuals with OA of knee. This all components furthers leads to decrease in physical functioning in individuals with OA knee. KEY WORDS: Osteoarthritis, knee, Kinesiophobia, TSK11, WOMAC, VAS.

OBJECTIVES: Fear of movement may be a source of systemic bias in studies reporting functional deficits in patients with Achilles tendinopathy. The purpose of this study was to assess the effects of kinesiophobia on completion rate and performance on tests evaluating lower extremity function, while controlling for self-reported pain. DESIGN: Cross-sectional study SETTING: Tendon research laboratory PARTICIPANTS: Ninety-four participants with Achilles tendinopathy. MAIN OUTCOME MEASURES: Completion (yes/no) and performance (cm) on the counter-movement jump, hopping, and drop counter-movement jump. RESULTS: The models fit the data (R^2 = 0.81, both models). TSK score did not predict completion (beta = −0.01, 95% CI = −0.13 – 0.09, P = 0.74) but pain did (beta = −0.36, 95% CI = −0.53 - −0.19, P < 0.0001). TSK score did not predict performance (beta = −0.06, 95% CI = −0.14 – 0.003, P = 0.07), but pain did (beta = −0.15, 95% CI = −0.22 - −0.07, P < 0.0001). CONCLUSIONS: Kinesiophobia did not affect the physical performance tests in patients with Achilles tendinopathy. Measures of physical performance should be interpreted alongside self-reported pain.

Psychological interventions have been found effective in helping athletes cope with the challenges associated with knee surgery. In this investigation, an interactive cognitive-behavioural multimedia program was evaluated as a means of delivering psychological interventions to individuals experiencing anterior cruciate ligament (ACL) surgery in a field trial with 69 ACL surgery patients (30 women and 39 men; 24 competitive athletes, 41 recreational athletes, and 4 nonathletes; M(age) = 35.01, SD = 11.98 years). Results indicated that compared to participants who received standard care, participants who received the multimedia program reported greater preoperative confidence in ability to cope, lower postoperative pain and kinesiophobia, and greater use and perceived utility of patient education materials. The findings suggest that the multimedia program has promise as an economical and effective means of educating and delivering psychological interventions to people experiencing ACL surgery and rehabilitation.

This study was designed to investigate the relationship between Type 2 diabetes mellitus (T2DM) and musculoskeletal system disorders and kinesiophobia levels. Eighty-four participants (41 diabetics and 43 nondiabetic individuals) self-reported their musculoskeletal problems and levels of kinesiophobia. Data were analyzed using descriptive statistics, nonparametric Pearson’s Chi-Square testing, and Mann–Whitney U test. Results indicated the total Cornell Musculoskeletal Discomfort Questionnaire score was 190.55 ± 261.56 for the patients with T2DM and 98.11 ± 167.31 for the control group (p < 0.05). Moreover, Tampa Kinesiophobia Scale scores were higher for the T2DM group (p < 0.05). We conclude from these findings that T2DM is associated with a higher frequency of musculoskeletal system disorders and higher levels of kinesiophobia.

The purpose of this study is to investigate the effects of post-mastectomy lymphedema on balance, kinesiophobia and fear of falling. A cross-sectional study with a control group. Seventy patients and 62 healthy volunteers were included. After determining the stage and limb volumes of the patients, all participants were evaluated with scales. There was a statistically significant difference in all scales compared to the control group (

Background: The Tampa Scale of Kinesiophobia (TSK) developed in 1990 is a 17-item scale originally developed to measure the fear of movement related to chronic lower back pain. It is believed to have application for other musculoskeletal pain conditions. When Lateral Epicondylalgia patients are treated, it would be easy and inexpensive tools to use to identify patients who are at higher risk of developing chronic symptoms and kinesiophobia.Objective: To review the literature regarding TSK and pain, disability and grip strength in Lateral Epicondylalgia patientsMethods: A review was performed of all published studies which used the fear avoidance model and assessed TSK in individuals with Lateral Epicondylalgia. Various databases like Pub Med, Pedro, Cochrane and google scholar were searched initially on March 17, 2020. On April 19, 2020 these databases were searched for a second time to find new articles. Keywords used were Tampa scale of Kinesiophobia, Lateral Epiconylalgia. Only studies which assessed TSK in adult Lateral epicondylalgia population and were available in English were included. Studies which reported Lateral epicondylalgia combined with any other musculoskeletal conditions were excluded.Results: Numerous studies were identified regarding Lateral Epicondylalgia and pain, function and grip strength. Very few studies were found regarding TSK in relation specific to Lateral Epicondylalgia. A total of 6 articles were reviewed according to inclusion criteria which included study from 2012 to 2017. Conclusion: The fear avoidance model can be applied to Lateral epicondylalgia patients and there is value from a psychometric perspective in using the TSK to assess kinesiophobia.

Aim: The aim of this study was to investigate the relationship between kinesiophobia and quality of life and shoulder functionality in patients with painful shoulder pathologies. Materials and Methods: Physical and sociodemographic data of the patients participating in the study were recorded. The resting and activity pain associated with the disease was evaluated with the Visual Analogue Scale (VAS). Shoulder active joint range of motion was evaluated with a universal goniometer. Kinesiophobia level was evaluated by Tampa Kinesiophobia Scale (TKÖ), Turkish version of life quality Nottingham Health Profile (NSP), shoulder functions were evaluated by Simple Shoulder Test (SST). Spearman's correlation analysis was used for statistical analysis and p 0.05). Conclusion: Kinesiophobia, which occurs due to painful movement in shoulder pathologies, causes patients to become inadequate in their daily life activities, and the low quality of life brought by this situation causes patients to fight both physical and psychological factors.

Parkinson´s Disease is the second most common neurodegenerative movement disorder worldwide and the first one in Europe, with a prevalence increasing with age. Freezing of gait is a motor disorder which fundamentally causes a block of lower limb, during this espisode patients can not generate a step. Furthermore, freezing of gait is one of the most motor disabling motor disorder in Parkinson´s Disease, being related to the progression of the disease and sometimes with the appearance of complications. Those complications can include increase fall risk, impairment of activities of daily life and reduction of quality of life; due to the related decrease in movement and physical activity in patients with Parkinson´s Disease and freezing of gait. Despite others studies have shown a relationship between kinesiophobia, physical activity and functionality in patients with Parkinson´s Disease, there are no evidences of this link in patients with Parkinson´s Disease and freezing of gait in ``On´´ state.

Demirci, Cevher Savcun (Balikesir Author), Objective: Shoulder pain is a common problem after stroke and causes functional limitations in patients. Pain leads to keep away from the movement and physical activities. The aim of this study was to evaluate the fear of movement in stroke patients with shoulder pain and to investigate its relationship with balance and fear of falling. Material and Methods: Forty six stroke patients were included in the study and divided into two groups, with and without shoulder pain. Fear of movement was evaluated by the Tampa Scale for Kinesiophobia, functional balance was by the Berg Balance Scale and fear of falling was by the Tinetti’s Falls Efficacy Scale. Results: The mean age of patients with and without pain were 65.60±11.37 years and 60.56±14.18 years respectively. In the shoulder painful group, it was determined that there was a negative correlation between balance and the fear of movement (r=-0.417; p=0.048) and that there was a positive correlation between the fear of falling and the fear of movement (r=0.429; p=0.041). In the shoulder painless group, there was no significant correlation (p>0.05). There was a statistically significant difference between the kinesiophobia values of two groups (p˂0.05). Conclusion: When balance problems and falls observed in stroke patients are combined with pain and fear of movement, it becomes important to take into account and evaluate the fear of movement in rehabilitation practices., Amaç: Omuz ağrısı, inme sonrası yaygın görülen bir problemdir ve hastalarda fonksiyonel kısıtlılıklara neden olur. Ağrı, hareketten ve fiziksel aktivitelerden uzak durmaya yol açar. Bu çalışmanın amacı, omuz ağrısı olan inmeli hastalarda hareket korkusunu değerlendirmek, denge ve düşme korkusu ile ilişkisini araştırmaktır. Gereç ve Yöntemler: Çalışmaya 46 inme hastası dâhil edildi ve omuz ağrısı olanlar ve olmayanlar olarak 2 gruba ayrıldı. Hareket korkusu Tampa Kinezyofobi Ölçeği ile fonksiyonel denge Berg Denge Ölçeği ile ve düşme korkusu Tinetti Düşme Etkinlik Ölçeği ile değerlendirildi. Bulgular: Ağrısı olan ve olmayan hastaların yaş ortalaması sırasıyla 65,60±11,37 yıl ve 60,56±14,18 yıl idi. Omuz ağrılı grupta denge ve hareket korkusu arasında negatif (r=-0,417; p=0,048), düşme korkusu ile hareket korkusu arasında pozitif (r=0,429; p=0,041) korelasyon olduğu belirlendi. Omuz ağrısı olmayan grupta anlamlı korelasyon yoktu (p>0,05). İki grubun hareket korkusu değerleri arasında istatistiksel olarak anlamlı fark vardı (p˂0,05). Sonuç: İnme hastalarında görülen denge problemleri ve düşmeler, ağrı ve hareket korkusu ile birleştiğinde, rehabilitasyon uygulamalarında hareket korkusunun dikkate alınması ve değerlendirilmesi önem kazanmaktadır.

To evaluate the effect of multimodal exercises integrated with cognitive-behavioural therapy on disability, pain, and quality of life in patients suffering from failed back surgery syndrome (FBSS), and to appraise its extent in the long term. By means of a parallel-group superiority-controlled trial, 150 outpatients were randomly assigned to a 10-week individual-based multimodal programme of task-oriented exercises integrated with cognitive-behavioural therapy (experimental group, 75 patients) or individual-based general physiotherapy (control group, 75 patients). Before treatment, 10 weeks later (post-treatment), and 12 months after the end of treatment, the Oswestry Disability Index (primary outcome), the Tampa Scale for Kinesiophobia, the Pain Catastrophising Scale, a pain intensity numerical rating scale and the Short-Form Health Survey were evaluated. Linear mixed model analysis for repeated measures was carried out for each outcome measure. Significant group (p < 0.001), time (p < 0.001), and time-by-group interaction (p < 0.001) effects were found for all outcome measures. Concerning disability, between-group differences (95% confidential interval) in favour of the experimental group of −9 (−10.7; −7.3) after training and of −13.2 (−14.7; −11.7) at follow-up were found. Also, kinesiophobia, catastrophising and pain showed significant between-group differences of 9, 12.5 and 1.7 points, respectively. The multimodal intervention proposed was superior to general physiotherapy in reducing disability, kinesiophobia, catastrophising, and enhancing the quality of life of patients with FBSS. The effects were reinforced one year after the programme ended.IMPLICATIONS FOR REHABILITATIONMultimodal exercises integrated with cognitive-behavioural therapy induced significant improvements in disability, pain, kinesiophobia, catastrophising, and quality of life of subjects with Failed Back Surgery Syndrome.A well-integrated rehabilitative team which contributes towards reaching intervention goals is advised.Physiotherapists should adopt task-oriented exercises to promote an earlier return to common activities of disabled patients.Psychologists should explain how to modify useless beliefs and support adequate behaviours, in order to produce constructive attitudes towards perceived disability. Multimodal exercises integrated with cognitive-behavioural therapy induced significant improvements in disability, pain, kinesiophobia, catastrophising, and quality of life of subjects with Failed Back Surgery Syndrome. A well-integrated rehabilitative team which contributes towards reaching intervention goals is advised. Physiotherapists should adopt task-oriented exercises to promote an earlier return to common activities of disabled patients. Psychologists should explain how to modify useless beliefs and support adequate behaviours, in order to produce constructive attitudes towards perceived disability.

Background: The rehabilitation phase of patients with lower extremity fractures (LEF) is often hindered post-operatively by fear of moving (kinesiophobia) with consequent deconditioning and declining of functions. Profiling the prevalence of kinesiophobia and its association with demographic variables could become useful during the rehabilitation process. Objective: The study aimed to determine the prevalence of kinesiophobia and its correlation with lower limb functions among patients with LEF post-operatively. Methods: One-hundred and nine (n = 109) patients [male = 79 (72.50%)] with mean age of 41.83 ± 17.37 yr. participated in the cross-sectional study. Participants with LEF who had either undergone closed reduction and immobilization or open reduction with internal or external fixation were recruited into this study using convenience sampling during the rehabilitation phase at the orthopaedic wards of two tertiary healthcare facilities in Accra. Data collection was performed using the Tampa Scale of Kinesiophobia (TSK) and Lower Extremity Functional Scale. Data were analyzed using Spearman’s Rho correlation coefficient and Chi-square tests at p < 0.05.Results: Seventy-nine (72.50%) of the participants exhibited kinesiophobia based on their TSK scores (≥37). The TSK scores were significantly inversely correlated with participants’ lower limb function (r = -0.345; p < 0.001). Participants’ sex as well as the causes, types and sites of the fractures sustained had no significant association (p > 0.050) with the level of kinesiophobia. Conclusion: There was a high prevalence of kinesiophobia which negatively correlated with LEF but was not associated with the type, site, and cause of fracture as well as the participants’ sex. Mitigating kinesiophobia should always be considered an integral rehabilitation goal for in-patients with LEF.

Spor yaralanmaları, sportif faaliyetler sırasında karşılaşılan, bireysel ya da çevresel faktörlerden dolayı oluşabilen yaralanmalardır. Spor yaralanmalarının özellikleri, yapılan spor branşına göre farklılık gösterir. Bu çalışma voleybolcularda görülen kas-iskelet sistemi yaralanmalarını tespit etmek, kinezyofobi düzeylerini incelemek, sporculara ait bazı kişisel bilgiler ile yaralanma ve kinezyofobi arasındaki ilişkiyi incelemek amacıyla yapılmıştır. Voleybol branşında 102 sporcu (61 kadın ve 41 erkek) çalışmaya dahil edildi. Sporcuların yaralanmaları “Kas-İskelet Sistemi Anketi” ile değerlendirildi. Sporcuların kinezyofobi düzeyleri “Tampa Kinezyofobi Ölçeği” ile değerlendirildi. Ayrıca, sporcular demografik bilgilerini içeren kişisel bilgi formunu da doldurdular. Verilerin değerlendirilmesinde SPSS 22 programı kullanıldı. Sonuçlar frekans, yüzde dağılımı, t testi, anova testi ve ki-kare testleri ile değerlendirildi. Anlamlılık düzeyi “p0.05).

To analyze if socioeconomic characteristics as lower education and lower family income are associated factors with the combination of pain catastrophizing and kinesiophobia in patients with knee osteoarthritis (KOA). This cross-sectional study included 140 participants aged 40 years or older with KOA grades II and III. Based on the Pain Catastrophizing Scale (PCS) and the Tampa Scale of Kinesiophobia (TSK), four groups were identified: non-catastrophic/non-kinesiophobic (NC/NK), non-catastrophic/non-kinesiophobic (NC/K), catastrophic/non-kinesiophobic (C/NK), and catastrophic/kinesiophobic (C/K). Pain intensity was measured using the visual analog scale (VAS). The 30-s chair stand test was performed to access physical function. Sociodemographic characteristics included age, sex, years of formal education (0 to 11 and > 11), and family income (up to 2 minimum wages and > 2). Multinomial regression analysis adjusted for age, radiographic severity, physical function, and pain intensity was used to determine the association between lower education and lower family income with the combination of pain catastrophizing and kinesiophobia. Only lower education was independently associated with the combination of pain catastrophizing and kinesiophobia (OR = 3.96 CI 95% 1.01–15.51). Lower education but not lower family income was an important associated factor with the combination of pain catastrophizing and kinesiophobia in individuals with knee osteoarthritis. Thus, physician and physical therapist must pay attention on this important socioeconomic characteristic while conducting the treatment, since specific strategies of approach could be necessary for those patients.

This study aims to compare the effectiveness between aquatic exercise interventions and land-based exercises in the treatment of Chronic Low Back Pain.

Objective: In this study, the most preferred methods of Primary Dysmenorrhea (PD) individuals to cope with menstrual pain and the relationship between kinesiophobia and pain severity. Method: This prospective study was conducted at Yozgat Bozok University Obstetrics and Gynecology Clinic. Sociodemographic information and complementary and alternative tecniques which used to reduce pain with PD diagnosis were recorded. Pain severity, visual analog scale and motion fear levels of PD patients were evaluated with Tampa Kinesiophobia questionnaire. Results: The study included 100 PD individuals with an average age of 20.05 ± 2.6 years and BMI: 22.17 ± 3.35 kg / m2. As a result of the study; it was stated that in order to overcome the pain related to PD, 72% of individuals lay down and rest, 63% cotton dressing, 56% rub the abdomen, 54% listen to music, 52% apply hot on feet, 50% take analgesics, 49% apply hot to the lower abdomen, 47% take hot shower, 36% pray, 34% classic massage, 31% distraction, 31% keep the waist area warm, 26% lie facedown, 26% drink chamomile tea, 25% drink green tea, 25% daydreaming, 22% do diaphragmatic breathing exercises, 23% do aerobic exercises. In addition, a positive correlation was found between kinesiophobia and pain severity. (p

The presence of kinesiophobia was identified in patients with foot problems. There was no finding of foot functionality according to the level of kinesiophobia in lower extremity problems. The aim of this study was to compare the lower extremity functional status in foot problems with a low or high level of kinesiophobia.Evaluated herein were 37 patients with foot problems (plantar fasciitis, hallux valgus, flat foot). Physical and demographic characteristics were recorded. Patients were divided into two groups based on if they had a high or low level of kinesiophobia using the Tampa kinesiophobia scale. Ankle plantar flexor and knee flexor muscles tightness were recorded. The foot posture was evaluated using the Foot Posture Index. Foot-related pain was measured using the Visual Analog Scale FootAnkle. The Foot Function Index and the American Orthopaedics Foot and Ankle Foundation Ankle-Hindfoot Scale and Hallux Metatarsophalangeal-Interphalangeal Scale were used to assess the foot function. The general functional status of the lower extremities was evaluated using the Lower Extremity Functional Scale.Foot function was better in patients with a low level of kinesiophobia (Patients with a high level of kinesiophobia presented with more functional problems in the foot and whole lower extremity; hence, function-based rehabilitation and pain coping strategies should be a crucial part of the rehabilitation program at the earliest opportunity.

ObjectiveKinesiophobia (i.e., fear of movement caused by pain) is increasingly acknowledged as a determinant of disuse among patients with chronic musculoskeletal pain. Kinesiophobia may affect life space—a crucial indicator of an active lifestyle among older people. This study aimed to investigate the previously unexamined association between kinesiophobia and life space among community-dwelling older people with chronic musculoskeletal pain.DesignCross-sectional study.SettingCommunity.SubjectsWe analyzed data from 194 community-dwelling older people (age ≥65 years, mean age = 75.7 years, 71.6% women) with chronic musculoskeletal pain.MethodsKinesiophobia, life space, and pain severity were assessed using the Tampa Scale for Kinesiophobia, Life Space Assessment, and Brief Pain Inventory. Linear regression models were applied to analyze the associations between kinesiophobia and life space, and pain severity and life space.ResultsIn our sample, the prevalence rates for chronic musculoskeletal pain were 10.82% (N = 21) for neck, 55.15% (N = 107) for lower back, 25.26% (N = 49) for shoulder, and 50.00% (N = 97) for knee. The results suggest that higher kinesiophobia is associated with smaller life space (adjusted beta = −0.91, 95% CI = −1.43 to −0.45, P ConclusionsOur findings suggest that kinesiophobia plays an important role in the determination of life space among older people with chronic musculoskeletal pain.

OBJECTIVE The variety and use of technologies used in vestibular rehabilitation are very limited. The purpose of this study was to investigate the effects of a Web-based system on vestibular rehabilitation in patients with vestibular hypofunction. DESIGN A total of 20 patients with unilateral vestibular hypofunction were randomly assigned to two groups. Conventional vestibular rehabilitation was applied to the control group, whereas the study group received treatment with the Web-based system supporting the vestibulo-ocular reflex with oculomotor and optokinetic stimulus (Simulation of Vestibulo-Ocular Reflex Exercises). Vestibular and balance tests, oculomotor level, the Tampa Kinesiophobia Scale, and the Dizziness Handicap Inventory were used to evaluate the treatment's efficacy. RESULTS Vestibular symptoms and findings, balance tests, oculomotor functions, Tampa Kinesiophobia Scale, and Dizziness Handicap Inventory improved significantly in both groups after the interventions (P < 0.05). In the intergroup analysis, improvement was found in eyes closed Romberg, semitandem, and left one-foot position balance tests in favor of the study group (P < 0.05). CONCLUSION The new vestibular technology, Simulation of Vestibulo-Ocular Reflex Exercises, was found to be effective in vestibular rehabilitation.

Background After a distal radius fracture (DRF), severe pain, disabilities, and pain-related psychological problems can arise and sometimes remain ~1 year later. DRF-related disabilities have been assessed with questionnaires but not by kinematic evaluations; the kinematic features of DRF patients are unknown. Here, we investigated the kinematic characteristics of DRF patients and explored the relationship between their clinical assessments and kinematic characteristics. Methods: We analyzed 20 patients with DRFs after their surgeries. We recorded their finger-tapping using a magnetic sensor, and we calculated the velocity, magnitude, and movement-initiation hesitation. The patients’ pain intensity and fear of movement were assessed by a visual analogue scale and the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH). To investigate the features of the patients who achieved only slight improvement, we compared the kinematic characteristics of the DRF patients in 2 subgroups: the “good improvement group” and the “slight improvement group” based on a cutoff value of the DASH score (>40) at 1 month postsurgery. Results: The DASH score at 30 days postsurgery was significantly correlated with hesitation at 1 day postsurgery ( r = .66, P < .0071) and with velocity at 7 days ( r = −.54, P < .0071). Our kinematic analyses revealed significant differences in velocity at 7 days postsurgery ( P < .05) and in hesitation at 1 day postsurgery ( P < .05) between the subgroups. Conclusions: Since assessments using range-of-motion measurements or a questionnaire are not sufficient to evaluate a patient’s movement disorder, a kinematic analysis should be conducted for quantitative assessments.

Fear is an uncomfortable feeling, which results from the proximity of actual threat or pain. A strong correlation exists between fear and pain. Kinesiophobia is the phobia of activity and physical movement, which results from a sensation of sensitivity to painful injury or reinjury. Low back pain (LBP) is among the frequent disorders of the musculoskeletal system. LBP is mainly due to bad postures and poor organisational ergonomics. Kinesiophobia has adverse effects on rehabilitation outcomes. So the systematic application of graded exposure to movements is recommended in patients with Kinesiophobia to prevent pain-related anxiety. We compared Kinesiophobia's impact on patients with both acute and chronic LBP. We aimed to find out the role of Kinesiophobia in patients having LBP. The survey-based research using Tampa scale of Kinesiophobia was conducted with cross-sectional design. It included participants of both genders,in the age group of 18-65 who were diagnosed with acute and chronic low back pain. Tampa Scale for Kinesiophobia, Evaluation Performa, NPRS and Goniometer were used as outcome measures for the study. The patients were thoroughly examined, and they were evaluated using the Tampa Scale. Scoring to 17-items Tampa Scale was performedin4-point Likert scale varying from “strongly disagree” to “strongly agree.” After the inversion of items 4, 8, 12, 16, the final score was determined. The total score ranges from a minimum of 17 to a maximum of 68. It was concluded that Kinesiophobia plays a crucial role in LBP, especially chronic LBP.

Ehlers–Danlos syndromes (EDS) are a group of inherited connective tissue disorders with an impaired quality of life in association with fatigue, pain, and kinesiophobia. A retrospective evaluation of the effects of an outpatient rehabilitation program (RP) was performed in Ehlers–Danlos syndrome hypermobile type (hEDS) patients. The 6‐minute walk test (6MWT) was used to evaluate functional capacity. Kinesiophobia, fatigue, pain, and quality of life were self‐evaluated at the start, at the end, and 6 weeks after the end of the RP. The retrospective analysis of patients' records showed significant improvement for the walked distance during the 6MWT (491.8 ± 72.5 vs. 439.4 ± 100.9 m) maintained at 6‐week follow‐up (p = .001), significant improvement for kinesiophobia (p = .033) and the impact of fatigue on activity (p = .01), and significant increase for quality of life with in particular improvements of vitality (p = .001). This retrospective study showed encouraging results of a RP for hEDS patients on functional capacity and quality of life, and prospective studies with long‐term follow‐up are needed to confirm them.

Purpose Fear of movement (kinesiophobia) is a major limiting factor in the return to pre-injury sport level after anterior cruciate ligament reconstruction (ACLR). The aim of this study was to gain insight into the prevalence of kinesiophobia pre-ACLR, 3 months post-ACLR and 12 months post-ACLR. Furthermore, the preoperative predictability of kinesiophobia at 3 months post-ACLR was addressed. Methods A retrospective study with data, which were prospectively collected as part of standard care, was conducted to evaluate patients who underwent ACLR between January 2017 and December 2018 in an orthopaedic outpatient clinic. Patient characteristics (age, sex, body mass index), injury-to-surgery time, preoperative pain level (KOOS pain subscale) and preoperative knee function (IKDC-2000) were used as potential predictor variables for kinesiophobia (TSK-17) at 3 months post-ACLR in linear regression analysis. Results The number of patients with a high level of kinesiophobia (TSK > 37) reduced from 92 patients (69.2%) preoperatively to 44 patients (43.1%) 3 months postoperatively and 36 patients (30.8%) 12 months postoperatively. The prediction model, based on a multivariable regression analysis, showed a positive correlation between four predictor variables (prolonged injury-to-surgery time, high preoperative pain level, male sex and low body mass index) and a high level of kinesiophobia at 3 months postoperatively (R2 = 0.384, p = 0.02). Conclusion The prevalence of kinesiophobia decreases during postoperative rehabilitation, but high kinesiophobia is still present in a large portion of the patients after ACLR. Timing of reconstruction seems to be the strongest predictor for high kinesiophobia 3 months post-ACLR. This study is the first step in the development of a screening tool to detect patients with kinesiophobia after ACLR. Identifying patients preoperatively opens the possibility to treat patients and thereby potentially increase the return to pre-injury sport level rate after ACLR. Level of evidence III.

Objective To investigate the levels of kinesiophobia, physical activity, depression, disability, and quality of life in patients with knee osteoarthritis. Design A cross-sectional study. Setting A tertiary health care center. Subjects Ninety-six patients with knee osteoarthritis. Methods Pain intensity was evaluated by the Visual Analog Scale, kinesiophobia by the Tampa Scale of Kinesiophobia and Brief Fear of Movement Scale, depression by the Beck Depression Inventory, disability by the Western Ontario and McMaster Universities Arthritis Index, physical activity level by the International Physical Activity Questionnaire short form, and quality of life by the Short Form 12 Health Survey Questionnaire. Results Of the patients, 85.7% had high-level kinesiophobia, 70.6% had depression, and 64.4% had low, 27.8% moderate, and 7.8% high physical activity levels. Age, activity-related pain score of the Visual Analog Scale, Tampa Scale of Kinesiophobia and Brief Fear of Movement Scale scores, and Western Ontario and McMaster Universities Arthritis Index and Beck Depression Inventory scores were higher in the group with high-level kinesiophobia, whereas the mental, physical, and total scores obtained from the Short Form 12 Health Survey Questionnaire were higher in the group with low-level kinesiophobia (P Conclusions As the treatment of pain alone in patients with knee osteoarthritis is not sufficient to reduce fear of movement, we suggest that approaches to increase awareness of fear of movement and physical activity and cognitive behavioral therapy related to fear of movement should be included in the treatment program.

Objective: The aim of this study was to compare the effectiveness of scapular exercises alone and combined with cognitive functional therapy in treating patients with chronic neck pain and scapular downward rotation impairment. Design: Single-blind randomized controlled trial. Setting: Outpatient. Subjects: A total of 72 patients (20–45 years old) with chronic neck pain were studied. Intervention: Allocation was undertaken into three groups: scapular exercise ( n = 24), scapular exercise with cognitive functional therapy ( n = 24) and control ( n = 24) groups. Each programme lasted three times a week for six weeks. Main outcomes: The primary outcome measure was pain intensity measured by the visual analogue scale scores. The secondary outcome measures included kinesiophobia and muscles activity. Results: Statistically significant differences in pain intensity were found when multidisciplinary physiotherapy group including a cognitive functional approach was compared with the scapular exercise alone group at six weeks (effect size (95% CI) = −2.56 (−3.32 to −1.80); P = 0.019). Regarding kinesiophobia, a significant between-group difference was observed at six-week (effect size (95% CI) = −2.20 (−2.92 to −1.49); P = 0.005), with the superiority of effect in multidisciplinary physiotherapy group. A significant between-group differences was observed in muscle activity. Also, there were significant between-group differences favouring experimental groups versus control. Conclusion: A group-based multidisciplinary rehabilitation programme including scapular exercise plus cognitive functional therapy was superior to group-based scapular exercise alone for improving pain intensity, kinesiophobia and muscle activation in participants with chronic neck pain.

Objective To investigate whether kinesiophobia with pregnancy-related lumbopelvic pain at late pregnancy influenced depressive symptoms at 1 month after delivery. Method Final participants were 43 pregnant women who experienced pregnancy-related lumbopelvic pain at late pregnancy and completed self-reported questionnaires at late pregnancy and 1 month after delivery. The Tampa Scale for Kinesiophobia was used to evaluate kinesiophobia, and depressive symptoms were assessed using the Self-Rating Depression Scale. We divided participants into two groups (depression and no-depression) using the score of the Self-Rating Depression Scale at 1 month after delivery. Univariate analysis and multiple logistic regression analysis identified kinesiophobia at late pregnancy as an independent predictor of depression at 1 month after delivery. Results In univariate analysis, kinesiophobia at late pregnancy was significantly higher in the depression group than in the no-depression group (P= .033). In multiple logistic regression analysis, kinesiophobia at late pregnancy were significantly associated with depression at 1 month after delivery even after adjusting for confounding factors (Odds Ratio, 1.25; 95% Confidence Interval, 1.03-1.52). Conclusion Results found that kinesiophobia at late pregnancy negatively influenced depressive symptoms at 1 month after delivery, suggesting that approaches to treat kinesiophobia at late pregnancymight reduce the risk of onset of postpartum depressive symptoms.

Objective: Physical and psychological factors affect disability in patients with chronic shoulder pain. Kinesiophobia which is described as fear of movement may induce disability. Therefore, we aimed to compare kinesiophobia levels between patients with chronic shoulder pain and healthy volunteers and to determine the correlations between kinesiophobia and disability, pain and anxiety. Material and methods: This is a case-control study. 54 patients with shoulder pain and 56 healthy volunteers similar to case group in terms of age, sex and body mass index were enrolled in this research. Patients were evaluated with visual analogue scale, active range of motion measurements, Tampa Scale for Kinesiophobia, Shoulder Pain and Disability Index and Beck Anxiety Inventory. Results: Tampa Scale for Kinesiophobia, Shoulder Pain and Disability Index-pain, Shoulder Pain and Disability Index-disability and Beck Anxiety Inventory scores were significantly higher in the patient group (p 0.05). Conclusion: Kinesiophobia is associated with disability, pain and anxiety in patients with chronic shoulder pain. Therefore, factors associated with kinesiophobia should be clearly identified and strategies should be created to improve kinesiophobia levels.

Background Limited evidence exists which details changes in quality of life, shoulder activity level, kinesiophobia, shoulder pain and disability following a first-time traumatic anterior shoulder dislocation (FTASD) in people treated non-operatively. This study had three objectives: (1) to examine quality of life, pain, disability and kinesiophobia after an FTASD within 12 weeks, (2) to examine whether these variables were different in people with and without recurrent shoulder instability and (3) to assess how these variables changed over 12 months. Methods A prospective cohort study was undertaken in people with an FTASD aged between 16 and 40 years. Measures of quality of life, kinesiophobia, shoulder activity, shoulder pain and disability were recorded within 12 weeks of an FTASD and at 3, 6, 9 and 12 months. Results An FTASD negatively impacted quality of life, shoulder pain and function and these variables improved over time. People with recurrent shoulder instability had poorer quality of life 12 months after an FTASD. Across the entire cohort, kinesiophobia did not significantly change across time in people following an FTASD. Conclusions Quality of life was significantly affected by an FTASD in people with recurrent shoulder instability. Across the entire cohort of people with an FTASD, kinesiophobia remained elevated in people following an FTASD. Level of evidence Level 1 prognostic study.

Purpose: To (1) investigate trends in kinesiophobia and pain catastrophizing after hip arthroscopy for femoroacetabular impingement syndrome (FAIS), and (2) determine whether kinesiophobia and pain catastrophizing scores are associated with achieving minimal clinically important difference (MCID) for any of the hip-specific patient-reported outcome questionnaires. Methods: Patients undergoing primary hip arthroscopy for treatment of FAIS between December 2016 and March 2017 were prospectively enrolled. Patients received the Tampa Scale of Kinesiophoibia-11 (TSK-11) and Pain Catastrophizing Scale (PCS) questionnaires preoperatively, 6 months, and 1 year postoperatively. They also received the hip-specific patient-reported outcome questionnaires (Hip Outcome Score Activities of Daily Living and Sport-Specific subscales, modified Harris Hip Score, and International Hip Outcome Tool-12), as well as visual analog scale for satisfaction and pain preoperatively and 1-year postoperatively. The threshold for achieving MCID was determined for each hip outcome tool, and patients achieving MCID were compared with those who did not. Results: A total of 85 (80.2%) patients (mean age: 33.7 ± 12.4 years; female: 75.3%) were included in the final analysis. At 1-year follow-up, there was a significant reduction in TSK-11 scores (26.22 ± 5.99 to 18.70 ± 6.49; P < .001) and PCS scores (17.81 ± 10.13 to 4.77 ± 7.57; P < .001) when compared with preoperative scores. 1-year PCS scores were significantly lower in patients achieving MCID compared with patients failing to achieve MCID (3.2 ± 4.4 vs 10.8 ± 15.2; P = .006). There were no significant differences in TSK-11 scores between those achieving and not achieving MCID. Conclusions: Patient kinesiophobia and pain catastrophizing both show significant improvements 1 year after undergoing hip arthroscopy for FAIS. However, pain catastrophizing scores at 1 year are significantly greater in patients not achieving MCID, whereas no association was identified between kinesiophobia and likelihood for MCID achievement. This suggests PCS may be a more useful tool than TSK-11 during postoperative rehabilitation for identifying patients at risk for not achieving MCID. Level of Evidence: Level II, prospective case series

PURPOSE: The primary goal of this study was to compare the health-related quality of life (HRQoL) of people with lumbar radiculopathy to age- and sex-adjusted population norms. Additionally, it aimed to explore the associations between the HRQoL difference scores and measures related to pain cognitions, pain intensity, and endogenous nociceptive modulation. METHODS: Using answers from the Short Form 36-item Health Survey and UK population norms, SF-6D difference scores were calculated. A one-sample t test was used to assess the SF-6D difference scores. Univariate and multivariate regression analyses were used to assess the associations between SF-6D difference scores and pain intensity [Visual Analogue Scale (VAS) for back and leg pain], pain cognitions [Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), Pain Vigilance and Awareness Questionnaire (PVAQ)], and correlates for endogenous nociceptive modulation using quantitative sensory testing. RESULTS: One hundred and twenty people with lumbar radiculopathy scheduled for surgery were included in this study. The mean SF-6D difference score of - 0.26 [SD = 0.09] was found to be significantly less than 0 [95%CI: - 0.27 to - 0.24]. Univariate analyses showed a significant influence from PCS, TSK, and PVAQ on the SF-6D difference scores. The final multivariate regression model included PCS and PVAQ, with only PCS maintaining a statistically significant regression coefficient [b = - 0.002; 95% CI: - 0.004 to - 0.001]. CONCLUSION: People diagnosed with lumbar radiculopathy report significantly lower HRQoL scores when compared with age- and sex-adjusted UK norm values. Even though all examined pain cognitions were found to have a significant association, pain catastrophizing showed the most significant relation to the SF-6D difference scores. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier No. NCT02630732. Date of registration: November 25, 2015.

Background and purpose: Low back pain (LBP)-related misbeliefs are known to be among risk factors for LBP chronification and for persistence of chronic pain. The main objective of this study was to investigate the current LBP-related beliefs in the general population in Belgium, considering the fact that the last survey in Belgium about the topic was conducted more than 15 years ago. Methods: A cross-sectional study design was used. Belgian adults (>17 years old) were recruited in the three regions of the country by means of non-probabilistic recruitment methods. Participants were invited to fill in a battery of questionnaires including demographic questions as well as questions about their LBP history and the LBP Beliefs Questionnaire (LBPBQ). Results: A total of 3724 individuals participated in the study. The LBPBQ scores indicated several LBP-related misbeliefs. About 15%-25% of participants still think that imaging tests can always identify the cause of pain and that bed rest is the mainstay of therapy. The majority of the participants think that "unnecessary" movements should be avoided when having LBP (58% of the respondents), and that they should "take it easy" until the pain goes away (69%). Most respondents also had maladaptive/wrong expectations, for example, a systematic worsening with time (65%) and a need for surgery in case of disc herniation (54%). Conclusions: The present study suggests that in 2020 several LBP-related misbeliefs are still current in Belgium, particularly regarding the vulnerability of the spine. Therefore, further efforts to improve LBP-related beliefs/knowledge in the general population are necessary.

Objective The authors sought to gain insight into the changes in psychological factors during rehabilitation after Achilles tendon rupture (ATR) and to explore the association between psychological factors during rehabilitation and functional outcome 12 months after ATR. Methods Fifty patients clinically diagnosed with ATR were invited to visit the hospital 3, 6, and 12 months after injury for data collection. They completed questionnaires assessing psychological factors: psychological readiness to return to sport (Injury Psychological Readiness to Return to Sport Questionnaire); kinesiophobia (Tampa Scale for Kinesiophobia); expectations, motivation, and outcome measures related to symptoms and physical activity (Achilles Tendon Total Rupture Score); and sports participation and performance (Oslo Sports Trauma Research Centre Overuse Injury Questionnaire). To determine whether psychological factors changed over time, generalized estimating equation analyses were performed. Multivariate regression analyses were used to study the association between psychological factors at 3, 6, and 12 months and outcome measures at 12 months after ATR. Results Psychological readiness to return to sport improved, and kinesiophobia decreased significantly during rehabilitation. Psychological readiness at 6 and 12 months showed significant associations with sports participation and performance. Kinesiophobia at 6 months was significantly associated with symptoms and physical activity. Motivation remained high during rehabilitation and was highly associated with symptoms and physical activity, sports participation, and performance. Conclusion Psychological factors change during rehabilitation after ATR. Patients with lower motivation levels during rehabilitation, low psychological readiness to return to sports, and/or high levels of kinesiophobia at 6 months after ATR need to be identified. Impact According to these results, psychological factors can affect the rehabilitation of patients with ATR. Physical therapists can play an important role in recognizing patients with low motivation levels and low psychological readiness for return to sport and patients with high levels of kinesiophobia at 6 months post-ATR. Physical therapist interventions to enhance motivation and psychological readiness to return to sport and to reduce kinesiophobia need to be developed and studied in the post-ATR population. Lay Summary With Achilles tendon rupture, level of motivation, psychological readiness for return to sport, and fear of movement can affect rehabilitation outcome. A physical therapist can help recognize these factors.

Individuals affected by chronic lower-back pain and obesity have an increased risk of long-lasting disability. In this study, we aimed to explore the contribution of kinesiophobia and pain catastrophizing in explaining pain intensity and pain-related disability in chronic lower-back pain associated to obesity. A cross-sectional study on 106 participants with obesity and chronic lower-back pain was performed. We assessed pain intensity, pain disability, pain catastrophizing, and kinesiophobia levels through self-reporting questionnaire. Hierarchical regressions were performed to assess the role of pain catastrophizing and kinesiophobia on pain intensity and pain disability. According to the results, kinesiophobia, but not pain catastrophing, significantly explained both pain intensity and pain-related disability. Kinesiophobia might play a significant role in enhancing pain-related disability and the pain intensity in individuals with chronic lower-back pain and obesity. We encourage future studies in which beliefs and cognition towards pain might be a therapeutic target in interdisciplinary pain management interventions.