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OBJECTIVE: To (1) compare activity-related psychological factors between individuals with and without knee conditions, and (2) assess associations between these factors and objective measures of function in individuals with knee conditions. DESIGN: A priori registered systematic review with meta-analysis. LITERATURE SEARCH: MEDLINE-Ovid, Embase-Ovid, Scopus-Elsevier, CINAHL-EBSCO, SPORTDiscus-EBSCO, and Cochrane Library were searched to May 27, 2022. STUDY SELECTION CRITERIA: We included peer-reviewed primary data studies (observational and experimental) of human participants with and without knee conditions reporting knee confidence, fear of movement/avoidance beliefs, and/or psychological readiness to return to sport (RTS) or reporting correlations between these factors and objective measures of function in knee conditions. DATA SYNTHESIS: Where possible, data were pooled by knee conditions, otherwise performed narrative syntheses. The Downs and Black checklist assessed the methodological quality of the included studies. RESULTS: Forty studies (3546 participants with knee conditions; 616 participants without knee conditions) were included. There was very low--certainty evidence of higher fear of movement in individuals with knee osteoarthritis (standardized mean difference [SMD], 0.46; 95% confidence interval [CI]: 0.41, 0.52), but not in individuals with patellofemoral pain (SMD, 0.66; 95% CI: -7.98, 9.29) when compared with those without knee conditions. There was very low-certainty evidence of no differences in psychological readiness to RTS after anterior cruciate ligament reconstruction (SMD, -1.14; 95% CI: -2.97, 0.70) compared to no knee condition, and negligible to weak positive correlations between psychological readiness to RTS and objective measures of function. CONCLUSION: There was very low-certainty evidence of higher fear of movement in individuals with knee osteoarthritis compared to those without, and very low--certainty evidence of no correlations between these factors and objective measures of function following anterior cruciate ligament reconstruction. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore whether preoperative pain intensity, pain cognitions, and quantitative sensory measures influence the established effectiveness of perioperative pain neuroscience education (PPNE) on health-related quality of life at 1 year after surgery for lumbar radiculopathy. DESIGN: Secondary analysis of a triple-blinded randomized controlled trial. METHODS: Participants (n = 90) were Dutch-speaking adults (18-65 years) who were scheduled for surgery for lumbar radiculopathy in 3 Belgian hospitals. They were randomized (1:1) to receive PPNE (n = 41) or perioperative biomedical education (n = 49). Linear mixed models were built for health-related quality of life (ie, SF-6D utility values, Physical and Mental Component of the 36-item Short Form Health Survey) using the following independent variables: therapy, time, and preoperative scores for back and leg pain intensity, pain catastrophizing, kinesiophobia, hypervigilance, and quantitative sensory measures. RESULTS: The impact of PPNE on SF-6D utility values over time was influenced by kinesiophobia (F = 3.30, P = .02) and leg pain intensity (F = 3.48, P = .02). Regardless of the intervention, back pain intensity negatively influenced SF-6D values over time (F = 3.99, P = .009). The Physical Component scores were negatively impacted by back pain intensity (F = 9.08, P = .003) and were influenced over time by leg pain intensity (F = 2.87, P = .04). The Mental Component scores were negatively impacted by back pain intensity (F = 6.64, P = .01) and pain catastrophizing (F = 5.42, P = .02), as well as hypervigilance (F = 3.16, P = .03) and leg pain intensity (F = 3.12, P = .03) over time. CONCLUSION: PPNE may be more effective than perioperative biomedical education in improving postoperative health utility values in patients who reported higher kinesiophobia and leg pain intensity before surgery for lumbar radiculopathy. [ABSTRACT FROM AUTHOR]

Chronic pain affects individuals’ activity levels. Three activity patterns are observed among individuals with chronic pain: avoidance, overdoing, and regularization. According to fear - avoidance models, kinesiophobia is related to pain severity and disability. Kinesiophobia is a psychological factor that attracts attention in people with persistent pain, is related to the severity and persistence of pain. The aim of this study was to compare demographic and clinical characteristics of individuals with chronic inflammatory low back pain (ILBP) and mechanical low back pain (MLBP), in relation to kinesiophobia, fear-avoidance beliefs, and pain/activity patterns. A total of 89 people (45 MLBP, 44 ILBP) aged 18-65 were included in this cross-sectional study. A Visual Analog Scale (VAS) was used to inquire about for the duration of axial spondylarthritis diagnosis, duration of LBP, duration of morning stiffness, general pain, pain during movement, and night pain. Patients' fear of movement due to pain was assessed with the Tampa Kinesiophobia Scale (TKS), pattern changes in daily activities were assessed with the Pain-Activity Pattern Scale (PAPS), and fear-avoidance was assessed with the Fear-Avoidance Beliefs Questionnaire (FABQ). The scores obtained were compared. There was no statistically significant difference between the MLBP and ILBP groups in terms of age (p=0.202), BMI (p=0.124), gender (0.459), education level (p=0.082) and VAS-movement (p=0.071), FABQ score (0.277), PAPSa (p=0.454), PAPSe (0.596), PAPSs (p=0.247), and TKS score (p=0167). Whereas a statistically significant difference was found between the duration of morning stiffness (p=0.001), pain duration (p=0.018), VAS resting (p=0.001), and VAS night (p=0.001) score. It was observed that high resting and night VAS scores in the ILBP group were not associated with fear-avoidance and kinesiophobia behaviors any more than in the MLBP group. The fear- avoidance and kinesiophobia behaviors of both groups were affected to a similar extent, even though the pain type was different. [ABSTRACT FROM AUTHOR]

Background Owing to progress in information and communication technology, use of computers has been increased in developed nations. Neck discomfort is known to have psychological effect that makes daily life challenging and contributes toward persistence. To create an effective, reliable rehabilitation plan and improve the existing protocols available for the patients, the proposed study attempted to address the subject of the association between kinesiophobia, anxiety, and chronic neck pain. Objective The aim of this study was to find the association between kinesiophobia, anxiety, and severe neck pain among computer programmers. Method After getting the consent, 388 subjects based on selection criteria were recruited from various information technology industries in Bangalore. Then, the subjects underwent a check for neck pain using Nordic Musculoskeletal questionnaires that were divided into case and control groups, respectively. Subjects were thereafter assessed for kinesiophobia and anxiety using Tampa Scale of Kinesiophobia and Penn State Worry Questionnaire, respectively. Descriptive and inferential statistics were used for the collected data using SPSS software. Results Out of 388 participants, the neck pain prevalence was found to be 68.80%. The result shows that the mean and standard deviation for kinesiophobia and anxiety score was 43.47 ± 16.132 and 47.15 ± 22.799 for case group, respectively, whereas for control group, it was 22.40 ± 6.470 and 21.92 ± 9.656, respectively. Significant association between kinesiophobia anxiety and long-term neck pain in computer programmers that shows p-value less than 0.05 was detected with chi-squared test. Conclusion There was positive association seen in kinesiophobia and anxiety among computer programmers with persistent neck pain. [ABSTRACT FROM AUTHOR]

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Background Onychocryptosis is a nail deformity that occurs when the side of the nail grows into soft tissue, which causes pain, sepsis and the formation of granulation. The aim of the study was to evaluate and compare different levels of kinesiophobia in subjects with onychocryptosis before and after surgery to eliminate this condition. Methods A descriptive and observational study was conducted with a total sample size of 25 subjects with a mean age of 40.96 ± 18.25 years. The pretest sample was composed of the 25 subjects before the surgical treatment of onychocryptosis and the posttest sample was composed of the same 25 subjects after the surgical treatment of onychocryptosis. Kinesiophobia levels and total scores were self-reported using the Spanish version of the Tampa Scale for Kinesiophobia (TSK-11). Results The Wilcoxon test for related samples and the Mann-Whitney U test for independent samples were used to compare the results before and after the surgical treatment. It was observed that in all the items as well as in the total score, there were significant changes in the levels of kinesiophobia, after the surgical intervention for onychocryptosis (P 0.05). Before surgery, 0% of the subjects with onychocryptosis reported not being afraid of movement, 16% reported mild fear of movement, 8% reported moderate fear of movement and 76% of the subjects with onychocryptosis reported severe and maximum fear of movement. On the other hand, 100% of the subjects did not report kinesiophobia after surgical treatment (P

Abstract Background The current study aimed to determine the changes in pre-and post-operative Pittsburg sleep quality index (PSQI) and Tampa scale of kinesiophobia (TSK) values ​​according to the Hamada classification in patients who underwent reverse shoulder arthroplasty (RSA) for rotator cuff tear arthropathy (RCTA). Methods One hundred and eight patients who underwent RSA for RCTA were reviewed retrospectively. The patients were divided into two groups with low grade (stages 1-2-3) (n = 49) and high grade (stages 4a-4b-5) (n = 59) according to the Hamada classification, which is the radiographic evaluation of RCTA. PSQI and TSK values ​​were calculated preoperatively, and post-operatively at the 6th week, 6th month, and 1st year. The change in PSQI and TSK values ​​between the evaluations and the effect of staging according to the Hamada classification on this change was examined. Results When compared in preoperative evaluations, PSQI and TSK scores were found to be lower in low-grade group 1 (7.39 ± 1.56, 51.88 ± 4.62, respectively) than in high-grade group 2 (10.47 ± 2.39, 57.05 ± 3.25, respectively) according to Hamada classification (both p 37). In the 1st year follow-ups, sleep disturbance was observed in 5 (5%) patients and kinesiophobia in 1 (1%) patient. When the Hamada stages were compared, it was seen that there was a significant difference before the operation (both p

Objective To determine the association between health-related quality of life (HRQOL) and neck pain, kinesiophobia, and modalities of physical activity in individuals with postoperative degenerative cervical myelopathy and radiculopathy (DCM/R) because postoperative pain after cervical spine surgery is likely to persist, causing kinesiophobia and avoidance of physical activity. Methods A questionnaire was distributed to 280 individuals with DCM/R. The questionnaire comprised the following four items: HRQOL (EuroQol 5-dimensions 5-level), neck pain (numerical rating scale [NRS]), kinesiophobia (11-item Tampa Scale for Kinesiophobia [TSK-11]), and physical activity (paid work, light exercise, walking, strength training, and gardening). Hierarchical multiple regression analysis was performed using the NRS, TSK-11, and physical activity as independent variables. Results In total, 126 individuals provided analyzable responses (45.0%). After including the NRS score as an independent variable to the multiple regression equation for participants’ background, the independent rate of the regression equation significantly improved by only 4.1% (R2=0.153). The addition of the TSK-11 score significantly improved this effect by 11.1% (R2=0.264). Finally, the addition of physical activity also significantly improved the explanatory rate by 9.9% (R2=0.363). Conclusion Neck pain, kinesiophobia, and physical activity (specifically paid work and walking) were independently associated with HRQOL in individuals with postoperative DCM/R.

Abstract Background Muscle weakness, balance, and functional capacity are affected in patients with chronic kidney disease (CKD) in dialysis. However, studies about kinesiophobia, peripheral and respiratory muscle strength, balance, exercise capacity, fatigue, and physical activity level in patients with CKD 3–4 are limited. The study aimed to compare the functional exercise capacity, peripheral and respiratory muscle strength, pulmonary function, balance, kinesiophobia, physical activity, fatigue, and dyspnea between patients with CKD 3–4 and controls. Methods This cross-sectional study included 43 patients and 45 controls. Functional exercise capacity [6-Minute Walking Test (6MWT)], peripheral and respiratory muscle strength, pulmonary function, dyspnea, fatigue, physical activity, balance [Berg Balance Scale (BBS)], and kinesiophobia were evaluated. Results Demographic characteristics were similar in patients [53(50–57) y, 26 M/17F] and controls [51(4.506-55) y, 33 M/12F] (p > 0.05). The 6MWT, respiratory and peripheral muscle strength, pulmonary function, physical activity, and BBS were significantly lower, and the level of dyspnea and kinesiophobia were higher in patients compared with controls (p

Abstract Background Physical activity is a guideline-recommended first-line intervention for people with knee osteoarthritis. Physical activity levels, and its potential correlates, is underexplored in Asian populations with knee osteoarthritis. Methods Participants enrolled in a longitudinal study in Singapore self-reported physical activity (UCLA activity score), function (Knee Osteoarthritis Outcome Score [KOOS-12]), kinesiophobia (Brief fear of movement [BFOM]), self-efficacy (ASES-8), and quality of life (EQ-5D-5 L). One-Way ANOVA was used to test the difference in outcomes between UCLA categories, while ordinal logistic regression was used to identify the associated factors to physical activity level. Results Seventy-three percent of all enrolled participants (n = 311/425) reported either inactivity or low physical activity (median 4, IQR 3–5). Significant, weak, positive correlations were observed be-tween UCLA activity score and either KOOS-12 (Spearman’s rho: 0.1961; p

Objectives: This study aimed to evaluate the measurement properties and methodological quality of assessment tools for Kinesophobia among patients with cardiovascular disease and provide a reference for healthcare professionals in selecting high-quality assessment tools. Methods: A systematic search was performed on specific databases: Embase, the Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang database, China Biological Medicine disc, CINAHL, and China Science and Technology Journal Database, from inception to April 1, 2023. The researchers retrieved studies on the measurement attributes of the exercise fear scale in patients with cardiovascular diseases. They also traced back the references of the included studies to supplement relevant literature. According to the inclusion and exclusion criteria, screening and data extraction were independently undertaken by two reviewers. Two researchers individually used the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) Risk of Bias Checklist to assess the methodological quality of the scale, applied the COSMIN criteria to evaluate the measurement properties of the scale, and used a modified Grading, Recommendations, Assessment, Development, and Evaluation system to assess the certainty of evidence. Results: Seventeen studies were identified that reported the psychometric properties of six patient reported outcome measurement tools (included different languages version) The methodological quality of content validity was adequate in only two studies, the remaining patient-reported outcome measures demonstrated doubtful content validity. Limited information on cross-cultural validity/measurement invariance, measurement error, and responsiveness was retrieved. The Swedish version and the Chinese version of the Tampa Scale for Kinesiophobia Heart were graded “A.” The remaining instruments were graded “B.” Conclusions: The methodological and measurement attributes of the Swedish and Chinese versions of the Tampa Scale for Kinesiophobia Heart are relatively high quality and can be tentatively recommended. The measurement properties of the remaining scales remain to be verified.

Purpose: Chronic non-specific low back pain (CNSLBP) is a common health issue caused by a mix of biological, psychological, and social factors. Cognitive functional therapy (CFT) is a comprehensive way to treat CNSLBP that focuses on changing negative thoughts and unhelpful habits through relaxation techniques. Since the evidence on the efficacy of CFT is still limited, it is essential to conduct clinical trials aimed at the effectiveness of CFT in the treatment of CNSLBP. This study aims to examine the effect of cognitive functional therapy on psychological variables in women with CNSLBP. Methods: Thirty women with CNSLBP were recruited for the clinical trial. They were randomly divided into two experimental and control groups (15 patients in each group). Our experimental group will have 18 individualized CFT sessions, each lasting an hour, over two months. The control group received no intervention. Pain intensity, disability, and kinesiophobia were assessed via the visual analog scale, Oswestry, and Tampa scale, respectively. Two-way repeated measures analysis of variance (ANOVA) was used to compare results between groups. Results: Two-way repeated measures ANOVA results showed that the experimental group compared to the control group in reducing pain (P=0.000, ηp2=0.787), disability (P=0.005, ηp2=0.457) and Kinesiophobia (P=0.000, ηp2=0.561) had a significant difference. Conclusion: CFT reduced pain, disability, and kinesiophobia in patients with CNSLBP. Further evaluation of the efficacy of CFT in high-quality randomized clinical trials among patients with CNSLBP is recommended.

Pain, muscle spasms, loss of muscle strength, and deteriorated posture adversely affect the patient's daily life activities and quality of life. Within the scope of this research, we aimed to elucidate pain, sleep quality, quality of life, and kinesiophobia levels in patients with lumbar disc herniation and to determine their relationship with depressive symptoms. The data of 74 patients who applied to our institution between 01/01/2020 – 01/04/2023 with a diagnosis of lumbar disc herniation have been analyzed retrospectively Sociodemographic information form (SIF), Nottingham Health Profile (NHP), Tampa Kinesiophobia Scale (TKS), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Scale (BDS), and Visual Analogue Scale (VAS) were applied to the participants in the study. A statistically significant difference has been achieved between the groups in the VAS pain severity, TAMPA, Pittsburgh sleep quality scale, 1, 2 in the NSP scale, and the sub-dimensions of emotion, sleep, social, physical and energy (p [Med-Science 2023; 12(4.000): 1112-6]

Abstract Background Movement behaviours, such as sedentary behaviour (SB) and moderate to vigorous physical activity (MVPA), are linked with multiple aspects of health and can be influenced by various pain-related psychological factors, such as fear of movement, pain catastrophising and self-efficacy for exercise. However, the relationships between these factors and postoperative SB and MVPA remain unclear in patients undergoing surgery for lumbar degenerative conditions. This study aimed to investigate the association between preoperative pain-related psychological factors and postoperative SB and MVPA in patients with low back pain (LBP) and degenerative disc disorder at 6 and 12 months after lumbar fusion surgery. Methods Secondary data were collected from 118 patients (63 women and 55 men; mean age 46 years) who underwent lumbar fusion surgery in a randomised controlled trial. SB and MVPA were measured using the triaxial accelerometer ActiGraph GT3X+. Fear of movement, pain catastrophising and self-efficacy for exercise served as predictors. The association between these factors and the relative time spent in SB and MVPA 6 and 12 months after surgery was analysed via linear regression models, adjusting for potential confounders. Results Preoperative fear of movement was significantly associated with relative time spent in SB at 6 and 12 months after surgery (β = 0.013, 95% confidence interval = 0.004 to 0.022, p = 0.007). Neither pain catastrophising nor self-efficacy for exercise showed significant associations with relative time spent in SB and MVPA at these time points. Conclusions Our study demonstrated that preoperative fear of movement was significantly associated with postoperative SB in patients with LBP and degenerative disc disorder. This finding underscores the potential benefits of preoperative screening for pain-related psychological factors, including fear of movement, preoperatively. Such screenings could aid in identifying patients who might benefit from targeted interventions to promote healthier postoperative movement behaviour and improved health outcomes.

Yi Zhou,1 Weina Gao,2 Shumin Gao,2 Xutong Guo,2 Meng Liu,2 Congjie Cao1 1School of Nursing, Langfang Health Vocational College, Langfang, Hebei, People’s Republic of China; 2Department of Orthopedics, Baoding No.1 Central Hospital, Baoding, Hebei, People’s Republic of ChinaCorrespondence: Weina Gao, Department of Orthopedics, Baoding No.1 Central Hospital, No. 320, Changcheng North Street, Lianchi District, Baoding, Hebei, 071000, People’s Republic of China, Tel/Fax +86 312-5975023, Email gaoweina984926@163.comPurpose: To examine whether exercise self-efficacy mediates the contributions of pain catastrophizing and kinesiophobia to exercise adherence in patients after total knee arthroplasty.Patients and Methods: A cross-sectional study design was conducted. A total 211 post-total knee arthroplasty patients were recruited from three orthopedics units of a tertiary hospital in China. Participants were invited to complete questionnaires on pain catastrophizing, kinesiophobia, exercise self-efficacy, and exercise adherence. Mplus 8.3 software was used to construct mediation models.Results: Pain catastrophizing and kinesiophobia were negatively correlated with exercise adherence (r = − 0.509, r = − 0.605, p < 0.001 respectively), while exercise self-efficacy were positively associated with exercise adherence (r = 0.799, p < 0.001). The results found exercise self-efficacy mediated the correlations of pain catastrophizing and kinesiophobia with exercise adherence after adjusting for demographic and clinical covariates. Pain catastrophizing indirectly affected patients’ exercise adherence through its effect on exercise efficacy (indirect effect: − 0.412), while Kinesiophobia is directly associated with exercise adherence and also indirectly through exercise self-efficacy (direct effect: − 0.184, indirect effect: − 0.415).Conclusion: Patients after total knee arthroplasty who have high levels of psychological distress (pain catastrophizing and kinesiophobia) are vulnerable to be non-adherent to exercise behaviors. Exercise self-efficacy explains the effects of pain catastrophizing and kinesiophobia on exercise adherence and may be a key target for measures to improve exercise behaviors in patients after total knee arthroplasty.Keywords: pain catastrophizing, kinesiophobia, self-efficacy, exercise, adherence, total knee arthroplasty

The current study aimed to investigate the weight status and the level of kinesiophobia of university male students with non-specific lower back pain. 106 male students were enrolled voluntarily in the study. Kinesiophobia had assessed using the Tampa Scale (TSK), pain with 0-to-10 Pain Numerical Rating Scale (NRS). Subgroups was classified according to BMI and to kinesiophobia level. Beyond descriptive statistics, Pearson's rank correlation test (rho) was adopted for identifying the correlation between parameters. Percentage of overweight and obese students was above 61%, and near to half of the university students had high TSK score. All studied variables (weight, BMI, TSK, pain) showed significant (p

Background: The current study aimed to determine the changes in pre-and post-operative Pittsburg sleep quality index (PSQI) and Tampa scale of kinesiophobia (TSK) values ​​according to the Hamada classification in patients who underwent reverse shoulder arthroplasty (RSA) for rotator cuff tear arthropathy (RCTA). Methods: One hundred and eight patients who underwent RSA for RCTA were reviewed retrospectively. The patients were divided into two groups with low grade (stages 1-2-3) (n = 49) and high grade (stages 4a-4b-5) (n = 59) according to the Hamada classification, which is the radiographic evaluation of RCTA. PSQI and TSK values ​​were calculated preoperatively, and post-operatively at the 6th week, 6th month, and 1st year. The change in PSQI and TSK values ​​between the evaluations and the effect of staging according to the Hamada classification on this change was examined. Results: When compared in preoperative evaluations, PSQI and TSK scores were found to be lower in low-grade group 1 (7.39 ± 1.56, 51.88 ± 4.62, respectively) than in high-grade group 2 (10.47 ± 2.39, 57.05 ± 3.25, respectively) according to Hamada classification (both p < 0.001). In the postoperative evaluations, PSQI and TSK results decreased gradually compared to the preoperative evaluations, and there was a severe decrease in both parameters between the 6th-week and 6th-month evaluations (both p < 0.001). Preoperatively, 102 (95%) patients had sleep disturbance (PSQI ≥ 6), and 108 (100%) patients had high kinesiophobia (TSK > 37). In the 1st year follow-ups, sleep disturbance was observed in 5 (5%) patients and kinesiophobia in 1 (1%) patient. When the Hamada stages were compared, it was seen that there was a significant difference before the operation (both p < 0.001), but the statistically significant difference disappeared in the PSQI value in the 1st year (p = 0.092) and in the TSK value in the 6th month (p = 0.164) post-operatively. It was observed that Hamada staging caused significant differences in PSQI and TSK values ​​in the preoperative period but did not affect the clinical results after treatment. Conclusions: RSA performed based on RCTA improves sleep quality and reduces kinesiophobia. RCTA stage negatively affects PSQI and TSK before the operation but does not show any effect after the treatment. [ABSTRACT FROM AUTHOR]

Introduction An area of emerging interest in chronic pain populations concerns fear of pain and associated fear of movement (kinesiophobia)—a cognitive appraisal pattern that is well-validated in non-headache chronic pain. However, there is limited research on whether this construct can be measured in a similar manner in headache populations. Methods The current project details a confirmatory factor analysis of the 12-Item Tampa Scale of Kinesiophobia (TSK-12) using a clinical data set from 210 adults with diverse headache diagnoses presenting for care at a multidisciplinary pain clinic. One item (concerning an "accident" that initiated the pain condition) was excluded from analysis. Results Results of the confirmatory factor analysis for the remaining 12 items indicated adequate model fit for the previously established 2-factor structure (activity avoidance and bodily harm/somatic focus subscales). In line with previous literature, total TSK-12 scores showed moderate correlations with pain severity, pain-related interference, positive and negative affect, depressive and anxious symptoms, and pain catastrophizing. Discussion The current study is the first to examine the factor structure of the TSK-12 in an adult headache population. The results support the relevance of pain-related fear to the functional and psychosocial status of adults with chronic headache, although model fit of the TSK-12 could be characterized as adequate rather than optimal. Limitations of the study include heterogeneity in headache diagnosis and rates of comorbid non-headache chronic pain in the sample. Future studies should replicate these findings in more homogenous headache groups (eg, chronic migraine) and examine associations with behavioral indices and treatment response. [ABSTRACT FROM AUTHOR]

BACKGROUND: Low back pain is an important widespread health problem that can occur at any age, causing serious socioeconomic losses. OBJECTIVE: The objective of this study is to investigate the relationship between kinesiophobia severity and pain severity, depression, and quality of life in patients with mechanical low back pain. METHODS: The study sample consisted of 155 patients, of whom 72 were female and 83 were male, aged between 18 and 75 years with mechanical low back pain. Quality of life was assessed with the 36-Item Short Form Health Survey (SF-36), pain intensity with the Visual Analogue Scale (VAS), kinesiophobia with the Tampa Kinesiophobia Scale (TKS), and depression with the Beck Depression Inventory (BDI). Patients were divided into the low (TKS ⩽ 37) and high kinesiophobia (TKS > 37) groups according to the scores they obtained from TKS. RESULTS: VAS-pain severity and BDI scores were significantly higher in the high kinesiophobia group than in the low kinesiophobia group (p < 0.001). On the other hand, the SF-36 subscale scores were significantly higher in the low kinesiophobia group than in the high kinesiophobia group (p < 0.001). The TKS scores were moderately correlated with VAS-pain severity (r = 0.470; p < 0.001) and BDI scores (r = 0.584; p < 0.001) in the positive direction, and strongly correlated with all sub-parameters of quality of life in the negative direction (p < 0.001). CONCLUSION: The results indicated that the severity of kinesiophobia in patients with non-inflammatory low back pain is associated with pain severity, depression, and poor quality of life. [ABSTRACT FROM AUTHOR]

Fear of movement has been related to lower limb activation patterns in older adults. However, insight into consecutive perturbations on stepping strategy while considering fall-related confidence is unknown. Are there latency time delays following three consecutive slip perturbations between subjects with and without kinesiophobia when considering limb dominance and fall efficacy differences? There were 15 older adults with kinesiophobia and 15 age- and body mass index (BMI)-matched control subjects. The subjects stood on the platform during three consecutive perturbations (250, 300, and 400 msec excursions), which were produced by a Bertec device. The subjects completed questionnaires to evaluate the psychological features of their fall-related fear (Tampa Scale for Kinesiophobia: TSK) as well as the modified fall efficacy scale (FES). The latency times (msec) measured the time it took for a subject to respond to a translation. Overall, the results of the FES demonstrated a moderate negative association with the TSK (r = −0.52, p = 0.004). There was a significant group difference for the FES (t = 2.78, p = 0.01). The FES demonstrated significant positive correlation coefficients (ranging from 0.40 to 0.51) and significant negative correlation coefficients (ranging from −0.41 to −0.61), except for the slow perturbations. The groups demonstrated a significant interaction on consecutive latency times and limb side (F = 5.84, p = 0.02). The latency time during the fast perturbations on the dominant limb (F = 5.53, p = 0.02) was significantly shorter in the kinesiophobia group. The control group demonstrated confidence during fall-related activities, but the latency times were significantly different between groups when considering the dominant limb following repeated slip perturbations. The kinesiophobia group demonstrated shorter latency times on the dominant limb to protect against potential fall-risks from perturbations. The group interactions on limb side and consecutive perturbations need to be considered with fall-related confidence and improved standing balance in older adults with kinesiophobia. • Fear of movement on limb activation patterns was compared in older adults. • The group interactions on limb side and perturbations were evident for fall risks. • The kinesiophobia group demonstrated shorter dominant limb reactions. • The control group demonstrated confidence during fall-related perturbations. [ABSTRACT FROM AUTHOR]

Patients with moderate to severe COPD frequently experience dyspnea, which causes these patients to acquire a fear of dyspnea and a fear of activity. This study developed a cognitive intervention combined with active cycle of breathing technique (ACBT) intervention program based on the fear-avoidance model, with the goal of evaluating the program's effectiveness in improving dyspnea-related kinesiophobia in patients with moderate to severe COPD. This study had a total of 106 participants. For 8 weeks, the intervention group (N=53) received cognitive combined with ACBT, while the control group (N=53) received standard care. The findings of the four times the dyspnea belief questionnaire were collected indicated that the combined intervention had a better impact on reducing dyspnea-related kinesiophobia than did routine nursing (P<0.05), and the impact persisted even after the intervention. Additionally, it may enhance dyspnea and quality of life, increase exercise capacity, and lower the BODE index. [ABSTRACT FROM AUTHOR]

• This is the first study to use network analysis to explore kinesiophobia in patients with cardiovascular diseases. • The three central items can be as targets for intervention on kinesiophobia. • Perception benefits of psychological outlook is useful for preventing kinesiophobia. • Perception barriers of physical exertion can be targets for avoiding kinesiophobia. Perception of exercise benefits/barriers and kinesiophobia are important predictors of low exercise behaviors in patients with cardiovascular diseases (CVDs). Little is known about the complex intercorrelations between different components of perception of exercise benefits/barriers and kinesiophobia. To identify the central components of kinesiophobia and to explore the interconnectedness between perception of exercise benefits/barriers and kinesiophobia. A total of 258 patients with CVDs were recruited in this study. The Tampa Scale for Kinesiophobia Heart and the Exercise Benefits/Barriers Scale were used to assess kinesiophobia and perception of exercise benefits/barriers. R software was used to visualize the networks and analyze the centrality of the networks. The index "expected influence" and "bridge expected influence" were employed to identify the central components and the bridge components of the networks. In the item network of kinesiophobia, three items ("It is really not safe for a person in my condition to be physically active/exercise", "I cannot do the same things as others because there is a too big risk that I will get heart problems", and "If I tried to be physically active/exercise my heart problem would increase") had the highest expected influence. In the exercise benefits/barriers–kinesiophobia network, the dimension of physical exertion had the highest positive bridge expected influence, while psychological outlook had highest negative value. The three central components of kinesiophobia and the two bridge components (perception exercise barriers of physical exertion and perception exercise benefits of psychological outlook) should be targeted in specific intervention for relieving kinesiophobia and further promoting exercise behaviors. [ABSTRACT FROM AUTHOR]

Background and Aims Anterior cruciate ligament (ACL) injury is one of the injuries that can permanently end the professional courier of an athlete. Almost half of athletes cannot return to their competitive levels before injury, even after successful rehabilitation. For this reason, there is another factor besides physical factors in not returning to sports practice, which in most studies is attributed to psychological factors. Fear of re-injury and fear of movement (kinesiophobia) are factors that prevent athletes from returning to sports activities after the reconstruction of the ACL. Many studies have examined the psychological factors after reconstruction and injury of the ACL. However, no study has so far examined and concluded about kinesiophobia after ACL reconstruction. Methods In this study, we searched published studies from 2000 to 2020 examining the effect of kinesiophobia on return to sport after anterior cruciate ligament reconstruction. In this study, we searched the relevant articles considering specialized English and Persian keywords, including «fear of movement,» «fear of re-injury,» «kinesiophobia,» «psychological factors of exercise,» «return to sport,» and «anterior cruciate ligament reconstruction» in academic Persian and English databases: Google Scholar, TRIP, PEDro, PubMed, Irandoc, SID, and Magiran. Results After the search, 162 articles were initially found. After reviewing the abstracts, 57 articles were remained. Then, based on inclusion and exclusion criteria, 26 articles were finally selected for inclusion in this study. Conclusion According to research findings, fear of movement and fear of re-injury in athletes after ACL reconstruction can delay their return to sports activities. This setback can reduce the quality of life and participation in sports and recreational games and causes depression and stress. Different rehabilitation approaches are highly effective in gaining various results after the reconstruction of ACL. Because physical and psychological improvement do not advance in parallel, it seems necessary to establish a new approach in sports rehabilitation after ACL reconstruction. [ABSTRACT FROM AUTHOR]

Fibromyalgia (FM) is a chronic pain syndrome hypothesized to arise from a state of neurogenic inflammation. Mechanisms responsible for pain, as well as psychological variables, are typically altered in this condition. The main objective of this research was to explore somatosensory and psychological alterations in women with FM. The secondary objective was to carry out a secondary analysis to correlate the different variables studied and delve into the influences between them. The relationship between different psychological variables in fibromyalgia is not clear in the previous scientific literature. Forty-four individuals participated, of which twenty-two were controls and twenty-two were women with fibromyalgia. The main outcome measures were the Numeric Pain Rating Scale, Fibromyalgia Impact Questionnaire, pressure pain threshold, conditioned pain modulation, anxiety and depression symptoms, catastrophizing and kinesiophobia cognitions. The main analysis showed that there is a moderate correlation between the psychological variables of depression and fear of movement and the ability to modulate pain. There is also a moderately inverse correlation between pain catastrophizing cognitions and pain intensity/disability. Multiple moderate and strong correlations were found among the various psychological variables studied. FM patients exhibit somatosensory alterations alongside negative psychological symptoms that influence the experience of pain, and they may perpetuate the state of neurogenic inflammation. [ABSTRACT FROM AUTHOR]

Context: Anterior cruciate ligament (ACL) injuries greatly impact patients in terms of future performance, reduced physical activity and athletic participation, and overall economic burden. Decades of research have investigated how to improve ACL reconstruction (ACLR) outcomes. Recently, there has been growing interest to understand the effects of psychosocial factors on patient outcomes. Study Design: Clinical review. Evidence Acquisition: A search of the PubMed database was performed in March 2023. Articles were reviewed by at least 2 authors to determine relevance. We highlighted publications of the past 5 years while incorporating previous pertinent studies. Level of Evidence: Level 5. Results: There is no standardization of psychosocial factors regarding ACLR. As such, there is a lack of consensus regarding which psychosocial measures to use and when. There is a need for clarification of the complex relationship between psychosocial factors and physical function. Despite this, psychosocial factors have the potential to help predict patients who are more likely to return to sport: (1) desire/motivation to return; (2) lower levels of kinesiophobia; (3) higher levels of self-efficacy, confidence, and subjective knee function; (4) risk acceptance; and (5) social support. However, there are no standardized interventions to improve psychosocial factors after ACLR. Conclusion: Psychosocial factors affect outcomes after ACLR. However, the interplay between psychosocial factors and physical function is complex. There is emerging evidence that testing and interventions may improve ACLR outcomes. There is a lack of standardized interventions to determine or improve psychosocial factors after ACLR. Further research is needed to identify psychosocial factors and to develop standardized interventions for clinicians to implement to improve clinical outcomes. [ABSTRACT FROM AUTHOR]

With the development of aging population, the number of elderly patients with osteoporotic fracture has increased dramatically. At present, it has become an important social health problem in China. Surgery is an important treatment for elderly patients with osteoporotic fractures. As a psychological problem, kinesophobia has great harm to postoperative rehabilitation exercise, which affects the rehabilitation effect and later quality of life of patients. On the basis of summarizing the kinesiophobia and its assessment scale, this study reviewed its harm, influencing factors and nursing countermeasures for elderly patients with osteoporotic fractures, in order to provide reference for reducing the occurrence of kinetophobia, promoting early rehabilitation and improving the quality of life of patients. [ABSTRACT FROM AUTHOR]

Background: The significance of studying Kinesiophobia, Limits of Stability (LOS), and functional balance in geriatric patients with CLBP and osteoporosis lies in their profound impact on rehabilitation outcomes and fall risk, ultimately affecting patients’ quality of life. This study aimed to examine LOS and functional balance in the geriatric population concurrently experiencing Chronic Low Back Pain (CLBP) and osteoporosis, in comparison to age-matched healthy controls; to assess the correlations between Kinesiophobia, LOS, and functional balance assessments; and to evaluate the mediating influence of Kinesiophobia on the association between LOS and functional balance tests. Methods: This cross-sectional study included a total of 86 participants in each group. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia (TSK). LOS variables were evaluated with a computerized Iso-free platform in eight different directions. Functional balance was measured using the Timed Up and Go (TUG) test and the Berg Balance Scale (BBS). Results: Patients with CLBP and osteoporosis showed significantly lower LOS percentages (45.78  ±  6.92) and impaired Functional Balance, reflected in a TUG Score (10.45  ±  2.23), compared to asymptomatic controls (LOS: 76.95  ±  8.21; TUG: 8.73  ±  1.90). Kinesiophobia showed a significant moderate negative correlation with LOS, indicated by r  = −0.362 (p <  0.01). Additionally, Kinesiophobia was found to correlate with functional balance tests. Specifically, there was a moderate positive correlation with the TUG Score (r  =  0.322, p <  0.01), indicating that higher Kinesiophobia is associated with slower TUG performance. Conversely, a stronger moderate negative correlation was observed with the Berg Balance Scale (BBS) Score (r  = −0.436, p <  0.001), suggesting that increased Kinesiophobia is associated with lower BBS scores, indicating poorer balance performance. Mediation analysis revealed that Kinesiophobia significantly influences LOS and Functional Balance. For LOS and the TUG score, Kinesiophobia showed a direct effect (B =  0.24), an indirect effect (B =  0.09), and a total effect (B =  0.13). Similarly, for LOS and the BBS score, the direct effect of Kinesiophobia was B =  0.38, with an indirect effect of B =  0.10 and a total effect of B =  0.20. Conclusion: This study underscores the substantial impact of Kinesiophobia on both stability and functional balance in individuals coping with CLBP and osteoporosis. The findings emphasize the clinical relevance of addressing Kinesiophobia as a potential target for interventions aimed at improving LOS and functional balance in this specific patient population. [ABSTRACT FROM AUTHOR]

Background: The management of fibromyalgia (FM) symptoms on a global scale remains a complex endeavor. This study endeavors to assess the impact of whole-body photobiomodulation (PBM) compared to placebo PBM on pain, functionality, and psychological symptoms in individuals afflicted with fibromyalgia. Objectives: The primary objectives of this research were to conduct a comparative analysis of the effects of whole-body photobiomodulation (PBM) and placebo PBM on pain, functionality, and psychological symptoms in patients suffering from fibromyalgia (FM). Methods: A total of 42 subjects were recruited from a private care practice for participation in this triple-blinded, placebo-controlled, randomized clinical trial. Participants underwent 12 treatment sessions, and assessments were conducted at various intervals, including baseline (T0), midway through the 12-session treatment (T1), at the completion of the 12 sessions (T2), and followups at 2 weeks (T3), 3 months (T4), and 6 months (T5). Results: Statistical analysis revealed significant reductions in pain at T2, T3, and T5. Additionally, quality of life exhibited marked improvements after sessions at T1, T2, T3, T4, and T5. Leisure activity also demonstrated statistically significant improvements at T2, T3, T4, and T5. Furthermore, kinesiophobia showed significant differences between groups immediately after treatment at T2, T3, T4, and T5. Self-efficacy, when compared between groups, demonstrated significant differences at T3, T4, and T5 (two weeks after treatment). Lastly, pain catastrophizing exhibited significant differences only at T5. Conclusion: The findings of this study indicate that whole-body PBM treatment for 4 weeks resulted in significant pain reduction and improved quality of life in individuals suffering from FM. Furthermore, kinesiophobia and self-efficacy demonstrated improvements in both short-term and long-term assessments, while pain catastrophizing showed improvement at the 6-month follow-up. Consequently, whole-body PBM emerges as a promising multifactorial treatment option for FM patients, though further studies are required to validate and strengthen these results. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to describe the postoperative psychological state of patients following osteochondral allograft (OCA) transplantation in the knee and to determine whether patient‐perceived kinesiophobia is associated with the rate of return to sport (RTS). Methods: A retrospective review of the electronic medical record at a single institution was conducted for all patients that underwent OCA transplantation from January 2010 to 2020. Patient‐reported outcomes including the visual analog scale (VAS), knee injury and osteoarthritis outcome score (KOOS) and the Tampa scale of kinesiophobia‐11 (TSK‐11) were collected. Patients were surveyed regarding their postoperative RTS status. Results: A total of 38 patients (52.6% female) were included in our analysis. Overall, 24 patients (63.2%) returned to sport with 12 (50%) of these patients returning at a lower level of play. When comparing patients that return to sport to those that did not, patients that return had significantly superior KOOS pain (p = 0.019) and KOOS QOL (p = 0.011). Measures of kinesiophobia (TSK‐11) were significantly higher among patients that did not return to sport (p = 0.014), while satisfaction (n.s.) and pain intensity (n.s.) were comparable between groups. Logistic regression models controlling for demographic factors, VAS pain scores and lesion size showed that for every one‐point increase in TSK‐11 kinesiophobia score, patients were 1.33 times more likely to return to sport at a lower level (p = 0.009). For every one‐point increase in TSK‐11 scores KOOS QOL decreased by 2.4 points (p < 0.001). Conclusion: Fear of reinjury decreases the likelihood that patients will return to their preoperative level of sport after OCA transplantation. Patients that do not return to sport report significantly greater fear of reinjury and inferior clinical outcomes, despite similar levels of satisfaction and pain compared to those that return. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Although there is growing evidence that kinesiophobia is correlated with temporomandibular disorders (TMD), its relationship with other characteristic TMD comorbidities, such as depression, anxiety, functional limitations, and pain in the TMD population, has rarely been investigated. This study aims to evaluate the relationship between kinesiophobia, emotional state, functional state and chronic pain in subjects both with and without TMD. A total of 94 subjects participated in the study and were divided into two groups (47 subjects each)—TMD (subjects with temporomandibular disorders) and nTMD (asymptomatic controls)—on the basis of the RDC/TMD protocol. All measurements were taken with self-administered questionnaires: TSK-TMD for kinesiophobia, PHQ-9 and GAD-7 for psychoemotional state, JFLS-20 for jaw functional limitations, and GCPS for chronic pain. The prevalence of kinesiophobia in the TMD group was 38.3% for moderate risk, and 61.7% for high risk. The TMD group showed significantly higher scores in all categories (kinesiophobia, depression, jaw functional limitations and chronic pain), with the exception of anxiety which was right at the cut-off point. Moreover, a significant correlation was found between kinesiophobia (TSK-TMD) and jaw functional limitations (JFLS-20). Results of this study could provide new insight into the relationship between kinesiophobia and TMD, further improving the diagnosis process. [ABSTRACT FROM AUTHOR]

Background: Physical activity is a guideline-recommended first-line intervention for people with knee osteoarthritis. Physical activity levels, and its potential correlates, is underexplored in Asian populations with knee osteoarthritis. Methods: Participants enrolled in a longitudinal study in Singapore self-reported physical activity (UCLA activity score), function (Knee Osteoarthritis Outcome Score [KOOS-12]), kinesiophobia (Brief fear of movement [BFOM]), self-efficacy (ASES-8), and quality of life (EQ-5D-5 L). One-Way ANOVA was used to test the difference in outcomes between UCLA categories, while ordinal logistic regression was used to identify the associated factors to physical activity level. Results: Seventy-three percent of all enrolled participants (n = 311/425) reported either inactivity or low physical activity (median 4, IQR 3–5). Significant, weak, positive correlations were observed be-tween UCLA activity score and either KOOS-12 (Spearman's rho: 0.1961; p < 0.001), ASES-8 (0.1983; p = 0.004), or EQ-5D-5 L (0.2078; p < 0.001). A significant, weak, negative correlation was observed between physical activity and BFOM (-0.2183; p < 0.001). Significant differences in function between groups (moderate vs. inactive or low physical activity) were not clinically important. Participants with obesity, from the eldest age category (i.e. ≥75), or who identified as Malay or female, were less physically active than those with a healthy BMI, below the age of 54, or who identified as Chinese or male, respectively. Conclusion: Healthcare professionals in Asia should be aware of the large proportion of people with knee osteoarthritis who are either inactive or have low physical activity levels. Screening for, and offering interventions to promote, physical activity and its correlates should be prioritised. [ABSTRACT FROM AUTHOR]

This innovative study addresses the prevalent issue of sports injuries, particularly focusing on ankle injuries, utilizing advanced analytical tools such as artificial intelligence (AI) and machine learning (ML). Employing a logistic regression model, the research achieves a remarkable accuracy of 90.0%, providing a robust predictive tool for identifying and classifying athletes with injuries. The comprehensive evaluation of performance metrics, including recall, precision, and F1-Score, emphasizes the model's reliability. Key determinants like practicing sports with injury risk and kinesiophobia reveal significant associations, offering vital insights for early risk detection and personalized preventive strategies. The study's contribution extends beyond predictive modeling, incorporating a predictive factors analysis that sheds light on the nuanced relationships between various predictors and the occurrence of injuries. In essence, this research not only advances our understanding of sports injuries but also presents a potent tool with practical implications for injury prevention in athletes, bridging the gap between data-driven insights and actionable strategies. [ABSTRACT FROM AUTHOR]

Background: Muscle weakness, balance, and functional capacity are affected in patients with chronic kidney disease (CKD) in dialysis. However, studies about kinesiophobia, peripheral and respiratory muscle strength, balance, exercise capacity, fatigue, and physical activity level in patients with CKD 3–4 are limited. The study aimed to compare the functional exercise capacity, peripheral and respiratory muscle strength, pulmonary function, balance, kinesiophobia, physical activity, fatigue, and dyspnea between patients with CKD 3–4 and controls. Methods: This cross-sectional study included 43 patients and 45 controls. Functional exercise capacity [6-Minute Walking Test (6MWT)], peripheral and respiratory muscle strength, pulmonary function, dyspnea, fatigue, physical activity, balance [Berg Balance Scale (BBS)], and kinesiophobia were evaluated. Results: Demographic characteristics were similar in patients [53(50–57) y, 26 M/17F] and controls [51(4.506-55) y, 33 M/12F] (p > 0.05). The 6MWT, respiratory and peripheral muscle strength, pulmonary function, physical activity, and BBS were significantly lower, and the level of dyspnea and kinesiophobia were higher in patients compared with controls (p < 0.05). Conclusions: Patients had impaired functional exercise capacity, upper and lower extremity muscle strength, respiratory muscle strength, pulmonary function, and balance, increased perception of dyspnea and kinesiophobia, and reduced physical activity level compared with controls. Patients should be directed to cardiopulmonary rehabilitation programs. [ABSTRACT FROM AUTHOR]

Exercise is significantly beneficial for patients with osteoporosis. However, physiological and psychological factors such as pain and kinesiophobia prevent patients from participating in exercise. Therefore, it is important to understand how these patients perceive participation in exercise. This qualitative study was conducted in China using conventional content analysis. Using a purposeful sampling method, 17 patients with primary osteoporosis were recruited. Data were collected through a semi-structured interview and managed using ATLAS.ti 21. Nine generic categories were developed from 26 subcategories and two main categories were identified: Barriers and facilitators, support systems, network resources, positive emotions, and reactions were the facilitators for exercise in this study. In addition, mindful exercise was positively viewed by the patients. Inefficient awareness, weak support systems, and burdens were identified as barriers. To improve compliance in clinical practice, targeted exercise protocols should be developed for patients based on these perceptions. [ABSTRACT FROM AUTHOR]

Patients with chronic ankle instability (CAI) often experience injury-related fear following ankle injuries, a condition known as kinesiophobia. Little research has investigated the impact of kinesiophobia in patients with CAI. How does kinesiophobia impact the static and dynamic balance of individuals with CAI? Fifty patients with CAI were divided into 2 subgroups based on their responses to the Tampa Scale of Kinesiophobia: 25 with kinesiophobia (CAI-K) and 25 without kinesiophobia (CAI-N). These groups were compared to 20 control participants. All participants performed a single-leg balance test with eyes open (EO) and eyes closed (EC). They also performed the Y-balance test (YBT) with EO. Romberg ratios were calculated as EC/EO and used for statistical analysis. No differences in static balance with EO and EC were found among three groups. However, the CAI-K group displayed a higher Romberg ratio in the mediolateral direction during static balance than both CAI-N and control groups. Additionally, both CAI-K and CAI-N groups displayed higher Romberg ratio in the anterior–posterior than controls. During YBT, the CAI-K group showed reduced reach distance in the anterior direction than CAI-N and control groups. The CAI-K group relies more on visual feedback during static balance in the mediolateral direction than CAI-N and control groups. Furthermore, the CAI-K group displayed less anterior reach distance during YBT compared to the CAI-N and control groups. Clinicians should consider both psychological and physical factors when designing rehabilitation programs. • Fear of reinjury may raise visual reliance in static balance among CAI patients. • CAI patients with kinesiophobia show reduced YBT reach linked to ankle joint changes. • CAI rehab programs should address both psychological and physical factors. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the physical and psychosocial problems and the clinical and sociodemographic factors affecting sexual life in patients with nonspecific chronic low back pain (CLBP), thus drawing attention to sexual disability and patients’ concerns in the conservative management of the disease. A total of 140 patients were included in the study. The assessment of disease characteristics, information about sexual life and related factors were evaluated by a self-constructed questionnaire. The Oswestry Disability Index (ODI), Pain Catastrophizing Scale (PCS), International Physical Activity Questionnaire (IPAQ), Tampa Scale of Kinesiophobia (TSK) and Beck Depression Inventory (BDI) were used to assess functional disability, pain-related anxiety, physical activity level, fear of movement and depression severity, respectively. Hierarchical cluster analysis was used to discover relationships among variables. Based on the dendrogram, the intensity of CLBP, the impact of CLBP on sexual life, decrease in libido, sexual satisfaction, frequency of intercourse, painful sexual behavior and questionnaire results (BDI, TSK, ODI, PCS) were in the same cluster. Consistent with this, positive correlations were found between BDI and PCS (p < 0.001, r = 0.481), BDI and TSK (p < 0.001, r = 0.319), and BDI and ODI (p < 0.001, r = 0.408). The other main clusters included demographic and clinical characteristics, ODI and IPAQ scores. The sexual lives of patients with CLBP are affected physically and psychosocially. In clinical practice, it is important to counsel sexual disability patients because of their concerns and hesitations. [ABSTRACT FROM AUTHOR]

Background: Virtual reality (VR) in different immersive conditions has been increasingly used as a nonpharmacological method for managing chronic musculoskeletal pain. Objective: We aimed to assess the effectiveness of VR-assisted active training versus conventional exercise or physiotherapy in chronic musculoskeletal pain and to analyze the effects of immersive versus nonimmersive VR on pain outcomes. Methods: This systematic review of randomized control trials (RCTs) searched PubMed, Scopus, and Web of Science databases from inception to June 9, 2024. RCTs comparing adults with chronic musculoskeletal pain receiving VR-assisted training were included. The primary outcome was pain intensity; secondary outcomes included functional disability and kinesiophobia. Available data were pooled in a meta-analysis. Studies were graded using the Cochrane Risk-of-Bias Tool version 2. Results: In total, 28 RCTs including 1114 participants with some concerns for a high risk of bias were identified, and 25 RCTs were included in the meta-analysis. In low back pain, short-term outcomes measured post intervention showed that nonimmersive VR is effective in reducing pain (standardized mean difference [SMD] –1.79, 95% CI –2.72 to –0.87; P <.001), improving disability (SMD –0.44, 95% CI –0.72 to –0.16; P =.002), and kinesiophobia (SMD –2.94, 95% CI –5.20 to –0.68; P =.01). Intermediate-term outcomes measured at 6 months also showed that nonimmersive VR is effective in reducing pain (SMD –8.15, 95% CI –15.29 to –1.01; P =.03), and kinesiophobia (SMD –4.28, 95% CI –8.12 to –0.44; P =.03) compared to conventional active training. For neck pain, immersive VR reduced pain intensity (SMD –0.55, 95% CI –1.02 to –0.08; P =.02) but not disability and kinesiophobia in the short term. No statistical significances were detected for knee pain or other pain regions at all time points. In addition, 2 (8%) studies had a high risk of bias. Conclusions: Both nonimmersive and immersive VR–assisted active training is effective in reducing back and neck pain symptoms. Our study findings suggest that VR is effective in alleviating chronic musculoskeletal pain. Trial Registration: PROSPERO CRD42022302912; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=302912 [ABSTRACT FROM AUTHOR]