Chain-mediating effects of kinesiophobia and self-efficacy on pain catastrophizing and physical activity in haemophilia patients.

BACKGROUND: There is a lack of research on the relationship between pain catastrophizing, kinesiophobia, and physical activity (PA) in people with haemophilia (PWH), and the underlying mechanisms connecting these variables remain unclear. AIM: The study's aim was to clarify the roles of kinesiophobia and self-efficacy in the relationship between pain catastrophizing and PA in PWH. METHODS: This cross-sectional study included adult PWH at the Haemophilia Centre of a Tertiary hospital in Beijing, China. The following questionnaires were used to collect data: the general information, the International Physical Activity Short Questionnaire, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia Scale, and the Exercise Self-Efficacy Scale. RESULTS: The study included a total of 187 PWH, including 154 having haemophilia A and 33 having haemophilia B. The median interquartile range of PA was 594 (198, 1554) MET-min/wk. There were significant differences in PA of patients based on age stage, treatment modality, highest pain score within the last seven days, and presence of haemophilic arthropathy (p < .05). It was showed that pain catastrophizing could directly predict PA (p < .001), accounting for 38.13% of the total effect. Pain catastrophizing also had indirect effects on PA through the mediating factors of kinesiophobia or self-efficacy, and through the chain-mediating effect of kinesiophobia and self-efficacy, accounting for 38.40%, 17.07%, and 6.40%, respectively. CONCLUSION: The study discovered that PWH have limited PA due to pain catastrophizing. This not only directly affects their activity but also indirectly influences it through kinesiophobia and self-efficacy.

Kinesiophobia, physical activity levels and barriers in breast cancer patients, survivors, and healthy controls: A case-control analysis.

OBJECTIVE: To investigate kinesiophobia, physical activity levels and barriers to physical activity in women with breast cancer and breast cancer survivors. METHODS: The case-control study was conducted at the Breast Clinic of Acibadem Maslak Hospital, and the Department of Physiotherapy and Rehabilitation at Acibadem Mehmet Ali Aydinlar University, Turkey, from October 2021 to July 2022, and comprised patients with breast cancer in group A, breast cancer survivors in group B and healthy controls in group C. The primary outcome measures were physical activity levels, barriers to physical activity and kinesiophobia levels, while the secondary outcome measures were levels of anxiety, depression, fatigue and quality of life. Data was collected using standard tools. Data was analysed using SPSS 22. RESULTS: Of the 212 women, 70(33%) were in group A with mean age 50.71±11.30 years, 70(33%) in group B with mean age 47.64±9.85 years, and 72(34%) in group C with mean age 47.03±7.48 years. Group C had better physical activity levels, fatigue and quality of life scores than the other groups, but it had worse perceptions of physical activity and more individual, psychosocial and environmental barriers to physical activity compared to the other groups (p<0.05). Group A had more barriers to exercise related to fear of overall body pain, poor balance, fear of falling and fear of feeling worse post-exercise compared to the other groups (p<0.05). Group B subjects were more afraid that lymphoedema might be exacerbated if they exercised (p<0.05). CONCLUSIONS: Women with breast cancer and breast cancer survivors had worse scores for physical activity levels, fatigue and quality of life compared to the healthy controls. All three groups had a variety of barriers to physical activity.

[Does patient communication influence kinesiophobia? A systematic review]. / ¿Influye la comunicación con el paciente sobre la kinesiofobia? Una revisión sistemática.

The aim of the present systematic review was to determine the effect of communication in the health care setting on kinesiophobia. To this end, a literature search was conducted in seven databases between November 2022 and February 2023. The review was carried out following the PRISMA statement and for the analysis of methodological quality we used: PEDro Scale, Van Tulder criteria and risk of bias analysis of the Cochrane Collaboration. A total of 13 articles were included with a mean methodological quality of 7.1 out of 10. Significant results were obtained for at least one variable (kinesiophobia, disability or level of physical activity) in 12 articles. There is strong evidence that communication can influence a subject's kinesiophobia. This influence is most likely to be in a negative or disabling sense, but it can also act in a positive sense by decreasing it.

Prevalence and influencing factors of kinesiophobia in patients with heart disease: a meta-analysis and systematic review.

This study aims to assess the global prevalence of kinesiophobia and the potential influencing factors among patients with heart disease. A comprehensive search was conducted in PubMed, Embase, Web of Science, PsycINFO, and Scopus databases to identify studies reporting on the prevalence of kinesiophobia and its influencing factors in heart disease patients up to January 2024. A random-effects model was employed to aggregate prevalence rates. Heterogeneity sources were investigated through subgroup analysis, while differences in the prevalence of kinesiophobia across regions, types of heart disease, and gender were evaluated. Additionally, a qualitative analysis of the factors influencing kinesiophobia was performed. This research incorporated 15 studies from six countries, with 14 providing data on the prevalence of kinesiophobia and nine exploring its potential influencing factors. The findings indicated that the overall prevalence of kinesiophobia among heart disease patients was 61.0% (95% CI 49.4-72.6%). Subgroup analysis revealed that the prevalence in upper-middle-income countries was 71.8% (95% CI 66.2-77.4%), while it stands at 49.9% (95% CI 30.2-69.5%) in high-income countries. The prevalence rates among patients with coronary artery disease, heart failure, and atrial fibrillation were 63.2% (95% CI 45.2-81.3%), 69.2% (95% CI 57.6-80.8%), and 71.6% (95% CI 67.1-76.1%), respectively. Gender-wise, no significant difference was observed in the prevalence of kinesiophobia between men and women (52.2% vs. 51.8%). A total of 24 potential influencing factors of kinesiophobia were identified, with education level, monthly income, anxiety, and exercise self-efficacy being the most recognized. The prevalence of kinesiophobia in patients with heart disease is notably high and is influenced by a multitude of factors. Early implementation of targeted preventive measures is imperative to mitigate the incidence of kinesiophobia in this population.

Is kinesiophobia associated with functional outcome measures in patients following medial patellofemoral ligament reconstruction?

BACKGROUND: This study aimed to investigate the potential relationship between kinesiophobia and functional outcomes in patients following medial patellofemoral ligament reconstruction (MPFLr). METHODS: Twenty-one patients (six males, 15 females) who underwent MPFLr between 2016 and 2020, (23.57 ± 9.49 years old) with a mean follow up period of 52.33 ± 24.82 months were included in the study. Following an assessment of patellar stability and alignment, kinesiophobia levels, function and balance were measured. The kinesiophobia was measured using the Tampa Scale of Kinesiophobia, while functional outcomes were assessed with the single-leg hop test, Y-Balance test and single-leg sway index. The self-reported function was measured by Kujala patellofemoral score and Lysholm knee score. RESULTS: The patients exhibited kinesiophobia scores of 43.10 ± 6.90. A negative correlation existed between kinesiophobia and both the Kujala scores (r = -0.75, P < 0.001) and the Lysholm scores (r = -0.79, P < 0.001). Moderate negative correlations were observed between kinesiophobia and the single-leg hop distance (r = -0.64, P < 0.01), as well as in Y-Balance test anterior reach distance (r = -0.51, P < 0.01) and posterolateral reach distance (r = -0.55, P < 0.01). Additionally, a low negative correlation was noted between kinesiophobia and Y-Balance test posteromedial reach distances (r = -0.43, P = 0.05), as well as the total sway index (r = -0.46, P = 0.04). CONCLUSIONS: A high level of kinesiophobia was strongly correlated with self-reported functional scores and moderately correlated with measured functional outcomes. The findings underscore a notable prevalence of kinesiophobia following biomechanically successful MPFLr. Investigating the impact of kinesiophobia on outcomes after MPFLr may provide a better understanding of patient recovery.

Knee Confidence, Fear of Movement, and Psychological Readiness for Sport in Individuals With Knee Conditions: A Systematic Review and Meta-analysis.

OBJECTIVES: 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. J Orthop Sports Phys Ther 2024;54(4):1-14. Epub 29 January 2024. doi:10.2519/jospt.2024.12070.

Comparison of kinesiophobia in patients with rheumatoid arthritis and systemic lupus erythematosus.

OBJECTIVE: Patients with rheumatic disease often experience arthritis and chronic joint pain, which can lead them to avoid movement, known as kinesiophobia. This may result in decreased mobility and endurance, as well as social isolation and depression. This study aimed to assess and compare the prevalence of kinesiophobia among patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and its association with disease activity, functional status, fear of falling, and fatigue. PATIENTS AND METHODS: A cross-sectional study was conducted with 124 RA, 76 SLE patients, and 87 healthy controls. The tampa kinesiophobia scale (TKS) was used to assess kinesiophobia. The disease activity was assessed using Disease Activity Score 28 (DAS28) in RA, and systemic lupus erythematosus Disease Activity Index 2000 (SLEDAI-2K) in SLE patients. The Health Assessment Questionnaire (HAQ) was used to assess functional status, the Falls Efficacy Scale International (FES-I) was used to assess fear of falling, and the Fatigue Severity Scale (FSS) was used to assess fatigue levels. RESULTS: Kinesiophobia was significantly more prevalent in RA patients compared to SLE patients [77.4% vs. 63.2%, odds ratio (OR): 2, 95% CI: 1.07-3.75; p<0.05]. The mean TKS score was 41.42±6.95 in RA patients, and 37.84±8.85 in SLE (p=0.005). TKS scores were positively correlated with DAS28 in RA patients; however, no correlation was found between SLEDAI-2K in SLE patients. A positive correlation was observed between TKS scores and the HAQ, FSS, and FES-I, both in RA and SLE patients. CONCLUSIONS: RA patients exhibited significantly higher kinesiophobia scores compared to SLE patients. The higher rate of kinesiophobia levels in RA patients compared to SLE patients suggests an association between kinesiophobia and the more destructive course of RA, indicating that tight control of the disease is important. Kinesiophobia was associated with functional impairment, fear of falling, and fatigue. Timely identification and intervention for patients with kinesiophobia are essential to prevent progression, mitigate long-term consequences, and maintain functional capacity.