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.

Electrocortical activity associated with movement-related fear: a methodological exploration of a threat-conditioning paradigm involving destabilising perturbations during quiet standing.

Musculoskeletal trauma often leads to lasting psychological impacts stemming from concerns of future injuries. Often referred to as kinesiophobia or re-injury anxiety, such concerns have been shown to hinder return to physical activity and are believed to increase the risk for secondary injuries. Screening for re-injury anxiety is currently restricted to subjective questionnaires, which are prone to self-report bias. We introduce a novel approach to objectively identify electrocortical activity associated with the threat of destabilising perturbations. We aimed to explore its feasibility among non-injured persons, with potential future implementation for screening of re-injury anxiety. Twenty-three participants stood blindfolded on a translational balance perturbation platform. Consecutive auditory stimuli were provided as low (neutral stimulus [CS-]) or high (conditioned stimulus [CS+]) tones. For the main experimental protocol (Protocol I), half of the high tones were followed by a perturbation in one of eight unpredictable directions. A separate validation protocol (Protocol II) requiring voluntary squatting without perturbations was performed with 12 participants. Event-related potentials (ERP) were computed from electroencephalography recordings and significant time-domain components were detected using an interval-wise testing procedure. High-amplitude early contingent negative variation (CNV) waves were significantly greater for CS+ compared with CS- trials in all channels for Protocol I (> 521-800ms), most prominently over frontal and central midline locations (P ≤ 0.001). For Protocol II, shorter frontal ERP components were observed (541-609ms). Our test paradigm revealed electrocortical activation possibly associated with movement-related fear. Exploring the discriminative validity of the paradigm among individuals with and without self-reported re-injury anxiety is warranted.

Kinesiophobia in patients after cardiac surgery: a scoping review.

BACKGROUND: This paper reviews the scope of research on kinesiophobia in patients after cardiac surgery. Further, it reviews the current situation, evaluation tools, risk factors, adverse effects, and intervention methods of kinesiophobia to provide a reference for promoting early rehabilitation of patients after cardiac surgery. METHODS: Guided by the scoping methodology, the Web of Science, PubMed, CINAHL, Cochrane Library, China Biomedical Literature Database, VIP Database, Wanfang Database, CNKI, and other databases were searched from database inception until July 31, 2024. The studies obtained were screened, summarised and systematically analysed by two researchers. RESULTS: Eighteen studies (16 cross-sectional studies, one qualitative study, and one randomised controlled trial) were included. The incidence of kinesiophobia in patients after cardiac surgery was 39.20-82.57%, and the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) was used to evaluate this incidence. The influencing factors of kinesiophobia in patients after cardiac surgery included demographic characteristics, pain severity, frailty, exercise self-efficacy, disease-related factors, and psychosocial factors. Kinesiophobia led to adverse health outcomes such as reduced recovery, prolonged hospital stays, and decreased quality of life in patients after cardiac surgery, and there were few studies on intervention methods for postoperative kinesiophobia. CONCLUSION: The kinesiophobia assessment tools suitable for patients after cardiac surgery should be improved, and intervention methods to promote the early recovery of patients after major clinical surgery and those with difficult and critical diseases should be actively researched.

Physical activity changes and related factors in chronic heart failure patients during the postdischarge transition period: a longitudinal study.

BACKGROUND: Physical activity (PA) is essential and effective for chronic heart failure (CHF) patients. A greater understanding of the longitudinal change in PA and its influencing factors during the postdischarge transition period may help create interventions for improving PA. The aims of this study were (1) to compare the change in PA, (2) to examine the influencing factors of PA change, and (3) to verify the mediating pathways between influencing factors and PA during the postdischarge transition period in CHF patients. METHODS: A total of 209 CHF patients were recruited using a longitudinal study design. The Chinese version of the International Physical Activity Questionnaire (IPAQ), Patient-reported Outcome Measure for CHF (CHF-PRO), and the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-Heart) were used to assess PA, CHF-related symptoms, and kinesiophobia. The IPAQ score was calculated (1) at admission, (2) two weeks after discharge, (3) two months after discharge, and (4) three months after discharge. Two additional questionnaires were collected during admission. Generalized estimating equation (GEE) models were fitted to identify variables associated with PA over time. We followed the STROBE checklist for reporting the study. RESULTS: The PA scores at the four follow-up visits were 1039.50 (346.50-1953.00) (baseline/T1), 630.00 (1.00-1260.00) (T2), 693.00 (1-1323.00) (T3) and 693.00 (160.88-1386.00) (T4). The PA of CHF patients decreased unevenly, with the lowest level occurring two weeks after discharge, and gradually improving at two and three months after discharge. CHF-related symptoms and kinesiophobia were significantly associated with changes in PA over time. Compared with before hospitalization, an increase in CHF-related symptoms at two weeks and two months after discharge was significantly associated with decreased PA. According to our path analysis, CHF-related symptoms were positively and directly associated with kinesiophobia, and kinesiophobia was negatively and directly related to PA. Moreover, CHF-related symptoms are indirectly related to PA through kinesiophobia. CONCLUSION: PA changed during the postdischarge transition period and was associated with CHF-related symptoms and kinesiophobia in CHF patients. Reducing CHF-related symptoms helps improve kinesiophobia in CHF patients. In addition, the reduction in CHF-related symptoms led to an increase in PA through the improvement of kinesiophobia. TRIAL REGISTRATION: The study was registered in the Chinese Clinical Trial Registry (11/10/2022 ChiCTR2200064561 retrospectively registered).

Quality of life, craniomandibular function, and psychosocial factors related to pain and movement in patients with head and neck cancer.

PURPOSE: To describe the characteristics of and the associations between health-related quality of life, pain, craniomandibular function, and psychosocial factors related to pain and fear of movement in patients with head and neck cancer. METHODS: Seventy-eight patients diagnosed with HNC were recruited. Measurements of the maximum mouth opening range and pressure pain thresholds on the masseter muscle and the distal phalanx of the thumb were conducted, as well as a battery of self-report questionnaires were administrated, including the QoL Questionnaire (EORT QLQ-H&N35), Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), the Spanish translation of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD), and the short version of the Craniofacial Pain and Disability Inventory (CF-PDI-11). RESULTS: The study sample (66.7% men, mean age 60.12 [11.95] years) experienced a moderate impact on their QoL levels (57.68 [18.25] EORT QLQ-H&N35) and high kinesiophobia values (20.49 [9.11] TSK-TMD). Pain was present in 41% of the patients, but only 3.8% reported severe pain. 26.4% had a restricted mouth opening range, and 34.62% showed significant catastrophism levels. There were strong positive correlations between EORT QLQ-H&N35 and CF-PDI-11 (r = 0.81), between NRS and CF-PDI-11 (r = 0.74), and between PCS and CF-PDI-11 (r = 0.66). CONCLUSION: Patients with HNC experience negative effects in their QoL, related to their impairment in craniomandibular function. Fear of movement, pain intensity, and catastrophism are associated with poorer functionality; relationships that should be considered when attempting to improve health care.

Initial validation of the 12-item Tampa Scale of Kinesiophobia in a retrospective sample of adults with chronic headache.

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.

Patient-reported physical activity, pain, and fear of movement after cardiac surgery: a descriptive cross-sectional study.

OBJECTIVES: After cardiac surgery, there may be barriers to being physically active. Patients are encouraged to gradually increase physical activity, but limited knowledge exists regarding postoperative physical activity levels. This study aimed to assess patient-reported physical activity six months after cardiac surgery, determine adherence to WHO's physical activity recommendations, and explore potential relationships between pain, dyspnea, fear of movement, and activity levels. METHODS: The study design was a cross-sectional study at Örebro University Hospital, Sweden. Preoperative and surgical data were retrieved from medical records and questionnaires concerning physical activity (Frändin-Grimby Activity Scale, the Physical activity Likert-scale Haskell, Patient-Specific Functional Scale, and Exercise Self-efficacy Scale) were completed six months after surgery. Data were collected on pain, dyspnea, general health status and kinesiophobia i.e. fear of movement, using the Tampa Scale of Kinesiophobia Heart. RESULTS: In total, 71 patients (68 ± 11 years, males 82%) participated in this study. Most patients (76%) reported a light to moderate activity level (Frändin-Grimby levels 3-4) six months after cardiac surgery. In total, 42% of the patients adhered to the WHO's physical activity recommendations (150 min/week). Pain and dyspnea were low. Patients with lower activity levels exhibited significantly higher levels of fear of movement (p =.025). CONCLUSIONS: The majority of patients reported engaging in light to moderate activity levels six months after cardiac surgery. Despite this, less than half of the patients met the WHO's physical activity recommendations. Potential barriers to physical activity such as pain, dyspnea and fear of movement were reported to be low.

Is Adding Education to Trunk and Hip Exercises Beneficial for Patellofemoral Pain? A Randomized Controlled Trial.

OBJECTIVE: To investigate the effect of adding education to trunk and hip exercises in patients with patellofemoral pain (PFP). DESIGN: A randomized controlled trial. SETTING: Research laboratory. PARTICIPANTS: Sixty patients with PFP (N=60) were randomly assigned to either an experimental group (education followed by trunk and hip exercises, n=30) or a control group (trunk and hip exercises, n=30). INTERVENTIONS: Both groups received 8 weeks of trunk and hip exercises, while patients in the experimental group participated in 3 prior education sessions. MAIN OUTCOME MEASURES: The primary outcome was pain; secondary outcomes were pain catastrophizing, kinesiophobia, function, and muscle strength. Outcomes were assessed at baseline, after 8 weeks (post-intervention), and 3 months post-intervention (follow-up). RESULTS: No significant between-group differences were observed for pain outcome post-intervention. The experimental group showed superiority over the control group in the improvement of pain catastrophizing (mean difference: -2.32; 95% confidence interval [CI] -1.059 to 0.028) and kinesiophobia (mean difference: -3.56; 95% CI -1.067 to -0.035) at post-intervention. In the experimental group, improvements were maintained at follow-up assessment for all outcomes, except muscle strength. CONCLUSION: Adding education to trunk and hip exercises was associated with greater improvements in psychological outcomes than trunk and hip exercises alone after the intervention. Education can be incorporated when designing trunk and hip exercises for patients with PFP.

Impairments of functional exercise capacity, muscle strength, balance and kinesiophobia in patients with chronic kidney disease: a cross-sectional study.

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.

The investigation of effect on foot plantar massage on functional recovery in older adults with general surgery, randomized clinical trial.

OBJECTIVE: Foot massage is known to be effective on the emotional state (anxiety, depression, etc.) in the postoperative period. However, studies on its effect on functional level are insufficient. AIM: The study aimed to investigate the impact of foot plantar massage on functional recovery in older adults undergoing general surgery, employing a randomized clinical trial design. METHODS: A total of 70 older adults aged 65 years and above who underwent abdominal surgery were included. Various assessments were conducted, including pain levels (Visual Analogue Scale), fear of mobility (Tampa Scale for Kinesiophobia), functional independence (Functional Independence Measure), balance (Berg Balance Scale), basic mobility (Rivermead Mobility Index), mental function status (Standardized Mini-Mental State Examination), and delirium (Nu-DESC). RESULTS: Statistically significant differences were observed in some assessment parameters within the groups during the 2nd and 3rd measurement times, with the intervention group demonstrating significant mean differences. DISCUSSIONS: The literature underscores the increase in kinesiophobia scores post-general/abdominal surgery in older adults, emphasizing the importance of evaluating functional level and kinesiophobia to expedite discharge processes and potentially plan early post-discharge rehabilitation to mitigate readmissions for functional reasons. CONCLUSIONS: Ultimately, foot massage was found to be effective in reducing kinesiophobia, improving balance, mobility, daily living skills, and mental status in older adults post-abdominal surgery, thereby advocating for the facilitation of post-discharge rehabilitation programs or the reduction of readmission rates. THE CLINICAL TRIALS NUMBER: NCT05534490.

Effect of cognitive behavioral therapy on pain, knee function, and psychological status in patients after primary total knee arthroplasty: a systematic review and meta-analysis.

OBJECTIVE: The clinical efficacy of cognitive behavioral therapy (CBT) after Total knee arthroplasty (TKA) is still controversial, and the purpose of this meta-analysis was to evaluate the effect of CBT on pain, knee function, and psychological status of patients after TKA. METHODS: We systematically searched electronic databases such as CNKI, CBM, VIP, PubMed, Cochrane Library, and EMBASE for randomized controlled studies up to February 30, 2023. Screening against inclusion criteria to select valid studies and extract data. The quality of included studies was evaluated by the Cochrane Collaboration risk-of-bias 2 (RoB 2) tool for randomized trials. Statistical analysis of the data from this study was carried out using Stata 15.1 software. RESULTS: Finally, our meta-analysis incorporated seven randomized controlled studies of high quality, including 608 patients. The findings of the meta-analysis demonstrated a noteworthy decrease in kinesiophobia levels during the early postoperative phase in the CBT group as compared to the usual care group (WMD = -6.35, 95% CI: -7.98 to -4.72, Z = 7.64, P < 0.001). However, no statistically significant difference between the CBT and usual care groups in terms of postoperative pain as well as knee function. CONCLUSION: CBT may effectively reduce the level of kinesiophobia in the short term after TKA, but did not significantly relieve knee pain or improve knee function.

A cross sectional study exploring the relationship of self-reported physical activity with function, kinesiophobia, self-efficacy and quality of life in an Asian population seeking care for knee osteoarthritis.

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.

The effect of cuff arthropathy stage on sleep disturbance and kinesiophobia in reverse shoulder arthroplasty patients.

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.

Immersive and Nonimmersive Virtual Reality-Assisted Active Training in Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis.

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.

Coping as a mediator of the relationship between kinesiophobia and illness perception in atrial fibrillation patients: A cross-sectional mediation analysis.

AIM(S): To explore the mediating role of coping styles in the association between illness perception and kinesiophobia in atrial fibrillation patients. DESIGN: A cross-sectional survey. METHODS: Between June 2021 and November 2022, data were collected using a self-designed demographic questionnaire, the Brief Illness Perception Questionnaire (BIPQ), Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) and Medical Coping Modes Questionnaire (MCMQ). The sample comprised 474 atrial fibrillation patients recruited from three hospitals in China. To analyse the data, multiple linear regression models with forced entry were employed, and the mediation Mode 4 of the PROCESS macro in SPSS was implemented. RESULTS: In total, 57.8% of patients exhibited a high level of kinesiophobia. Regression analyses uncovered associations between kinesiophobia and various demographic and disease characteristics, as well as assessments of both illness perception and coping styles. Path analysis results indicated that illness perception reduced kinesiophobia through the mediating effect of confrontation, while avoidance and resignation intensified kinesiophobia. The mediating factor of coping styles explained a significant 53% of the overall effect. CONCLUSIONS: Coping styles mediate the relationship between illness perception and kinesiophobia, resulting in a shift in coping styles as illness perception decreases and ultimately leading to reduced kinesiophobia. IMPACT: Coping styles play a mediating role in the relationship between kinesiophobia and illness perception. The results suggest healthcare providers in identifying high-risk individuals and tailoring interventions to effectively break the vicious cycle of kinesiophobia. Therefore, screening and intervening with patients showcasing heightened illness perception aims to promote a transformation in coping styles, subsequently reducing atrial fibrillation kinesiophobia. REPORTING METHOD: The results of the observations were reported in adherence to the STROBE criteria. PATIENT OR PUBLIC CONTRIBUTION: No patient and public involvement.

Increased kinesiophobia leads to lower return to sport rate and clinical outcomes following osteochondral allograft transplantation of the knee.

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.

Relationship between Fear-Avoidance Beliefs and Muscle Co-Contraction in People with Knee Osteoarthritis.

Excessive muscle co-contraction is one of the factors related to the progression of knee osteoarthritis (OA). A previous study demonstrated that pain, joint instability, lateral thrust, weight, and lower extremity alignment were listed as factors affecting excessive co-contraction in knee OA. However, this study aimed to assess the association between fear-avoidance beliefs and muscle co-contraction during gait and stair climbing in people with knee OA. Twenty-four participants with knee OA participated in this cross-sectional study. Co-contraction ratios (CCRs) were used to calculate muscle co-contraction during walking and stair climbing, using surface electromyography. Fear-avoidance beliefs were assessed by the Tampa Scale for Kinesiophobia-11 (TSK-11) for kinesiophobia and the Pain Catastrophizing Scale (PCS) for pain catastrophizing. Secondary parameters that may influence co-contraction, such as degree of pain, lateral thrust, weight, and lower extremity alignment, were measured. The relationships between the CCR during each movement, TSK-11, and PSC were evaluated using Spearman's rank correlation coefficient and partial correlation analysis, adjusted by weight and lower extremity alignment. Partial correlation analysis showed a significant correlation only between medial muscles CCR and TSK-11 during stair descent (r = 0.54, p < 0.05). Our study revealed that kinesiophobia could be associated with co-contraction during stair descent in people with knee OA.

Kinesophobia and its related factors in patients after percutaneous coronary intervention: A cross-sectional study.

OBJECTIVES: To explore the postoperative kinesophobia of patients after percutaneous coronary intervention (PCI) and its related factors. BACKGROUND: Percutaneous coronary intervention is an effective method to treat coronary heart disease (CHD), and cardiac rehabilitation is an important auxiliary method after PCI. However, the compliance of patients with cardiac rehabilitation after PCI is not good, among which kinesophobia is an important influencing factor. DESIGN: A descriptive cross-sectional design was implemented, and the high-quality reporting of the study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology Statement. METHODS: In total, 351 inpatients who underwent PCI in three tertiary grade-A hospitals in China were selected by convenient sampling method. We use one-way ANOVA and multiple linear regression analysis to determine the relevant related factors. RESULTS: The kinesophobia of patients after PCI was negatively correlated with chronic illness resource utilization and sense of personal mastery, and positively correlated with illness perception. Education level, clinical classification of CHD, exercise habits, chronic illness resource utilization, illness perception and sense of personal mastery entered the regression equation, which could explain 78.1% of the total variation. CONCLUSION: The level of kinesiophobia of patients after PCI is high. Education level, clinical classification of CHD, exercise habits, chronic illness resource utilization, illness perception and sense of personal mastery are the related factors of kinesiophobia of patients after PCI. RELEVANCE TO CLINICAL PRACTICE: By reducing the level of exercise fear of patients after PCI, patients are more likely to accept and adhere to the cardiac rehabilitation plan, thus improving their prognosis and improving their quality of life. PATIENT OR PUBLIC CONTRIBUTION: The patient underwent PCI in the research hospital. Researchers screen them according to the inclusion criteria and invite them to participate in this study. If they meet the requirements, participants will answer the research questionnaire face to face after signing the informed consent form.

The mediating role of cardiac patients' perception of nursing care on the relationship between kinesiophobia, anxiety and depression in rural hospitals: a cross-sectional study.

BACKGROUND: Kinesiophobia could act as a significant barrier against physical activity following cardiac procedures worsening cardiovascular health problems and potentially leading to conditions like hospital-acquired anxiety and depression among patients with cardiovascular disease (CVD). Nurses are the vanguard health care team who can aid patients in taking proactive steps to overcome fear of movement following cardiac procedures. AIM: The overarching aim is to investigate the relationship between kinesiophobia, anxiety and depression, and patients' perception of nursing care. METHOD: A descriptive correlational research design in two rural hospitals, conducted at cardiac intensive care units of Kafr Eldawar Hospital and Damanhur Medical National Institute. Data were collected from 265 nurses, using the following patient-reported outcome measures, the Tampa Scale for Kinesiophobia (TSK), the Hospital Anxiety and Depression Scale (HADS), the Person-Centered Critical Care Nursing Questionnaire (PCCNP) and the patients' demographic and clinical profile. RESULT: A significant negative correlation was found between HADS and PCCNP (r: -0.510, p < 0.001) however, Kinesiophobia was significantly and positively correlated (r: 0.271, p < 0.001). A direct effect of PCCNP in the presence of the mediator was found to be not statistically significant (-0.015, CR = 0.302, p = 0.763). Nonetheless, PCCNP indirectly affects kinesiophobia through HADS (p=-0.099). IMPLICATION FOR NURSING PRACTICE: Customizing individualized cardiac rehabilitation (CR) programs based on the emotional experience of cardiac patients will be conducive to rehabilitation and prognosis for patients, thereby lessening the physical burden and improving their quality of life.

Joint position sense testing at the wrist and its correlations with kinesiophobia and pain intensity in individuals who have sustained a distal radius fracture: A cross-sectional study.

BACKGROUND: Sensorimotor impairment following distal radius fracture (DRF) has been associated with a significant decline in function. Joint position sense (JPS) testing is a meaningful and responsive way to assess sensorimotor impairment for individuals who have sustained a DRF; however, there are factors that may influence the results of JPS testing, including kinesiophobia and pain intensity. PURPOSE: This study aimed to evaluate the influence kinesiophobia may have on wrist JPS testing and if pain intensity impacts kinesiophobia and JPS in individuals with a DRF. STUDY DESIGN: This was a cross-sectional study. METHODS: Participants referred from two medical centers with a diagnosis of DRF treated with at least 3 weeks of immobilization were enrolled in the study. Data were collected at 1 week and 6 weeks postimmobilization period. Demographics were summarized with descriptive statistics, and linear relationships between kinesiophobia, pain intensity, and wrist JPS were examined using Pearson correlation coefficient. RESULTS: Forty-eight participants were included in this study (mean age 42.9 years). Significant positive correlations were found between the Tampa Scale for Kinesiophobia (TSK) and Numeric Rating Scale (NRS; r = 0.951, p < 0.001), TSK and JPS error (r = 0.942, p < 0.001), as well as NRS and JPS error (r = 0.898, p < 0.001). These correlations indicate that higher levels of kinesiophobia are associated with increased pain intensity and greater JPS error. T-tests reveal no significant difference between male and female for the TSK, NRS, or JPS scores. CONCLUSIONS: There is an association for individuals with high levels of kinesiophobia and both greater pain and errors with JPS testing.