Tampa Scale For Kinesiophobia Scores Research Articles

Effects of Manual Therapy Plus Pain Neuroscience Education with Integrated Motivational Interviewing in Individuals with Chronic Non-Specific Low Back Pain: A Randomized Clinical Trial Study.

Background and Objectives: Chronic non-specific low back pain (CNLBP) persists beyond 12 weeks. Manual therapy recommended for CNLBP demonstrates short-term efficacy. Pain Neuroscience Education (PNE) teaches patients to modify pain perception through explanations, metaphors, and examples, targeting brain re-education. Motivational Interviewing (MI) enhances motivation for behavioral change, steering patients away from ambivalence and uncertainty. These approaches collectively address the multifaceted nature of CNLBP for effective management. The aim of this study was to investigate a manual therapy intervention combined with PNE with MI on pain, pressure pain threshold (PPT), disability, kinesiophobia, catastrophizing, and low back functional ability in individuals experiencing CNLBP. Materials and Methods: Sixty adults with CNLBP were randomly divided into three equal groups (each n = 20). The first group received manual therapy and PNE with integrated MI (combined therapy group), the second group underwent only manual therapy (manual therapy group), and the third group followed a general exercise program at home (control group). Pain in the last 24 h was assessed using the Numeric Pain Rating Scale (NPRS), functional ability with the Roland-Morris Disability Questionnaire (RMDQ), PPT in the lumbar region through pressure algometry, kinesiophobia with the Tampa Scale for Kinesiophobia (TSK), catastrophizing with the Pain Catastrophizing Scale (PCS), and performance using the Back Performance Scale (BPS) at baseline, in the fourth week, and six months post-intervention. Results: Statistically significant differences between the intervention groups and the control group were found in both the fourth-week measurement and the six-month follow-up, as evident in the NPRS and RMDQ scores, as well as in the total values of tested PPTs (p < 0.05). Differences were also observed between the two intervention groups, with a statistically greater improvement in the combined therapy group at both time points (fourth week and six-month follow-up) (p < 0.05). Regarding the TSK and PCS scores in the fourth week, statistically significant differences were observed between the two intervention groups compared to the control group, as well as between the two intervention groups (p < 0.05). However, in the six-month follow-up, statistically significant differences were found only between the combined therapy group and the other two groups, with the combined therapy group showing significant improvements (p < 0.05). In relation to BPS, both intervention groups exhibited statistically significant differences compared to the control group in the fourth week, without any significant differences between the two intervention groups. However, in the six-month follow-up, significant differences were noted between the combined therapy group and the other two groups (p < 0.05), with combined therapy demonstrating greater improvement. Conclusions: The addition of PNE with integrated MI enhanced the positive effects of a manual therapy intervention in all outcome measures. The combination of manual therapy plus PNE with integrated MI appeared to provide greater improvements compared to the isolated application of manual therapy, and these improvements also lasted longer. These short- and long-term positive effects are likely attributed to the combination of PNE with integrated MI, which contributed to increasing the effectiveness of the treatment. Further studies are required to investigate the optimum dosage of manual therapy and PNE with integrated MI in individuals with CNLBP.

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

BackgroundThe 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).MethodsOne 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.ResultsWhen 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.ConclusionsRSA 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.

The relationship between kinesiophobia, balance, and upper extremity functions in patients with painful shoulder pathology.

Poor balance ability may contribute to shoulder pathology in patients with existing shoulder pathologies or vice versa. The relationship between kinesiophobia and chronic shoulder pain intensity has been researched, although the conclusions are conflicting. To our knowledge, no study in the literature explores the association between kinesiophobia and balance in patients with shoulder pain. To investigate the relationship between kinesiophobia, upper extremity functions, and balance abilities in patients with shoulder pain. Cross-sectional observational study. Physical medicine and rehabilitation hospital. Not applicable. A total of 44 patients with shoulder pain were included in the study. The pain severity was assessed using a visual analog scale (VAS). The Tampa Scale for Kinesiophobia (TSK), Berg Balance Scale (BBS), and Shoulder Pain and Disability Index (SPADI) were used to assess the patients. Ultrasound was used to diagnose underlying shoulder joint problems. Static and dynamic postural control was evaluated. The most common pathologies detected by ultrasound were supraspinatus tendinitis/rupture (77.3%), cortical irregularity (68.2%), and bursitis (63.6%). TSK score did not correlate with age, body mass index, symptom duration, or VAS score in rest (all p > .05), but it was associated with scores on the BBS (r = -0.437, p = .003), SPADI-pain (r = 0.474, p = .001), SPADI-disability (r = 0.355, p = .018), SPADI-total (r = 0.405, p = .006), and VAS in activity (r = 0.331, p = .028). According to multiple linear regression analysis, BBS score, SPADI-total score, and anterior-posterior sway length were significant predictors of TSK (r = 0.645, r2 = 0.416). According to the findings of this study, the main risk factors for high levels of kinesiophobia are poor balance, severe pain, and disability. In addition to mechanical causes of shoulder pain, diagnosing and intervening on underlying balance issues and psychosocial causes of shoulder pain will improve treatment success.

Impact of sensory reweighting strategies on postural control using the sensory organization test in older adults with and without fall risks.

The Sensory Organization Test (SOT), an integral part of computerized dynamic posturography, plays a crucial role in evaluating postural stability under various altered sensory conditions. Despite its importance, there have been noted inconsistencies in the results pertaining to equilibrium and sensory system evaluations. This study aimed to compare four sensory analysis scores and equilibrium indices between older adults with and without fall risks. The study included 34 participants identified as being at risk of falls and 42 control subjects. To categorize individuals between the two groups, we performed area under the receiver operating characteristic curve analyses. This classification was based on scores from the Modified Falls Efficacy Scale (MFES) and the composite scores obtained from the SOT. In addition, we used the Tampa Scale for Kinesiophobia (TSK) as well as the level of disability. The fall risk group demonstrated significantly higher TSK scores (39.39± 15.24 for control group vs. 54.65±10.70 for fall risk group; t=-5.09, p=0.001). The groups demonstrated a significant interaction on the equilibrium index (F=4.59, p=0.03), which was lower in the fall risk group in Condition 6 with a moving surface and surround and eyes open (t=2.29, p=0.01). The fall risk group demonstrated a higher somatosensory score (t=-1.73, p=0.04). The fall risk group had a lower equilibrium index score in Condition six of the SOT, which was useful for identifying deficits in vestibular function to integrate sensory information under challenging conditions for postural adaptation. This strategy suggested that the fall risk group could compensate for their risk of falls by utilizing more effective somatosensory reweighting strategies compared with the control group.

The effect of conventional physiotherapy and median nerve radiofrequency therapy on kinesiophobia in lumbar facet syndrome

Aim: This study was carried out to investigate the effect of conventional physiotherapy (CPT) and median nerve radiofrequency therapy (MNRFT) on kinesiophobia in patients with lumbar facet syndrome (LFS).&#x0D; Methods: The sample of this study consisted of 60 patients over 18 with facet joint pain persisting for at least 3 months and unresponsive to medical treatment were included in the study. The patients were divided into CPT and MNRFT groups of 30 patients each according to the treatment they received. The patients were evaluated for pain severity, kinesiophobia, sleep quality, functional status, and depression both before the treatment and one month after the treatment using the Visual Analogue Scale (VAS), Tampa Scale for Kinesiophobia (TKS), Pittsburgh Sleep Quality Index (PSQI), Oswestry Disability Index (ODI) and Beck’s Depression Inventory (BDI), respectively.&#x0D; Results: There was a significant difference between the pre- and post-treatment VAS, PSQI, ODI, and BDE scores in both the CPT and MNRFT groups. Additionally, there was a significant difference between the pre- and post-treatment TKS scores in the RFT group, but not in the CPT group. There was no significant difference between the groups in any of the pre-treatment scores. There was also no significant difference between the groups in the post-treatment scores, except for the TKS scores.&#x0D; Conclusion: The study findings indicated that MNRFT and median nerve blockade reduced kinesiophobia more than CPT.

INVESTIGATION OF PERSISTENT POST-COVID-19 SYMPTOMS, FRAILTY, KINESIOPHOBIA, AND QUALITY OF LIFE IN OLDER ADULTS: AN OBSERVATIONAL CROSS‑SECTIONAL STUDY

Purpose: The aim of this study was to compare kinesiophobia and quality of life in older adults among subgroups created according to persistent post-COVID-19 symptoms and frailty. Methods: This study included 63 adults over the age of 65 with COVID-19.. Frailty was assessed with the Clinical Frailty Scale (CFS). Tampa Scale of Kinesiophobia (TSK) was used to assess the kinesiophobia and The World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) was used to assess quality of life. Results: The TSK score was significantly higher in the visibly frail and frail group than in the non-frail group (p=0.040). The TSK score was also significantly higher in the group with at least one persistent symptom after COVID-19 than participants with no persistent symptoms (p=0.008). Among participants with at least one persistent post-COVID-19 symptom, the TSK score was significantly higher in those with persistent dyspnea compared to those without (p=0.016). There was no significant difference in the WHOQOL-OLD scores of any sub-groups (p&gt;0.05). Conclusion: The results of the study showed that kinesiophobia was affected by the presence of persistent COVID-19 symptoms and dyspnea, and frailty in older adults. In addition, quality of life was found to be independent of frailty and persistent COVID-19 symptoms.

Short-term fear of movement improves less after anterior cruciate ligament reconstruction with concomitant meniscus repair

BackgroundPsychological response is important in return-to-sport decisions for athletes recovering from anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare psychological response after ACLR with a concomitant meniscus repair compared to isolated ACLR. MethodsThirty-five individuals completed the Tampa Scale of Kinesiophobia (TSK) and Anterior Cruciate Ligament Return-to-Sport after Injury (ACL-RSI) scale before ACLR and 2, 4, and 6 months after ACLR. Participants were dichotomized based on presence of concomitant meniscus repair (Yes/No). Separate group X time repeated measures analyses of variance were conducted for both scales. ResultsParticipants were 65.7% female, 19.1 ± 4.7 years old with BMI of 24.9 ± 4.4 kg/m2. Sixteen individuals had an isolated ACLR with 19 individuals having an ACLR with concomitant meniscus repair. For the TSK, there was a group × time interaction effect(p = 0.028), with improvement in TSK scores for the isolated ACLR group (ACLR:2 months = 24.8 ± 3.7; 4 months = 22.0 ± 5.7; 6 months: 19.9 ± 5.9; Meniscus Repair:2 months = 25.5 ± 4.7; 4 months = 24.1 ± 5.0; 6 months: 23.8 ± 4.7). Six months after ACLR, TSK scores were worse in the meniscus repair group(p = 0.036). For the ACL-RSI, there was no interaction(p = 0.07). ConclusionConcomitant meniscus repair with ACLR results in less post-operative improvement in kinesiophobia through 6 months after ACLR compared to isolated ACLR.

Kinesiophobia and Artificial Joint Awareness After Total Knee Arthroplasty

Background: Total Knee Arthroplasty (TKA) is a commonly performed surgical procedure designed to alleviate pain and disability from knee arthritis. This study aims to explore the psychological aftermath of TKA, focusing on Kinesiophobia (fear of movement) and joint awareness. Objective: To investigate the relationship between Kinesiophobia and the awareness of an artificial joint in patients post-TKA. Methods: This cross-sectional study involved 64 patients aged 45-64 who underwent TKA 6-12 months prior. Exclusion criteria included other lower extremity surgeries, infection, or history of TKR revision or dislocation. The Forgotten Joint Score (FJS) and the Tampa Scale for Kinesiophobia (TSK) were used for evaluation. Data analysis was performed using SPSS. Results: The study revealed a significant negative correlation between FJS and TSK scores (r = –0.375; p = 0.002), indicating that higher Kinesiophobia levels correlate with increased artificial joint awareness. Additionally, 20.31% of participants had Kinesiophobia and 79.69% had severe Kinesiophobia, with a notable female predominance (84.4%). The mean FJS score was 28.63 (±22.469), and the mean TSK score was 41.10 (±18.68), suggesting a moderate level of Kinesiophobia with wide variability among participants. Conclusion: The study concludes a significant negative relationship between Kinesiophobia and artificial joint awareness post-TKA, highlighting the psychological impact of TKA on patients. These findings emphasize the need for considering psychological factors in post-operative care and rehabilitation.

Ankilozan Spondilitte Hastalık Aktivitesi ve Obezitenin Kinezyofobi Üzerindeki Etkisi

Objective: This study aims to determine the rate of kinesiophobia in ankylosing spondylitis (AS) patients and to determine the relationship between kinesiophobia and disease activity, obesity, quality of life, functional status, fatigue, and fear of falling. Methods: The study design is a prospective study. That included 83 ankylosing spondylitis patients and 79 age- and gender-matched healthy controls. Kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia (TSK), disease activity with the Bath AS Disease Activity Index (BASDAI), functional status with the Health Assessment Questionnaire (HAQ) and Bath AS Functional Index (BASFI), fear of falling with the Falls Efficacy Scale International (FES-I) and Fatigue Severity Scale (FSS), Quality of Life Questionnaire (ASQoL), Body Mass Index (BMI). The correlation of outcome measures with kinesiophobia levels was analyzed, and all parameters were compared in patients with (TSK&amp;gt;37) and without kinesiophobia (TSK≤37). Results: In AS patients, the rate of kinesiophobia was 78.3%, the mean TSK score was 43.85±9.78, while in healthy controls, the kinesiophobia rate was 17.7%, the mean TSK score was 27.07±8.46 (odds ratio (OR)=16.766, 95% confidence interval (CI): 7.697-36.518; p&amp;lt;0.001). TSK was positively correlated with BMI, ASQoL, BASDAI, HAQ, FES-I, FSS, and BASFI (r=0.336, r=0.457, r=0.341, r=0.447, r=0.269, r=0.371, p&amp;lt;0.05 for each). Patients with a BMI&amp;gt;25, and a BASDAI&amp;gt; 4 had higher TSK scores (p=0.041 and p&amp;lt;0.001, respectively). Conclusion: AS patients have a very high rate of kinesiophobia. Patients with obesity and high disease activity have higher levels of kinesiophobia. Detection of kinesiophobia in patients with AS, control of weight/obesity, and reduction of disease activity should be an important goal.

Analysis of Factors Correlated with Postoperative Kinesiophobia in Patients with Cervical Spondylotic Myelopathy: A Cross-Sectional Survey.

To investigate the prevalence of postoperative kinesiophobia in patients with cervical spondylotic myelopathy (CSM) and factors influencing the occurrence of kinesiophobia, to provide relevant basis for making clinical decisions for targeted interventions. We enrolled a total of 85 patients who underwent CSM surgery at two grade-A general public hospitals in Fujian Province between September 2021 and May 2022. We conducted a questionnaire survey using the Tampa Scale for Kinesiophobia (TSK) and the Zung Self-Rating Anxiety Scale (SAS). Patients evaluated pain using a visual analogue scale. We used one-way ANOVA and logistic multiple regression analysis to identify the relevant influencing factors. The TSK score was (41.88±4.46) in 85 postoperative CSM patients, 65 males and 20 females, and there were 31 patients under 40 years old, 54 patients over 40 years old, 58 patients below high school education and 27 patients above high school education, and among them, 81.17% were diagnosed with kinesiophobia. Age was positively correlated with TSK score (r = 0.379, P < 0.05) and therefore a risk factor for kinesiophobia (OR = 1.941, 95% CI = 1.021-3.690). Additionally, the duration of the disease was a protective factor for kinesiophobia (OR = 0.179, 95% CI = 0.053-0.605). Patients with CSM were at high risk of developing kinesiophobia postoperatively. Age and duration of the disease were factors influencing the occurrence of kinesiophobia in this group.

Impact of Undergoing Thoracolumbar Surgery on Patient Psychosocial Profiles.

Prospective cohort study. Investigate the impact of thoracolumbar surgery on patients' psychosocial profiles. A prospective cohort study of thoracolumbar surgery patients (N = 177). Measures of interest collected at baseline and 24-months after surgery were: modified Oswestry Disability Index (mODI), Numerical Rating Scores for Back Pain (NRS-B), Leg Pain (NRS-L), Pain Catastrophizing Scale (PCS), Tampa Scale of Kinesiophobia (TSK), Chronic Pain Acceptance Questionnaire-8 (CPAQ-8), Multidimensional Scale of Perceived Social Support (MSPSS), Mental Component Summary (MCS) and patient expectations for surgery impacts on mental well-being. Cohorts were separated based on attaining meaningful change defined as either 30% improvement or minimal scores in NRS-B, NRS-L and mODI. Mixed measures ANOVAs were run (α = .05). Patients who showed meaningful change had significant improvements in PCS, TSK and CPAQ-8 scores but not in MSPSS scores. Patients had improvement in MCS scores over 24-months follow-up, but this change was not significantly different based on attainment of meaningful change. Overall, 75.9% of patients reported their mental well-being expectations were met. Patients who did not achieve meaningful change showed no change on any psychosocial measures with only 55.9% reporting their mental well-being expectations met. Thoracolumbar surgery results in significant improvement of psychosocial variables for patients who experienced meaningful change for pain and disability. Worsening of psychosocial health was not evident in patients who did not attain meaningful change.

Spinal Mobility Limitation Can Be the Main Reason of Kinesiophobia in Ankylosing Spondylitis.

Objective The aim of this study is to determine the presence of kinesiophobia in patients with ankylosing spondylitis (AS) and to examine the factors affecting kinesiophobia. Materials and methods Sixty patients with AS participated in the study. Kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia (TSK). Disease activity was assessed using the Bath AS Disease Activity Index (BASDAI) and AS Disease Activity Score with C-reactive protein (ASDAS-CRP), functional status using the Bath AS Functional Index (BASFI), spinal mobility using the Bath AS Metrology Index (BASMI), and quality of life using the AS Quality of Life Questionnaire (ASQoL). Those with a TSK score of >37 were classified as patients with high kinesiophobia, while those with a score of ≤37 as patients with low kinesiophobia. Results High kinesiophobia was detected in 29 (48.3%) patients. Age, disease duration, BASDAI, ASDAS-CRP, BASFI, ASQoL, and BASMI values were higher in these patients. The TSK scores correlated with age, duration of disease, ASDAS-CRP, BASFI, BASMI, and ASQoL (r = 0.697, r = 0.600, r = 0.410, r = 0.690, r = 0.889, and r = 0.576, respectively). As a result of the multivariate binary logistic regression analysis, BASMI was found to be the only statistically significant factor for high kinesiophobia (OR 5.338, 95% CI: 1.133-25.159, p = 0.034). Conclusion Kinesiophobia is seen at a high rate in patients with AS. In this study, the most important risk factor for kinesiophobia is found to be decreased spinal mobility. To prevent kinesiophobia - which prevents exercise, the cornerstone of AS treatment - patients should be encouraged to exercise and be active.

The relationship between kinesiophobia and physical activity levels, gestational weight gain, and musculoskeletal pain in pregnant women

ABSTRACT The aim of this cross-sectional study was to investigate the effect of kinesiophobia on musculoskeletal pain, physical activity levels, and gestational weight gain in pregnant women. One hundred and sixty-three pregnant women participated in the study by completing a personal characteristics information form along with the Tampa Scale of Kinesiophobia, the Pregnancy Physical Activity Questionnaire, and the Cornell Musculoskeletal Discomfort Questionnaire. The results showed a weak negative correlation between total physical activity scores and Tampa Scale of Kinesiophobia scores (p = .005). Excessive gestational weight gain was associated with a 1.27-fold increase in kinesiophobia and a 1.16-fold increase in musculoskeletal pain compared to adequate weight gain (p < .001). Those with musculoskeletal pain had significantly higher kinesiophobia scores than those without musculoskeletal pain (p = .012). In the pregnant women in this study, an increase in kinesiophobia was associated with a decrease in physical activity. Sedentary and light-intensity activities prevailed among the pregnant women in the study. Musculoskeletal pain and kinesiophobia were associated with excessive weight gain, and those with pain had higher levels of kinesiophobia. Therefore, during pregnancy follow-ups, health professionals should evaluate pregnant women for kinesiophobia, pain, physical activity status, and weight gain.

Occupational self-perception level effects on the development of kinesiophobia in individuals with total knee arthroplasty

The development of kinesiophobia after Total Knee Arthroplasty (TKA) has been one of the important issues. However, the early results and the presence of kinesiophobia before surgery have not been adequately investigated. In addition, the effects of factors such as pain perception, postoperative pain level, and demographic characteristics were mentioned. However, occupational factors such as occupational expectations and occupational self-perception level have not been adequately investigated. Each assessment tool was administered three times: once on the first day of the preoperative period and then again at the third and sixth weeks after the surgery. The assessment tools employed were the Knee Injury and Osteoarthritis Outcome Score, Tampa Scale for Kinesiophobia, Occupational Self Assessment, and Timed Up and Go test. To analyze the differences in Tampa Scale for Kinesiophobia scores, a one-way ANOVA was conducted. Subsequently, the patients were categorized into two groups based on their level of kinesiophobia: high and low. Independent sample t-tests were employed to compare continuous and normally distributed data between the two groups, while the Mann-Whitney U test was used for non-normally distributed data. The Pearson correlation coefficient was utilized to assess the relationship between continuous data, whereas the Spearman rank-order correlation was employed for non-normally distributed data. High levels of kinesiophobia were identified in individuals both prior to and following surgery. Significant differences were observed between the high and low kinesiophobia groups in terms of the mean OSA Competency (p<0.05). However, no statistically significant differences were found between the groups in relation to the other evaluation scores during the follow-up periods. Furthermore, a negative correlation was observed between TSK score and OSA Competence results (p<0.05). Occupational self-perception levels effect the level of kinesiophobia in individuals with TKA and high rates of kinesiophobia observed before the surgery intensified after the surgery, especially in the early period. It may be necessary to focus more on factors such as individual factors, individuals' values, habits, and beliefs.

Youth With a Sport-Related Knee Injury Exhibit Significant and Persistent Knee-Related Quality-of-Life Deficits at 12-Month Follow-up Compared to Uninjured Peers.

OBJECTIVE: We aimed to compare knee-related quality of life (QOL) between youth with and without an intra-articular, sport-related knee injury at baseline (≤4 months postinjury), 6-month, and 12-month follow-up, and assess the association between clinical outcomes and knee-related QOL. DESIGN: Prospective cohort study. METHODS: We recruited 86 injured and 64 uninjured youth (similar age, sex, sport). Knee-related QOL was assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS) QOL subscale. Linear mixed models (95% confidence interval [CI]; clustered on sex and sport) compared KOOS QOL between study groups over the study period, considering sex-based differences. We also explored the association of injury type (anterior cruciate ligament [ACL]/meniscus injury or other), knee extensor strength (dynamometry), moderate-to-vigorous physical activity (accelerometer), intermittent knee pain (Intermittent and Constant Osteoarthritis Pain [ICOAP] measure), and fear of reinjury (17-item Tampa Scale of Kinesiophobia) with knee-related QOL. RESULTS: Participant median (range) age was 16.4 (10.9-20.1) years, 67% were female, and 56% of injuries were ACL ruptures. Injured participants had lower mean KOOS QOL scores at baseline (-61.05; 95% CI: -67.56, -54.53), 6-month (-41.37; 95% CI: -47.94, -34.80), and 12-month (-33.34; 95% CI: -39.86, -26.82) follow-up, regardless of sex. Knee extensor strength (6- and 12-month follow-up), moderate-to-vigorous physical activity (12-month follow-up), and ICOAP (all time points) were associated with KOOS QOL in injured youth. Additionally, having an ACL/meniscus injury and higher Tampa Scale of Kinesiophobia scores were associated with worse KOOS QOL in injured youth. CONCLUSION: Youth with a sport-related knee injury have significant, persistent knee-related QOL deficits at 12-month follow-up. Knee extensor strength, physical activity, pain, and fear of reinjury may contribute to knee-related QOL. JOSPT 2023;53(8):1-10. Epub: 20 June 2023. doi:10.2519/jospt.2023.11611.

The association between kinesiophobia and functional limitations in service members with knee pain

BackgroundKnee diagnoses account for more than 50% of lower extremity musculoskeletal conditions in non-deployed US Service members. However, there is limited information regarding kinesiophobia in Service members with non-operative knee diagnoses. HypothesesThe objectives of this study were to determine the prevalence of high levels of kinesiophobia in US military Service members with knee pain across different knee diagnoses, and to determine the relationships between kinesiophobia and lower extremity function and/or specific functional limitations in Service members with knee pain. It was hypothesized Service members with knee pain would exhibit high levels of kinesiophobia across all knee diagnoses examined, and higher levels of both kinesiophobia and pain would be associated with worse self-reported function in this population. It was also hypothesized higher levels of kinesiophobia would be associated with functional activities with high knee loading. DesignRetrospective cohort study. Level of evidenceIV. MethodsSixty-five US Service members presenting to an outpatient physical therapy clinic were included in this study (20 females; age = 30.8 ± 7.7 years; height = 1.74 ± 0.9 m; mass = 80.7 ± 16.2 kg). Inclusion criterion was the presence of knee pain (duration = 50 ± 59 months); exclusion criterion was knee pain as a sequela of knee surgery. Data regarding demographic, pain chronicity, pain by Numeric Rating Scale (NRS), Tampa Scale of Kinesiophobia (TSK), and Lower Extremity Functional Scale (LEFS) were retrospectively obtained from patients’ medical records. A high level of kinesiophobia was defined as a TSK score of greater than 37 points. Patient diagnoses included: osteoarthritis (n = 16); patellofemoral pain syndrome (n = 23); and other non-operative knee diagnoses (n = 26). Commonality analysis was utilized to determine the effects of age, height, mass, NRS, and TSK on LEFS score. Predictor values were interpreted as <1% = negligible, >1% = small; >9% = moderate, >25% = large. Additionally, exploratory item-specific analyses examined the strength of the relationships between kinesiophobia and LEFS item responses. Binary logistic regression determined if difficulty with an individual LEFS item could be predicted from either NRS or TSK score. Statistical significance was set at P < 0.05. ResultsHigh levels of kinesiophobia were identified in 43 individuals (66%). NRS and TSK explained 19.4% and 8.6% of the unique variance in LEFS, and 38.5% and 20.5% of total variance, respectively. Age, height, and mass explained negligible to small proportions of the unique variance in LEFS. TSK and NRS were independent predictors for 13/20 individual LEFS items, with odds ratios ranging from 1.12 to 3.05 (P < 0.05). ConclusionThe majority of US Service members in this study exhibited high levels of kinesiophobia. Kinesiophobia was significantly related to self-reported functional scores and performance on individual functional tasks in Service members with knee pain. Clinical relevanceTreatment strategies addressing both fear of movement and pain reduction in patients with knee pain may help optimize functional outcomes.

A cross-sectional investigation of back pain beliefs and fear in physiotherapy and sport undergraduate students.

Although low back pain (LBP) beliefs have been well investigated in mainstream healthcare discipline students, the beliefs within sports-related study students, such as Sport and Exercise Science (SES), Sports Therapy (ST), and Sport Performance and Coaching (SPC) programmes have yet to be explored. This study aims to understand any differences in the beliefs and fear associated with movement in students enrolled in four undergraduate study programmes-physiotherapy (PT), ST, SES, and SPC. 136 undergraduate students completed an online survey. All participants completed the Tampa Scale of Kinesiophobia (TSK) and Back Beliefs Questionnaire (BBQ). Two sets of two-way between-subjects Analysis of Variance (ANOVA) were conducted for each outcome of TSK and BBQ, with the independent variables of the study programme, study year (1st, 2nd, 3rd), and their interaction. There was a significant interaction between study programme and year for TSK (F(6, 124) = 4.90, P < 0.001) and BBQ (F(6, 124) = 8.18, P < 0.001). Post-hoc analysis revealed that both PT and ST students had lower TSK and higher BBQ scores than SES and SPC students particularly in the 3rd year. The beliefs of clinicians and trainers managing LBP are known to transfer to patients, and more negative beliefs have been associated with greater disability. This is the first study to understand the beliefs about back pain in various sports study programmes, which is timely, given that the management of injured athletes typically involves a multidisciplinary team.

Comparison of balance and function in the long term after all arthroscopic ATFL repair surgery.

We compared the balance, ROM, clinical scores, kinesiophobia and functional outcomes of patients after all-arthroscopic ATFL repair surgery with the non-operated side and healthy control group. Twenty-five patients with follow up time 37.32 ± 12.51months and twenty-five healthy controls participated in the study. Postural stability was evaluated with the Biodex® balance system by measuring overall (OSI), anterior-posterior (API), and mediolateral (MLI) stability index. Dynamic balance and function were measured using the Y-balance test (YBT) and single-leg hop test (SLH). Limb symmetry index for SLH and contralateral comparisons (YBT, OSI, API, MLI) was performed. The AOFAS score and the Tampa Scale of Kinesiophobia (TSK) were applied. Two subgroups were created (with OLT and without OLT). There was no statistically significant difference between subgroups. There was no statistically significant difference between bilateral OSI, API, MLI values and YBT anterior reach distances of all groups. Single leg OSI (0.78 ± 0.27/0.55 ± 0.12), API (0.55 ± 0.22/0.41 ± 0.10), and MLI (0.40 ± 0.16/ 0.26 ± 0.08) values were significantly worse and YBT posteromedial (73.88 ± 15.70/89.62 ± 12.25), posterolateral reach (78.03 ± 14.08/92.62 ± 8.25) and the SLH distance (117.14 ± 27.84/165.90 ± 20.91) were significantly lower on the patients than controls (p < 0.05), respectively. In contralateral comparisons, all reach distances on YBT were similar and SLH limb symmetry index of the operated side was 98.25%. AOFAS scores of the patients were 92.62 ± 11.13, TSK scores were 46.45 ± 11.32, and 21 patients (84%) had kinesiophobia. AOFAS score, limb symmetry index, and bilateral balance of the patients were successful; however, there is single-leg postural stability insufficiency and kinesiophobia. Although the extremity symmetry index of the operated side of the patients was 98.25, the fact that these values are lower than those of the healthy control may have been caused by kinesiophobia. During the long-term rehabilitation, kinesiophobia should be considered and single-leg balance exercises should be monitored during the rehabilitation period. Level III.

Associations between psychological factors, pressure pain thresholds and conditioned pain modulation and disability in (sub)-acute low back pain: a three-month follow-up study

ABSTRACT Background The clinical presentation and pain experience of patients with (sub)-acute low back pain ((S)ALBP) can strongly vary in clinical practice. However, despite growing evidence that psychological factors are associated with disability in chronic pain conditions including low back pain, studies examining the influence of psychological factors, quantitative sensory testing (QST) (i.e. pressure pain thresholds (PPTs)) and conditioned pain modulation (CPM) on future disability are still lacking in (S)ALBP. Objective This prospective cohort study aims to determine associations between baseline psychological factors, PPTs and CPM in (S)ALBP and disability after 3 months. Methods Fifty-two patients with (S)ALBP underwent a baseline PPT evaluation in rest and during a CPM protocol. Patients were asked to fill in self-report questionnaires: the Visual Analogue Scale (VAS), the Quebec Back Pain Disability Scale (QBPDS), the Pain Catastrophizing Scale (PCS), the Tampa Scale for Kinesiophobia (TSK) and the Illness Perception Questionnaire – Brief version (IPQ-B). At 3-month follow-up, participants were asked to fill in the QBPDS again. Multiple linear regression analysis was conducted to determine associations between baseline factors and disability at follow-up. Results Thirty-eight patients participated at follow-up. Because of the multicollinearity issue, the TSK score was selected for analyses and the PCS and IPQ-B score were excluded from the model. No significant associations between baseline factors and disability at follow-up were found. Conclusion Neither baseline psychological factors nor PPTs or CPM in (S)ALBP were significantly associated with disability after 3 months. Our multiple linear regression analysis was likely underpowered to detect significant associations.

Kinesiophobia Is Related to Acute Musculoskeletal Injury Incidence Following Concussion.

Athletes with a history of sport concussion (SC) have an increased risk of musculoskeletal injury (MSK); however, the underlying mechanisms have yet to be determined. The purpose of our study was to evaluate kinesiophobia in college athletes with or without a time-loss MSK within 180 days of unrestricted return to play following a SC. This was a retrospective cohort study within a sports medicine facility. Participants were eligible if they were diagnosed with a SC, completed the Tampa Scale of Kinesiophobia (TSK), and completed an unrestricted return to play. Fifty-six college athletes (40 men and 16 women) with an average age of 19.5 (1.25) years, height of 183.5 (10.45) cm, and mass of 94.72 (24.65) kg, were included in the study. MSK participants were matched to non-MSK participants 1:1. Demographic and TSK outcome scores were compared using independent t tests. The proportion of participants in each group who scored above the clinical threshold (TSK ≥ 37) was compared using a chi-square analysis. Alpha was set at α = .05. The MSK group (31.2 [6.30]) reported similar TSK scores to the matched group (28.9 [3.34]; t54 = 1.70, P = .10, d = 0.45 [-0.08 to 0.97]). A greater proportion of athletes who were diagnosed with an MSK-reported scores above the cutoff (χ2[1] = 6.49, P = .01). Athletes diagnosed with SC had similar kinesiophobia values regardless of MSK status. However, a higher proportion of athletes with a time-loss MSK injury reported a TSK score greater than the clinical cutoff. Our results suggest that factors such as kinesiophobia should be considered following a SC.