Tampa Scale Research Articles

Influence of kinesiophobia on activity, function, and anxiety levels in patients with rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is a chronic autoimmune disorder that causes joint inflammation and affects quality of life. Appropriate physical activity can enhance joint function and lower cardiovascular disease risk. However, individuals with RA often have reduced physical activity levels, likely due to kinesiophobia, or fear of movement.AimThis study aimed to assess the prevalence of kinesiophobia among RA patients and its influence on functional impairment, physical activity, and pain-related anxiety.MethodsUsing a convenience sampling method, we surveyed 350 RA patients attending outpatient clinics in the rheumatology and immunology departments of three tertiary hospitals in Henan Province, China, from August 18 to September 1, 2023. Participants completed the Tampa Scale of Kinesiophobia (TSK), the Signals of Functional Impairment Scale (SOFI), the International Physical Activity Scale—Short Form (IPAQ-SF), and the Pain Anxiety Symptoms Scale-20 (PASS-20). The Disease Activity Score 28 (DAS28) was retrieved for each participant to assess disease activity in RA patients. Descriptive analysis, Chi-square tests, Spearman correlation, and multiple linear regression assessed factors influencing kinesiophobia, with significance set at p < 0.05.ResultsResults indicated that 70.86% of participants experienced kinesiophobia, which was positively correlated with functional impairment and pain-related anxiety, while inversely related to physical activity levels (p < 0.001). Regression analysis revealed that kinesiophobia was explained by 65.5% of the variance, with gender, education level, functional impairment, pain-related anxiety, and pain severity identified as significant predictors (p < 0.05).ConclusionThe findings suggest that RA patients exhibit a high prevalence of kinesiophobia, predominantly influenced by factors such as gender, lower educational attainment, increased pain levels, greater functional impairment, and pain-related anxiety. Notably, physical activity levels did not serve as a predictor of kinesiophobia in this cohort.

Therapeutic Neuroscience Education In Fibromyalgia: A Randomized Controlled Trial

Abstract To investigate additive effect of Therapeutic Neuroscience Education (TNE) to pilates exercises in female patients with fibromyalgia (FM).25 female patients FM included in the study. They randomly separated into two groups. There were 11 patients in the intervention group and 14 patients in the control group. Pilates exercises and TNE were applied in the intervention group, and only pilates exercises were applied in the control group. Dynamic Loewenstein Occupational Therapy Cognitive Assessment (DLOTCA), Visual Analogue Scale (VAS), Brief Pain Inventory (BPI), Widespread Pain Index (WPI), Fibromyalgia Impact Questionnare (FIQ), Symptom Severity Scale (SSS), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), Biopsychosocial Questionnaire (BETY-BQ) and pressure algometer was used for evaluation.After the treatment, control group improved in the “visuomotor construction” and “thinking operations"cognitive areas andtotal score of DLOTCA, BPI-pain severity score, VAS, FIQ, SSS, PCS-magnification, and only left medial knee mean score of pressure pain thresholds (p<0.05). Intervention group improved in the “thinking operations” cognitive area and total score of DLOTCA, BPI-pain severity score, BPI-pain interference score, VAS, WPI, FIQ, SSS, TSK, BETY-BQ and all pressure pain thresholds (excluding left trapezius) (p<0.05). In the comparison of delta values, the intervention group improved more in WPI, FIQ, right trapezius mean score and left trapezius, right quadriceps femoris, right-left medial knee maximum and mean scores of pressure pain thresholds (p<0.05). TNE increased the effectiveness of pilates exercises on pain, functional status and pressure pain thresholds in patients with FM.

The model of fear of movement/(re)injury runs clockwise from catastrophizing: evidence from a sample of outpatients with chronic non-specific low back pain

ABSTRACT Objective To provide evidence that catastrophizing is the primer of the cognitive-behavioural model of fear of movement/(re)injury (FAM). Design A cross-sectional analysis of 180 outpatients with chronic non-specific low back pain who completed the Pain Catastrophizing Scale (PCS), the Tampa Scale of Kinesiophobia (TSK), the Roland-Morris Disability Questionnaire (RMDQ), the Hospital Anxiety and Depression Scale – Depression (HADS-D), and a pain intensity numerical rating scale (NRS). The intercorrelations of the outcome measures were estimated using Pearson’s correlation coefficient (r), and regression analyses were used to examine their predictive values by following the left side of the FAM clockwise from the PCS (p = 0.05). A postdictive analysis dichotomizing the sample into high- and low-level catastrophizers evaluated the effects of addressing catastrophizing on disability and pain. Results: The intercorrelations of the PCS with the TSK, RMDQ, HADS-D and NRS were respectively r = 0.59, r = 0.54, r = 0.18, and r = 0.44. PCS was a significant predictor of TSK; PCS and TSK significantly predicted RMDQ and HADS-D; and PCS, TSK, RMDQ and HADS-D significantly predicted NRS. The postdictive analysis showed that addressing catastrophizing reduces disability and pain experience by 14% in high-level catastrophizers and 86% in low-level catastrophizers. Conclusion Our findings provide evidence that catastrophizing is the primer of the FAM.

Do Anxiety, Depression, Fear of Movement and Fear of Achilles Rupture Correlate with Achilles Tendinopathy Pain, Symptoms or Physical Function?

Objectives: To determine if psychological factors, such as anxiety, depression, fear of movement and fear of rupture are associated with increased tendon-related disability, quantified by the Tendinopathy Severity Assessment-Achilles (TENDINS-A). Design: Cross-sectional. Setting: Online Qualtrics survey. Participants: Sixty-eight participants (54% female) with Achilles tendinopathy and a mean (standard deviation) age of 40.1 (12.6) years. Main Outcome Measures: The TENDINS-A (including subscales of pain; symptoms such as stiffness; physical function), Patient Health Questionnaire-9, General Anxiety Disorder-7, Tampa Scale for Kinesiophobia and fear of tendon rupture. Associations were evaluated using generalised linear models (adjusting for age and sex), with significance accepted when p < 0.05. Results: Anxiety symptoms were positively associated with Achilles pain (p = 0.035), symptoms (p = 0.045) and physical function (p = 0.019). Depressive symptoms were negatively associated with symptoms (p = 0.045) but not pain (p = 0.078) or physical function (p = 0.429). Fear of movement was not associated with pain (p = 0.479), symptoms (p = 0.915) or physical function (p = 0.064). Fear of rupture was associated with pain (p = 0.042), but not symptoms (p = 0.797) or physical function (p = 0.509). Conclusions: Our research demonstrated significant correlations between anxiety and depression with the severity of tendon-related disability. Fear of movement was only associated with physical function, whereas fear of rupture was associated with pain and physical function.

Kinesophobia in patients with osteoporotic vertebral compression fractures: a latent profile analysis.

To explore the status of kinesophobia in patients with osteoporotic vertebral compression fractures and analyze the influencing factors of different kinesophobia profiles. Cross-sectional survey study. A total of 245 patients with osteoporotic vertebral compression fractures who underwent surgical treatment at our Department of Orthopedics between January 2023 and March 2024 were selected. A general data questionnaire and Tampa Scale for Kinesiophobia were used in the investigation. Latent profile analysis was conducted to categorise kinesophobia in patients with osteoporotic vertebral compression fractures, while univariate logistic regression was performed to identify the factors influencing the latent profiles of kinesophobia. The average kinesophobia score of the patients with osteoporotic vertebral compression fractures was 45.38 ± 7.12 points. The patients were divided into three latent profile categories, namely high, medium, and low kinesophobia, with mean probabilities of 0.958, 0.966, and 0.970, respectively. Furthermore, age, gender, pain score, injury cause, and other injuries were significant influencing factors in the kinesophobia groups (P < 0.05). Kinesophobia in patients with osteoporotic vertebral compression fractures is heterogeneous and affected by age, gender, pain score, injury cause, and other injuries. Clinical staff should recognise the characteristics of patients in different kinesophobia categories and actively adopt appropriate measures for those in the high kinesophobia group to enhance the alleviation of their fear status and mitigate the occurrence of fear-induced adverse outcomes, such as disability and weakness.

Validity and Reliability of the Tampa Scale for Kinesiophobia for Adolescents with Heart Disease.

Kinesiophobia (KP) is the fear of movement or physical activity (PA) that is related to a medical condition. In adolescents, KP is associated with depression, anxiety, and impaired quality of life (QoL). Adolescents with heart disease (HD) often avoid PA. Factors that may moderate PA avoidance, such as KP, have not been adequately studied in this population. Purpose: To assess the validity and reliability of a newly adapted Tampa Scale for KP for adolescents with HD (TSK-Heart-A). Methods: The TSK-Heart-A survey consists of 17 Likert scale items, producing a summary score (SS) ranging from 17 (low KP) to 68 (high KP). Following content and face validity, adolescents (age 12-18 years) with arrhythmia disorders or Fontan palliation were recruited. The PROMIS pediatric anxiety and depression short forms, PedsQL generic core and cardiac module, and a PA questionnaire for adolescents (PAQ-A) were used for criterion validity. The TSK-Heart-A was completed twice (20.4 ± 6.3 days apart) for assessment of internal and test-retest reliability. Pearson correlations and Cronbach's alpha determined validity and reliability, respectively. Results: Adolescents (n = 63) were 15.5 ± 1.8 years-old, 50.8% female, and 69.8% had arrhythmia disorder. Mean TSK-Heart-A SS was 33.8 ± 7.8 (range: 20 to 56). The TSK-Heart-A SS correlated significantly with PROMIS T-scores (anxiety: 49.7 ± 12.2, r = 0.48; depression: 46.9 ± 12.7, r = 0.41), PedsQL score (generic QoL: 75.2 ± 18.9, r = -0.61; cardiac QoL: 74.7 ± 17.5, r = -0.56), and PAQ-A (score: 2.0 ± 0.7, r = -0.35). Test-retest and internal reliability had a total score of r = 0.77 (p = 0.89). Conclusions: The new TSK-Heart-A survey is valid and reliable and suggests KP is present in some adolescents with HD.

Impact of functional re-education and environmental adaptation in cancer patients with respiratory pathology: Study protocol.

In recent years, cancer survival rates have increased exponentially. However, this rise in survival comes with a significant drawback. As the number of treatment lines has grown, so too have the side effects, which can severely impact patients' functionality and quality of life. One of the most concerning effects is dyspnoea, a serious health issue that imposes substantial limitations on individuals. While traditional clinical approaches, primarily focused on pharmacological interventions, are commonly employed to manage dyspnoea, we argue that these methods may not always provide optimal symptomatic relief. Therefore, we propose a study protocol to implement an interdisciplinary intervention for these patients. This protocol aims to enhance standard clinical practice by introducing a program of functional re-education and environmental adaptation. We believe this intervention is essential for the follow-up care of patients with respiratory conditions after hospital discharge. A two-arm, randomized, parallel, controlled clinical trial will be conducted by the University of Salamanca, Spain, in collaboration with the Medical Oncology Service of the University Health Care Complex of Salamanca. The trial aims to recruit 80 oncology patients who exhibit symptoms of dyspnoea during hospital admission. Participants will be randomly assigned to one of two groups: the control group, which will receive a health education program, and the experimental group, which will receive both the health education program and a functional re-education and environmental adaptation program. Assessments will be conducted at three time points: baseline (prior to hospital discharge), follow-up (15 days after discharge), and the end of the intervention (1 month after discharge). During these assessments, sociodemographic data will be collected, and the following scales will be administered: Barthel Index, Medical Research Council Dyspnoea Scale (mMRC), EuroQol 5-D questionnaire (EQ-5D), Visual Analogue Scale (VAS), Short Physical Performance Battery (SPPB), Tampa Scale for Kinesiophobia (TSK), and the Zarit Reduced Caregiver Burden Scale. The findings of this research can be easily implemented in clinical settings by introducing a targeted intervention to improve the quality of life for this patient population. This study aims to advance traditional clinical approaches by facilitating the recovery or adaptation of cancer patients in their daily routines, in relation to the severity of their symptoms. Our primary goal is to enhance independence and functionality, ultimately improving their overall standard of living. ClinicalTrials.gov; ID: NCT06035263. Registered on: September 19, 2023. https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000DM2U&selectaction=Edit&uid=U0004OJ7&ts=6&cx=f7qqxo.

“PREVALENCE OF KINESIOPHOBIA AND DISCONTENTMENT IN POST LAMINECTOMY PATIENTS AND ITS IMPACT ON LEVEL OF PHYSICAL ACTIVITY- A CROSS SECTIONAL STUDY”

Background: A laminectomy is a type of spine decompression used to treat stenosis. Fear of motion was known as kinesiophobia. Patients who are unhappy with their surgery results may be less likely to exercise, which could have a major impact on their quality of life. Methodology: The 126 post-laminectomy patients using non-probability convenience sampling, from Prime Teaching Hospital and Irfan General Hospital Peshawar were included. The Tampa scale was used for kinesiophobia, the Surgical Satisfaction Questionnaire (SSQ8) to assess post-operative satisfaction or dissatisfaction, and the International Physical Activity Questionnaire (IPAQ) to assess physical activity in post-laminectomy patients. Result: Out of 126 participants 71 (56.35%) males and 55 (43.65%) were females. The mean age of participants was 44.10±9.635 years. Kinesiophobia affects 81.7%, 14(11.1%), participant shows very low level of satisfaction, 41(32.5%) participants show low satisfaction 48(38.1%) participants show moderate level of satisfaction and 23(18.3%) participants shows high level of satisfaction regarding surgical intervention. P-value of kinesiophobia and physical activity is 0.060 and surgical satisfaction and physical activity value is 0.230. Conclusion: This study shows that kinesiophobia and post-operative dissatisfaction have a substantial detrimental impact on patients' overall level of physical activity, which in turn affects their physical, emotional, and social well-being.

Comparison of the effects of exergaming and balance training on dynamic postural stability during jump-landing in recreational athletes with chronic ankle instability.

The primary inquiry of this study was to determine if exergaming is more effective than balance training in improving dynamic postural control during jump-landing movements among athletes with chronic ankle instability (CAI). Additionally, the study aimed to compare the effectiveness of these interventions on clinical and psychological outcomes. This study was a randomized, single-blinded, controlled trial in which participants were assigned to either an exergaming group or a balance training group. Outcome measures were assessed before, after, and one month following the intervention. Primary outcomes included the stability index (SI) and time to stabilization (TTS) in the anteroposterior (AP), mediolateral (ML), and vertical (V) directions, the dynamic postural stability index (DPSI), and the resultant vector time to stabilization (RVTTS). Secondary outcomes included performance, fear of movement, and perceived ankle instability, measured using the side-hop test, the Tampa Scale for Kinesiophobia (TSK), and the Cumberland Ankle Instability Tool (CAIT), respectively. Results indicated a significant decrease in ML SI in both groups one month after treatment compared to before and after treatment (P = 0.013 and P<0.001, respectively). Additionally, one-way ANCOVA revealed a significant difference between the groups post-treatment (F(1,31) = 6.011, P = 0.020, η2 = 0.162) and one month post-treatment (F(1,31) = 4.889, P = 0.035, η2 = 0.136), with ML SI being significantly lower in the exergaming group than the balance training group at both time points. In both group, the DPSI also decreased significantly one month post-treatment compared to before and after treatment (P = 0.040 and P = 0.018, respectively). Both groups showed improvements in performance, severity of perceived ankle instability, and fear of movement. Thus, the study concluded that both exergaming and balance training effectively improved postural control during jump-landing, with exergaming showing superior performance in the ML direction both after and one month post-treatment. In terms of clinical and psychological outcomes, both interventions were effective, with neither showing superiority over the other.

Kinesiophobia and Its Correlation with Upper Limb and Hand Functionality Among Individuals with Wrist/Hand Injury: A Cross-Sectional Study.

Background/Objectives: Wrist/hand injury incidences in the general population are high and contribute to a significant health problem. Fear of pain from movement can impact physical recovery, contributing to prolonged disability and impaired function in an upper limb after wrist/hand injury. The study's objectives are (1) to evaluate the relationship between kinesiophobia, pain catastrophizing, QuickDASH, and Patient-Rated Wrist Evaluation and (2) to evaluate the data regarding the influence that basal kinesiophobia may have on upper limb functionality after wrist/hand immobilization. Methods: Participants referred from different medical centers with a wrist or hand injury that required immobilization were enrolled in the study. Data were collected just after the post-immobilization period. The following outcome measures were evaluated: the QuickDASH, the PRWE (Patient-Rated Wrist Evaluation), the TSK (Tampa Scale of Kinesiophobia), and the PCS (Pain Catastrophizing Scale). Demographics were summarized with descriptive statistics and linear relationships between variables using Pearson's correlation coefficient. Furthermore, multivariate linear regression analysis was performed to determine whether kinesiophobia could predict upper functional performance. Results: 64 patients (40 women, 24 men) participated in the study. Significant kinesiophobia positive correlations were found between the TSK and the QuickDASH (r = 0.848, p < 0.001) as well as the TSK and the PCS error (r = 0.521, p < 0.001). The regression model explains 30.4% of the variance in upper limb function, suggesting that the PRWE, the Pain Catastrophizing Scale, and the QuickDASH are important in predicting dysfunction. Conclusions: Kinesiophobia may contribute to but is not a significant predictor of dysfunction in this model.

Comparison of pain, functional and psychological trajectories between total and unicompartmental knee arthroplasties: secondary analysis of a 6-month prospective observational study

IntroductionUnicompartmental knee arthroplasty (UKA) treats osteoarthritis in one knee compartment, while total knee arthroplasty (TKA) addresses all compartments. The debate focuses on UKA's advantages of quicker recovery and fewer complications versus TKA's lower long-term revision rates, emphasizing the need for thorough outcome evaluations. The aim of the present study is to describe and compare the pain, functional and psychological trajectories during a 6-month postoperative rehabilitation period between total and unicompartmental knee arthroplasties.Materials and Methods115 participants who had undergone either TKA or UKA were recruited. Outcome measurements were performed at 1, 4, 12 and 24 weeks post-surgery. Measurements included pain intensity (Visual Analog Scale), range of motion, walking speed (4 m walking test), physical performance (30-s chair stand test), health functioning (Western Ontario and McMaster Universities Osteoarthritis Index), pain catastrophizing (pain catastrophizing scale), fear of movement (Tampa Scale of Kinesiophobia), anxiety and depression (Hospital Anxiety and Depression Scale). A mixed-effects model was used to estimate the influence of type of surgery (either unicompartmental or total knee arthroplasty) to pain, function, and psychological trajectories.ResultsBoth TKA and UKA groups showed significant improvements across the six-month rehabilitation period except for anxiety symptoms in the TKA group, and fear of movement and depression in the UKA group. Between group analysis revealed that in the acute phase UKA patients showed improved range of motion and TKA patients displayed faster walking speed but higher fear of movement. Overall, the type of surgery does not significantly influence the overall rehabilitation pain, functional and psychological trajectories.ConclusionsDespite differences in the acute phase, there are no differences in pain, functional and psychological trajectories throughout the six-month rehabilitation period. These results should be acknowledged to better inform patients and to improve patient education during the perioperative period.Trial registration numberNCT03378440 (2017-12-18), retrospectively registered.Level of evidenceLevel II.

Reliability and validity of the Tampa Scale for Kinesiophobia in patients with traumatic hand-forearm injuries.

Fear of movement in patients with traumatic hand-arm injuries can negatively affect functional outcomes. Therefore, it is important to evaluate fear of movement in this patient population. The aim of this study was to investigate the validity and reliability of the Tampa Scale for Kinesiophobia in patients with traumatic hand-forearm injuries. Cross-sectional. Hand rehabilitation unit in a university hospital. The study included 170 patients with traumatic hand-arm injuries and a mean age of 37.57 (11.85) years. Tampa Scale for Kinesiophobia, Pain Catastrophizing Scale, Beck Anxiety Inventory and pain severity rating (via Visual Analog Scale) were completed by interview in the first session. In addition, Modified Hand Injury Scoring System was used to determine severity of the injury. Tampa Scale for Kinesiophobia was re-administered 15 days after the first session. Test-retest reliability, internal consistency, and construct validity of the Tampa Scale for Kinesiophobia were evaluated. In addition, exploratory factor analysis was completed using baseline data. Cronbach's alpha for the scale was 0.604, and test-retest reliability was acceptable (ICC = 0.646). Tampa Scale for Kinesiophobia had a significant relationship with Beck Anxiety Inventory (r = 0.269, p < 0.001), Pain Catastrophizing Scale (r = 0.457, p < 0.001) and pain severity at rest (r = 0.168, p = 0.029). Factor analysis estimated the scale represented five subsections in this population. Psychometric properties of the Tampa Scale for Kinesiophobia were acceptable in patients with hand-forearm injuries. However, since our results were weaker than those in the literature, this should be considered when interpreting the results.

Do Patients with Rheumatoid Arthritis Have an (In)Adequate Level of Physical Activity? A Latent Class Analysis Approach.

Regular physical activity (PA) has a beneficial effect on joint pain, stiffness, strength, flexibility, and aerobic capacity in patients with rheumatoid arthritis (RA). The aim of this study was to assess the level of PA in patients with rheumatoid arthritis and to identify potential barriers to this activity. The study involved 132 patients with RA. Participants completed the International Physical Activity Questionnaire (IPAQ), the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F), the Tampa Scale for kinesiophobia (TSK), Strength, Ambulation, Rising from a chair, Stair climbing and history of Falling questionnaire (SARC-F) for sarcopenia assessment, and the Patient Health Questionnaire-9 (PHQ-9) for depression. Basic socio-epidemiological data, disease activity score in 28 joints (DAS28), duration of disease, and therapy information were retrieved from electronic patient records. Latent class analysis (LCA) was used to identify subpopulations of patients. The study included 109 women (82.6%) and 23 men (17.4%). Low levels of PA were observed in 16 patients (12%), moderate levels in 70 patients (53%), and high levels in 42 patients (35%). Symptoms of pronounced fatigue were significantly associated with low PA (28.5 ± 11.3 vs. 37 ± 7 vs. 37 ± 10; p = 0.002). The risk of sarcopenia was significantly higher in RA patients with low PA (p = 0.05). Kinesiophobia was present in all three groups (65.2%). LCA identified two classes. In the first class, patients were more likely to be non-exercisers compared to the second class. Patients in the first class were characterized by a higher probability of being female, obese, with lower education levels. Patients in the first class had pronounced fatigue, kinesiophobia and more frequent symptoms of depression. The second class (65% of the total population) included patients who exercised moderately to frequently (93%) and were middle-aged. They were less obese, highly educated, employed, and majority of them achieved low disease activity or remission. In addition, they had lower risks for sarcopenia, depression, fatigue, and kinesiophobia. This study showed that RA patients with moderate and high levels of PA have better disease control, fewer symptoms of fatigue and depression, and a lower risk of sarcopenia. However, kinesiophobia was significantly present in all three groups, indicating a need for further promotion of this non-pharmacological treatment.

Pain Neuroscience with exercise versus Biomedical Education with Exercise for treatment of Rotator Cuff-related Shoulder Pain: A Randomised Clinical Tria

ntroduction: A common clinical issue, rotator cuff pathology has a worldwide prevalence of 20.7%. It has been noted that exercise has traditionally been a primary treatment approach for shoulder disorders, but more recently, Pain Neuroscience Education (PNE) and Biomedical Education (BME) programs have shown promising effects in decreasing patients’ pain and disability. Aim: To compare the efficacy of pain neuroscience and BME programs with exercise in individuals with rotator cuff-related pain. Materials and Methods: A concurrent parallel randomised group clinical study was conducted at the College of Physiotherapy, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India from August 2022 to August 2023. 100 patients who were randomly assigned to two groups: 50 in the PNE plus exercise group and 50 in the BME plus exercise group. The study’s outcome measures included pain intensity (measured by the Numeric Pain Rating Scale, NPRS), shoulder disability (assessed using the Shoulder Pain and Disability Index, SPADI), kinesiophobia (measured by the Tampa Scale), and pain experience (assessed using the Pain Catastrophising Scale, PCS). Data were collected at baseline, two weeks, and four weeks for all variables. Between-group comparisons were performed using independent samples t-tests. Results: The mean age of participants in the PNE plus exercise group was 47.24±12.61 years, while in the BME plus exercise group, it was 45.46±11.87 years. In the PNE plus exercise group, there were 36 males and 14 females, whereas in the BME plus exercise group, there were 34 males and 16 females. A total of 30 females and 70 males participated in the study. At the 2nd and 4th weeks, there were statistically significant differences between the PNE and BME groups regarding kinesiophobia and pain-related beliefs (p≤0.05). However, there were no statistically significant differences between the two groups concerning pain intensity and shoulder disability (p&gt;0.05). Conclusion: The study demonstrated that the PNE program, when coupled with exercise, was more effective in reducing kinesiophobia and altering perceptions about pain. This information, which emphasises the potential benefits of incorporating PNE into treatment regimens for patients with rotator cuff-related pain, is valuable for healthcare providers.

Application of Multidisciplinary Collaborative Interventions in the Early Rehabilitation of Patients with Hemorrhagic Stroke and Kinesiophobia

Objective: This study aims to explore the role of multidisciplinary collaborative interventions in the early rehabilitation of patients with hemorrhagic stroke and kinesiophobia. Methods: Using a convenience sampling method, 100 patients with hemorrhagic stroke and kinesiophobia admitted to the Department of Neurology at Nantong First People’s Hospital between January 2022 and December 2023 were selected as subjects. Fifty patients admitted between January 2022 and January 2023 were assigned to the control group, while 50 patients admitted between February 2023 and December 2023 were assigned to the experimental group. The control group received conventional care, while the experimental group received multidisciplinary collaborative interventions provided by a team consisting of neurologists, rehabilitation therapists, psychological counselors, and nurses. The study evaluated the differences in emotional state (using the Hospital Anxiety and Depression Scale, HAD), kinesiophobia level (using the Tampa Scale for Kinesiophobia, TSK), functional recovery (using the modified Rankin Scale, mRS), and daily living abilities (using the Barthel Index, BI) before and after intervention. Results: After the intervention, the HAD scores in the experimental group were significantly lower than those in the control group (P &lt; 0.05). The TSK scores in the experimental group were also significantly lower than in the control group (P &lt; 0.05), while mRS and BI scores showed significant improvement compared to the control group (P &lt; 0.05). Conclusion: Multidisciplinary collaborative interventions have significant effects in reducing kinesiophobia, promoting functional recovery, and improving the quality of life in patients with hemorrhagic stroke.

Investigation of the effect of low back pain severity on functional level, quality of life and fear-avoidance behavior in women with hip osteoarthritis

ABSTRACT Purpose: The objective of the this study was to investigate the effect of low back pain (LBP) severity on functional level, quality of life (QoL), and fear-avoidance behavior in patients with hip osteoarthritis (HOA). Material and Methods: A cross-sectional study conducted on a total of 43 female patients diagnosed with HOA. The patients were divided into two groups according to pain intensity; group 1 consisted of patients with moderate-to-high intensity low back pain (VAS: 3.5-10 cm; n=21), group 2 consisted of patients with mild back pain (VAS: 0.5-3.49 cm; n=22) occurred. Functional level (Lumbar Spine Mobility, Harris Hip Score, Timed Up and Go Test), quality of life (Nottingham Health Profile) and kinesiophobia (Tampa Scale of Kinesiophobia) were evaluated. Results: When the groups were compared, it was found that the QoL, QoL-pain and emotional reactions sub-parameters scores of Group 1 were significantly higher than Group 2 (p0.05). Conclusion: The results of our study showed that the QoL were negatively affected in patients with moderate-high severity of LBP in HOA in comparison with mild severity of LBP.

The Influence of Kinesiophobia on Time to Clinical Recovery in Collegiate Athletes with Concussion.

Several factors such as acute symptom severity, premorbid anxiety, and depression have been associated with concussion recovery. Elevated kinesiophobia has been associated with recovery from musculoskeletal conditions, as well as increased reaction time and vestibular-ocular motor dysfunction following concussion. However, kinesiophobia has yet to be evaluated as a modifier of concussion recovery time. This study was designed to evaluate the role of acute kinesiophobia levels on days until clinical recovery in collegiate athletes with concussion. We hypothesized that collegiate athletes with elevated Tampa Scale of Kinesiophobia (TSK) scores would take a greater number of days to achieve clinical recovery compared with athletes with lower values. Division I collegiate athletes diagnosed with a concussion (N = 113, 19.9 ± 1.5years, 42% female) participated in this descriptive laboratory study. Participants were assigned to high [≥ 37 (H-TSK, n = 54)] or low [< 37 (L-TSK, n = 59)] TSK groups on the basis of the first TSK values recorded within 72h of their concussion. Participants were also administered the Revised Head Injury Scale (HIS-r) to assess symptom severity within 72h of injury. The Immediate Postconcussion and Cognitive Test (ImPACT) battery was administered at baseline and used to gather demographic variables such as biological sex, age, history of anxiety/depression, and concussion history, and as part of the athletes' symptom-free assessment. Days until clinical recovery between H-TSK and L-TSK groups were compared using a Mann-Whitney U test. Spearman's rank correlation coefficients were calculated to determine the relationship between TSK and days until clinical recovery in addition to other modifiers of recovery. Multiple linear regression was used to evaluate days until clinical recovery as a function of the TSK total score, controlling for the HIS-r and ImPACT variables. Days until clinical recovery was significantly longer in the H-TSK group (median difference = 2.5days, p < 0.001) compared with the L-TSK group. A significant, moderate positive correlation between the TSK score and days to clinical recovery (ρ = 0.45, p < 0.001) was observed, which was also the strongest correlation among all variables. Our regression model demonstrated that for every point increase on the TSK, days until clinical recovery increased by 0.23 while controlling for total symptom severity, age, concussion history, psychiatric history, and biological sex (β = 0.23, p = 0.018). All other variables entered into the regression were not statistically significant. Our data suggest that athletes with TSK scores above 37 within 72h of a concussion had a greater number of days until clinical recovery when compared with athletes with TSK values below 37. The TSK score had the highest correlation with days until clinical recovery when compared with other known modifiers of recovery, including total symptom severity. The TSK score was also the strongest predictor of days until clinical recovery. Collectively, these findings suggest that the TSK score should be considered by healthcare professionals to help inform effective management strategies for collegiate athletes with concussion.

COMPLICATIONS DUE TO POST OPERATIVE KINESIOPHOBIA IN PATIENTS FOLLOWING MODIFIED RADICAL MASTECTOMY

Background: Breast cancer remains a significant health challenge, particularly in developing countries, where late-stage diagnosis and limited access to care contribute to poor outcomes. In many cultures, cancer is perceived as a lifelong disability, and surgical interventions, such as mastectomy, are seen as compounding this tragedy. Kinesiophobia, the fear of movement, may exacerbate physical inactivity and delay rehabilitation following mastectomy, potentially leading to a higher prevalence of post-operative complications. Addressing these complications is critical for improving recovery and quality of life. Objective: The study aimed to determine the frequency and types of complications due to post-operative kinesiophobia in patients who underwent modified radical mastectomy for breast cancer. Methods: A cross-sectional study was conducted at Jinnah Hospital, Lahore, over six months from August 2015 to January 2016. A total of 77 female patients aged 15 to 60 years who underwent modified radical mastectomy were recruited using non-probability convenience sampling. Kinesiophobia was assessed using the Tampa Scale, and complications such as pain, lymphedema, and decreased shoulder range of motion were documented. Data analysis was conducted using SPSS version 20, with numerical data presented as means and standard deviations, while qualitative data was summarized using frequencies and percentages. Results: All 77 participants experienced pain associated with kinesiophobia, with 89.6% (n=69) reporting sharp pain, 6.5% (n=5) experiencing burning pain, and 3.9% (n=3) presenting with neuropathic pain. Lymphedema was reported by 96.1% (n=74) of the patients, while decreased shoulder range of motion was observed in 100% of participants. Axillary web formation was less frequently reported. The mean age of participants was 37.19 years, with a standard deviation of 4.133. Conclusion: Pain, particularly sharp pain, lymphedema, and reduced shoulder range of motion were the most common complications following modified radical mastectomy. The findings highlight the pervasive impact of kinesiophobia on post-operative recovery and emphasize the need for targeted interventions to manage these complications effectively.

Analysis of influencing factors and construction of nomogram prediction model of postoperative kinesiophobia in patients undergoing total knee arthroplasty.

To explore the influencing factors of kinesiophobia and to establish a nomogram prediction model. A retrospective observational study was conducted in 354 patients who underwent TKA in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from December 2019 to December 2022. Sociodemographic characteristics, anesthesia methods, Tampa Scale for Kinesiophobia (TSK), numeric rating scale (NRS), hospital for special surgery (HSS), activities of daily living (ADL), and self-rating anxiety scale (SAS) were reviewed and analyzed. Logistic regression analysis was used to identify the influencing factors of kinesiophobia, and a nomogram model was established based on the identified influencing factors and verified by consistency index (C-index), calibration curve, and receiver operating characteristic (ROC) curve. Incidence of kinesiophobia in patients who received TEAS combined with western medicine (dexmedetomidine and remifentanil) was significantly lower than that in patients who received western medicine alone. The logistic regression analysis showed that family monthly income level, HSS, ADL, and combined TEAS and western medicine approach were independent protective factors for kinesiophobia (all P<0.05). The degree of pain and anxiety were independent risk factors for kinesiophobia (both P<0.05). A nomogram model was constructed with C-index of 0.721 (0.658, 0.784), and the area under curve (AUC) was 0.748 (95 %CI: 0.685-0.807). The calibration curve also showed good consistency between actual observations and nomogram model predictions. Family monthly income level, anesthesia methods, NRS, HSS, ADL, and SAS scores are influencing factors of kinesiophobia, and the nomogram model can be useful for predicting postoperative kinesiophobia.

Effectiveness of multimodal active physiotherapy for chronic knee pain: a 12-month randomized controlled trial follow-up study.

Active physiotherapy (APT) embraces a patient-centered approach, prioritizing self-management within the biopsychosocial model and involving active patient movements. Beyond structured exercise, APT incorporates pain neuroscience education, Mulligan Mobilization (MWM), and active myofascial release techniques to integrate sensory-motor information for functional recovery and pain relief. This study aims to rigorously compare the effectiveness of APT versus conventional physical therapy (CPT) on pain and functional outcomes in patients with chronic knee pain. Eighty-seven patients with symptomatic and radiographically confirmed knee pain were included in this 12-month follow-up of a randomized controlled trial, conducted at a national institute and a rehabilitation clinic. Patients were randomized to either APT (n = 44) or CPT (n = 43). The APT protocol integrated pain neuroscience education, MWM, active myofascial release techniques, and structured exercises focusing on flexibility, stability, neuromuscular control, and coordination. The CPT protocol included health education, laser therapy, ultrasound therapy, and exercise. Both interventions were performed for 60 min twice a week for 3 months. The primary outcome was the Knee Injury and Osteoarthritis Outcome Score-4 domain version (KOOS4). Secondary outcomes included pain intensity (VAS), KOOS-pain, activities of daily living (ADL), function in sport and recreation (Sports/Rec), knee-related quality of life, global rating of change (GROC), quality of life (SF-36), Tampa Scale for Kinesiophobia (TSK), and functional performances measured at different intervals. Intention-to-treat analyses were performed. Of the 87 patients, 70 (80.5%) completed the 12-month follow-up. KOOS4 improved more in the APT group (16.13; 95% CI, 10.39-21.88) than in the CPT group (11.23; 95% CI, 5.42-17.04). APT showed additional improvement in KOOS4 compared to CPT (2.94; 95% CI: 0.04 to 5.85, p = 0.047). The VAS difference was -3.41 mm (95% CI: -6.40 to -0.43, p = 0.025), favoring APT. APT also showed more improvements in KOOS-pain, KOOS-ADL, KOOS-Sports/Rec, and TSK (p < 0.05). No differences between groups were observed in GROC and SF-36. APT significantly improved most functional performance variables compared to CPT (p < 0.05). Active Physiotherapy outshines conventional physical therapy by delivering more substantial reductions in pain intensity and marked enhancements in function among patients with knee pain. This distinctive efficacy underscores the invaluable role of APT in the management of chronic knee pain. By actively involving patients in their recovery journey, APT not only fosters superior results but also emphasizes the critical need to integrate these advanced therapeutic strategies into everyday clinical practices.