Kinesiophobia and its correlations with pain, proprioception, and functional performance among individuals with chronic neck pain

Abstract

Chronic neck pain (CNP) incidence in the general population is high and contributes to a significant health problem. Kinesiophobia (fear of pain to movement or re-injury) combined with emotions and physical variables may play a vital role in assessing and managing individuals with CNP. The study’s objectives are 1) to evaluate the relationship between kinesiophobia, neck pain intensity, proprioception, and functional performance; 2) to determine if kinesiophobia predicts pain intensity, proprioception, and functional performance among CNP individuals. Sixty-four participants with CNP (mean age 54.31 ± 9.41) were recruited for this cross-sectional study. The following outcome measures were evaluated: Kinesiophobia using the Tampa Scale of Kinesiophobia (TSK), neck pain intensity using the visual analog scale (VAS), cervical proprioceptive joint position errors (in flexion, extension, and rotation directions) using cervical range of motion (CROM) device and handgrip strength as a measure of functional performance using the Baseline® hydraulic hand dynamometer. Kinesiophobia showed a strong positive correlation with neck pain intensity (r = 0.81, p<0.001), a mild to a moderate positive correlation with proprioception joint position errors (JPE) in extension, rotation left and right directions (p<0.05), but no correlation in flexion direction (p = 0.127). Also, there was a moderate negative correlation with handgrip strength (r = -0.65, p<0.001). Regression analysis proved that kinesiophobia was a significant predictor of pain intensity, proprioception, and functional performance (p<0.05). This study infers that kinesiophobia in individuals with CNP predicts pain, proprioception, and functional performance. Kinesiophobia assessment should be considered in regular clinical practice to understand the barriers that can influence rehabilitation outcomes in CNP individuals.

Association between Kinesiophobia and Knee Pain Intensity, Joint Position Sense, and Functional Performance in Individuals with Bilateral Knee Osteoarthritis

“…Further, in the regression analysis, kinesiophobia significantly predicted pain intensity level. These findings in our study are in accordance with studies that showed a significant association between kinesiophobia and pain intensity level in different conditions with musculoskeletal pain [ 20 , 29 , 30 ]. A recent study reveals that fear of movement and catastrophic thoughts lead an individual to painful adverse consequences and affect the neurophysiology of pain regulation [ 31 ].…”

“…Limited studies show the association between kinesiophobia and knee proprioception, but studies in other regions with musculoskeletal conditions have shown a positive association. Asiri et al [ 20 ] showed mild to moderate positive correlations between kinesiophobia and cervical joint position errors (extension: r = 0.48, p < 0.001; right rotation: r = 0.31, p = 0.011) [ 20 ]. Similar to our study results, the regression analysis proved that kinesiophobia was a significant predictor of JPS [ 20 ].…”

“…Asiri et al [ 20 ] showed mild to moderate positive correlations between kinesiophobia and cervical joint position errors (extension: r = 0.48, p < 0.001; right rotation: r = 0.31, p = 0.011) [ 20 ]. Similar to our study results, the regression analysis proved that kinesiophobia was a significant predictor of JPS [ 20 ]. Aydoğdu et al [ 40 ] did not find any relation between kinesiophobia and proprioception in individuals following anterior cruciate ligament reconstruction.…”

“…In addition, functional limitations, such as squatting, walking, performing sitting-to-standing actions, and climbing up and down the stairs, in the elderly are partially due to the normal aging process [ 19 ]. The presence of kinesiophobia may further deteriorate functional performance and impact the activities of daily living [ 20 , 21 ]. Even though kinesiophobia had been studied in different musculoskeletal conditions, its impact on knee pain intensity, knee JPS, and functional performance in elderly individuals with KOA is limited.…”

Reliability of hip joint position sense tests using a clinically applicable measurement tool in elderly participants with unilateral hip osteoarthritis

“…Proprioception, according to Sherrington, is the perception of the position, motion of joints, and the perception of force in space 1 . Integrated action of different mechanoreceptors present in muscles, tendons, joint capsules, ligaments contributes to proprioception 2 , 3 . The proprioception is crucial in maintaining balance and body posture with precise and coordinated movements 4 , 5 .…”