Mediation Effect of Pain on the Relationship between Kinesiophobia and Postural Control: Comparison and Correlations in Individuals with Fibromyalgia Syndrome and Asymptomatic Individuals—A Cross-Sectional Study

Abstract

Background: Individuals with fibromyalgia syndrome (FM) usually present with a fear of movement (kinesiophobia), which causes their symptoms to be maintained and exacerbated. Kinesiophobia can significantly impact postural control; ascertaining their association is crucial in evaluating and managing individuals with FM. This study aims to (1) compare postural control between individuals with FM and asymptomatic individuals, (2) estimate the relationship between kinesiophobia and postural control in individuals with FM, and (3) evaluate whether pain intensity mediates the association between kinesiophobia and postural control in individuals with FM. Methods: This study enrolled 92 individuals (mean age: 51.52 ± 7.7 years) diagnosed with FM and 106 asymptomatic individuals (mean age: 50.47 ± 6.6 years). The examiners estimated the fear of movement and the intensity of pain utilizing the Tampa scale of kinesiophobia (TSK) scores and the visual analogue scale (VAS), respectively. The postural control variables included anteroposterior (A-P) sway in mm, medio-lateral (M-L) sway in mm, and ellipse area in mm2. Results: The individuals with FM had impaired postural control compared to the asymptomatic individuals (p < 0.001). Kinesiophobia exhibited mild-to-moderate correlations with the postural control variables (nondominant side: A-P sway: r = 0.48, M-L sway: r = 0.49, ellipse area: r = 0.43. Dominant side: A-P sway: r = 0.41, M-L sway: r = 0.33, ellipse area: r = 0.44). The pain intensity significantly mediated the relationship between kinesiophobia and postural control (p < 0.001). Conclusion: Kinesiophobia showed a significant positive relationship with postural control. The individuals with FM with higher TSK scores had decreased postural control. Pain intensity mediated the relationship between kinesiophobia and postural control. These factors must be considered when evaluating and formulating treatment strategies for people with FM.

The Mediation Effect of Pain on the Relationship between Kinesiophobia and Lumbar Joint Position Sense in Chronic Low Back Pain Individuals: A Cross-Sectional Study

“…Pain has the ability to influence numerous aspects of the nervous system, including the sensitivity of muscle spindles and the way the central nervous system modulates proprioceptive afferent signals [ 59 ]. Asiri et al [ 37 ] conducted a study investigating the mediation effect of pain on the relationship between kinesiophobia and postural control in fibromyalgia syndrome, and the results demonstrated that pain significantly mediated their relationship to produce altered motor control, hence impacting balancing ability. Similarly in our study, pain may have impacted the relationship between kinesiophobia and LJPS.…”

“…Increased pain is associated with increased proprioceptive errors and decreased balance and functional mobility [ 32 ]. Previous studies have shown that pain is a significant factor that can increase fear of movement and impair motor control [ 33 , 34 , 35 , 36 , 37 ]. However, it is unknown how pain influences kinesiophobia and its relationship with LJPS in CLBP individuals.…”

Unveiling the Nexus of Cervical Proprioception, Postural Stability, and Impeding Factors in Cervical Spondylosis: Insights from Reposition Errors, Limits of Stability, and Mediation Analysis

“…Each item is rated on a 4-point Likert scale, with responses ranging from "strongly disagree" to "strongly agree". The total score on the TSK provides an indication of an individual's level of kinesiophobia, with higher scores reflecting a greater fear of movement [26][27][28][29][30].…”

Mediation Effect of Kinesiophobia on the Relationship between Cervical Joint Position Sense and Limits of Stability in Individuals with Fibromyalgia Syndrome: A Cross-Sectional Study Using Mediation Analysis

“…These modifications can significantly alter the afferent proprioceptive input, hence affecting the joint position sensation and stability limits [21]. Chronic persistent pain might exacerbate FMS patients' fear of movement, hence diminishing their proprioceptive and balance abilities [21]. These findings demonstrate that kinesiophobia may serve as a mediator between cervical JPS and limitations of stability in patients with FMS.…”

“…These altered activation patterns can result in somato-motor-system-related muscular weakening and atrophy [20]. These modifications can significantly alter the afferent proprioceptive input, hence affecting the joint position sensation and stability limits [21]. Chronic persistent pain might exacerbate FMS patients' fear of movement, hence diminishing their proprioceptive and balance abilities [21].…”