Elevated Kinesiophobia Is Associated With Reduced Recovery From Lower Extremity Musculoskeletal Injuries in Military and Civilian Cohorts

Ruth L Chimenti; Molly S Pacha; Natalie A Glass; Mathew Frazier; Amy O Bowles; Andrew D Valantine; Kristin R Archer; Jason M Wilken

doi:10.1093/ptj/pzab262

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Elevated Kinesiophobia Is Associated With Reduced Recovery From Lower Extremity Musculoskeletal Injuries in Military and Civilian Cohorts

Journal article

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Peer reviewed

Elevated Kinesiophobia Is Associated With Reduced Recovery From Lower Extremity Musculoskeletal Injuries in Military and Civilian Cohorts

Ruth L Chimenti, Molly S Pacha, Natalie A Glass, Mathew Frazier, Amy O Bowles, Andrew D Valantine, Kristin R Archer and Jason M Wilken

Physical therapy, Vol.102(2), pzab262

02/01/2022

DOI: 10.1093/ptj/pzab262

PMCID: PMC9432473

PMID: 34935980

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Abstract

The purpose of this study was to examine associations between level of kinesiophobia and improvement in physical function during recovery from lower extremity injury. A total 430 adults (mean [SD]: age = 27.3 [6.4] years; sex = 70.5% men; body mass index = 27.6 [5.2] kg/m2) were included in the analyses. Using the Patient-Reported Outcomes Measurement Information System, physical function was evaluated in parallel with treatment from a physical therapist at the initial visit and every 3 weeks until final visit or up to 6 months. A Tampa Scale of Kinesiophobia (TSK-17) score of >41 indicated elevated TSK. Four TSK groups were identified: (1) TSK score improved from >41 at initial visit to <41 by final visit (TSK_I), (2) TSK score was <41 at initial and final visits (TSK-), (3) TSK score was >41 at initial and final visits (TSK+), and (4) TSK score worsened from <41 at initial visit to ≥41 by final visit (TSK_W). Linear mixed effects models were used to examine differences between groups in improved physical function over time, with adjustment for depression and self-efficacy. Groups with elevated kinesiophobia at the final visit had smaller positive improvements in physical function (mean change [95% CI]: TSK+ = 7.1 [4.8-9.4]; TSK_W: 6.0 [2.6-9.4]) compared with groups without elevated kinesiophobia at the final visit (TSK_I = 9.8 [6.4-13.3]; TSK- = 9.7 [8.1-11.3]) by 12 weeks. Elevated kinesiophobia that persists or develops over the course of care is associated with less improvement in physical function within military and civilian cohorts. The findings of this prospective longitudinal study support the need to assess for elevated kinesiophobia throughout the course of care because of its association with decreased improvement in physical function. To help improve your physical function, your physical therapist can monitor the interaction between fear of movement and your clinical outcomes over the course of treatment.

Adult

Behavior Rating Scale

Fear - psychology

Female

Humans

Leg Injuries - psychology

Leg Injuries - rehabilitation

Linear Models

Longitudinal Studies

Lower Extremity - physiopathology

Male

Military Personnel - psychology

Patient Reported Outcome Measures

Phobic Disorders - etiology

Phobic Disorders - physiopathology

Physical Therapy Modalities - psychology

Prospective Studies

Recovery of Function

Details

Title: Subtitle: Elevated Kinesiophobia Is Associated With Reduced Recovery From Lower Extremity Musculoskeletal Injuries in Military and Civilian Cohorts
Creators: Ruth L Chimenti - University of Iowa
Molly S Pacha - University of Iowa
Natalie A Glass - University of Iowa
Mathew Frazier - Carl R. Darnall Army Medical Center
Amy O Bowles - Brooke Army Medical Center
Andrew D Valantine - Spirit AeroSystems (United Kingdom)
Kristin R Archer - Vanderbilt University Medical Center
Jason M Wilken - University of Iowa
Resource Type: Journal article
Publication Details: Physical therapy, Vol.102(2), pzab262
DOI: 10.1093/ptj/pzab262
PMID: 34935980
PMCID: PMC9432473
NLM abbreviation: Phys Ther
ISSN: 0031-9023
eISSN: 1538-6724
Grant note: DOI: 10.13039/100000005, name: US Department of Defense Peer Reviewed Orthopedic Research Program, award: W81XWH-11-2-0222; DOI: 10.13039/100006108, name: National Center For Advancing Translational Sciences of the National Institutes of Health, award: UL1TR002537; DOI: 10.13039/100000069, name: National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health, award: R00AR071517; DOI: 10.13039/100000002, name: NIH
Language: English
Date published: 02/01/2022
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9984281634202771

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