Kinesiophobia and Its Association With Health-Related Quality of Life Across Injury Locations

Arch Phys Med Rehabil. 2018 Jan;99(1):43-48. doi: 10.1016/j.apmr.2017.06.023. Epub 2017 Jul 29.


Objective: To compare baseline kinesiophobia levels and their association with health-related quality of life across injury locations.

Design: Retrospective cross-sectional study.

Setting: Single, large outpatient physical therapy clinic within an academic medical center.

Participants: Patients (N=1233) who underwent an initial evaluation for a diagnosis related to musculoskeletal pain and completed the 11-item version of the Tampa Scale for Kinesiophobia (TSK-11) and the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8) questionnaires within 7 days of their first visit were eligible for inclusion. Three hundred eighty patients were excluded because of missing data or because they were younger than 18 years. A total of 853 patients (mean age, 43.55y; range, 18-94y) were included.

Interventions: Not applicable.

Main outcome measures: Comparison of baseline kinesiophobia levels and their association with health-related quality of life across injury locations in an outpatient physical therapy setting.

Results: Separate analysis of variance models compared TSK-11 scores based on involved body region, and Pearson correlation coefficients were used to examine the association between TSK-11 scores and the SF-8 subscales at each body region. TSK-11 scores did not differ by body region (range, 23.9-26.1). Weak to moderate negative correlations existed between kinesiophobia and the SF-8 subscales.

Conclusions: Kinesiophobia levels appear elevated and negatively associated with health-related quality of life at initial physical therapy evaluation regardless of injury location. These findings suggest that physical therapists in outpatient orthopedic settings should implement routine kinesiophobia assessment and provide stratified care based on kinesiophobia levels across musculoskeletal conditions.

Keywords: Low back pain; Musculoskeletal pain; Pain; Physical therapists; Psychology; Quality of life; Rehabilitation; Therapeutics.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Fear*
  • Humans
  • Lower Extremity / injuries
  • Middle Aged
  • Movement*
  • Musculoskeletal Pain / etiology
  • Musculoskeletal Pain / psychology*
  • Pain Measurement
  • Quality of Life / psychology*
  • Retrospective Studies
  • Spinal Injuries / etiology
  • Spinal Injuries / psychology
  • Surveys and Questionnaires
  • Upper Extremity / injuries
  • Wounds and Injuries / etiology
  • Wounds and Injuries / psychology*
  • Young Adult