Fear of movement and (re)injury is associated with condition specific outcomes and health-related quality of life in women with patellofemoral pain

Abstract

Objectives: Investigate the association of fear of movement and (re)injury with clinical outcomes in women with patellofemoral pain (PFP).

Methods: This cross-sectional study included 92 women with PFP who completed the TAMPA scale for kinesiophobia. The TAMPA score and its two subscales - activity avoidance and somatic focus were correlated with BMI, physical activity level, pain catastrophizing scale, health-related quality of life, pain sensitivity via pressure pain threshold, self-reported disability, and worst knee pain in last month.

Results: Greater fear of movement and (re)injury, activity avoidance, and somatic focus were correlated with lower local pain sensitivity (rho = -0.29 to -0.55), lower health-related quality of life (rho = -0.38 to -0.42), greater pain catastrophizing (rho = 0.41 to 0.47), and greater self-reported disability (rho = -0.31 to -0.52). Greater fear of movement and (re)injury and activity avoidance were correlated with adjacent and remote pain sensitivity (rho = -0.24 to -0.39). Greater fear of movement and (re)injury and somatic focus were correlated with greater worst knee pain in last month (rho = 0.21 to 0.32). Fear of movement and (re)injury predicted pain measures, disability, and health-related quality of life (p ≤ 0.010).

Conclusion: The relationship of greater fear of movement and (re)injury with greater disability, pain catastrophizing, pain sensitization, and poorer health-related quality of life highlights the potential importance of considering this psychological feature of PFP during assessment and management.

Keywords: Knee; avoidance behavior; hyperalgesia; kinesiophobia; physical functional performance.