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. 2022 Jun 29:13:886015.
doi: 10.3389/fpsyg.2022.886015. eCollection 2022.

A Mixed Comparison of Interventions for Kinesiophobia in Individuals With Musculoskeletal Pain: Systematic Review and Network Meta-Analysis

Jialu Huang  1 , Yining Xu  1 , Rongrong Xuan  2 , Julien S Baker  3 , Yaodong Gu  1
Affiliations

A Mixed Comparison of Interventions for Kinesiophobia in Individuals With Musculoskeletal Pain: Systematic Review and Network Meta-Analysis

Jialu Huang et al. Front Psychol. .

Abstract

Objective: This systematic review aims to make a mixed comparison of interventions for kinesiophobia and individuals with musculoskeletal pain.

Methods: A comprehensive search strategy was conducted in the database of PubMed, MEDLINE, and Web of Science with the inclusion criteria: (1) randomized controlled design; (2) patients with musculoskeletal pain as participants; (3) treatments protocols of kinesiophobia as interventions or comparisons; (4) the score of Tampa Scale Kinesiophobia (TSK) as outcome measures. A network meta-analysis was used to synthesize the data after checking the model consistency. The risk of bias was assessed by the Cochrane Collaboration Risk of Bias Assessment Tool.

Results: Thirty-one studies were included in this review after a comprehensive search strategy with a low risk of bias and good consistency. According to the results of the network meta-analysis, a multi-modal treatment protocol had the highest probability to become the best choice in dealing with kinesiophobia caused by musculoskeletal pain, whereas psychological treatment protocols also showed a potentially positive effect on musculoskeletal pain-induced kinesiophobia.

Conclusion: Multi-modal protocols could be recommended as the preferred option when dealing with kinesiophobia caused by musculoskeletal pain. However, it is still worth mentioning that there are also potentially positive therapeutic effects of psychological interventions. Since the concept of kinesiophobia is based on the fear-avoidance model, the psychological mechanism should be paid enough attention to during treatment.

Registration number: CRD42021286450.

Keywords: kinesiophobia; musculoskeletal pain; network meta-analysis; non-surgical; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The PRISMA 2009 flow diagram of the search and study selection.
Figure 2
Figure 2
The result of the risk of bias assessment. (A) Risk of bias summary; (B) Risk of bias graph.
Figure 3
Figure 3
Network geometry of the interventions (APE, Active Physical Exercise; ST, Supervised Training; PI, Psychological Intervention; MP, Multi-modal Protocols; PM, Passive Modalities; ED, External-used Devices; TAU, Treatment as Usual; These figures represent the number of studies that have made direct comparisons between interventions).
Figure 4
Figure 4
Ranking of measures and probabilities (APE, Active Physical Exercise; ST, Supervised training; PI, Psychological Intervention; MP, Multi-modal Protocols; PM, Passive Modalities; ED, External-used Devices; TAU, Treatment as Usual).
See this image and copyright information in PMC

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