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Review
. 2023 Nov;31(11):5199-5206.
doi: 10.1007/s00167-023-07537-2. Epub 2023 Aug 8.

Kinesiophobia contributes to worse functional and patient-reported outcome measures in Achilles tendinopathy: a systematic review

Prushoth Vivekanantha  1 , Darren de Sa  2 , Mansur Halai  3 , Timothy Daniels  3 , Christopher Del Balso  4 , Ellie Pinsker  3 , Ajay Shah  5
Affiliations
Review

Kinesiophobia contributes to worse functional and patient-reported outcome measures in Achilles tendinopathy: a systematic review

Prushoth Vivekanantha et al. Knee Surg Sports Traumatol Arthrosc. 2023 Nov.

Abstract

Purpose: To assess the effect of kinesiophobia or fear of reinjury on patient-reported outcome measures and physical performance measures in patients with chronic Achilles tendinopathy (AT).

Methods: Three databases were systematically screened for studies from inception to May 22nd, 2023 for literature investigating the impact of kinesiophobia on PROMs or physical performance metrics in AT. The authors adhered to the PRISMA and R-AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data on demographics, pain, level of activity, self-reported injury severity, quality of life, single-leg hop performance, and heel-raise performance were recorded. Data was presented primarily in a narrative summary fashion. The MINORS score was used for all studies to perform a quality assessment of included studies.

Results: Six studies comprising 705 patients were included in this review. Variations of the Tampa Scale of Kinesiophobia (TSK-11 or TSK-17) were used in all studies. TSK scores were strongly correlated with the Pain Catastrophizing Score (PCS) and Visual Analogue Scale (VAS) scores and were correlated with decreased Victorian Institute of Sports Assessment Achilles (VISA-A) and Foot and Ankle Outcome Scores Quality of Life (FAOS-QoL) subscale scores. Kinesiophobia was associated with heel raise completion with conflicting evidence on correlations with hop test performance.

Conclusion: Increased kinesiophobia scores (> 35 points), measured by TSK are associated with worse PROMs, including increased pain, decreased quality of life, increased self-reported severity, and is also associated with poorer physical performance measures in patients with AT.

Level of evidence: IV.

Keywords: Achilles; Fear-of-reinjury; Kinesiophobia; Rehabilitation; Tendinopathy.

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References

References:

    1. Alghamdi NH, Pohlig RT, Lundberg M, Silbernagel KG (2021) The impact of the degree of kinesiophobia on recovery in patients with Achilles tendinopathy. Phys Ther 101(11):pzab178 - DOI - PubMed - PMC
    1. Andersen LG, Groenvold M, Jørgensen T, Aadahl M (2010) Construct validity of a revised Physical Activity Scale and testing by cognitive interviewing. Scand J Public Health 38(7):707–714 - DOI - PubMed
    1. Brindisino F, Garzonio F, Giacomo DIG, Pellegrino R, Olds M, Ristori D (2023) Depression, fear of re-injury and kinesiophobia resulted in worse pain, quality of life, function and level of return to sport in patients with shoulder instability: a systematic review. J Sports Med Phys Fitness 63(4):598–607 - DOI - PubMed
    1. Cheng S-T, Chen PP, Chow YF, Chung JWY, Law ACB, Lee JSW, Leung EMF, Tam CWC (2019) The Pain Catastrophizing Scale-short form: psychometric properties and threshold for identifying high-risk individuals. Int Psychogeriatr 31(11):1665–1674 - DOI - PubMed
    1. Chimenti RL, Hall MM, Dilger CP, Merriwether EN, Wilken JM, Sluka KA (2020) Local anesthetic injection resolves movement pain, motor dysfunction, and pain catastrophizing in individuals with chronic Achilles tendinopathy: a nonrandomized clinical trial. J Orthop Sports Phys Ther 50(6):334–343 - DOI - PubMed - PMC