Kinesiophobia and Its Impact on Pain and Function in Knee Osteoarthritis

NCT07161895 | Completed

• 2 other identifiers: AnkaraTRH-FTR-NK-08E-25-543
• Study Type: observational
• Target: 84
• Locations: 1 country
• Sites: 1

Brief Summary

Knee osteoarthritis (OA) is the most common chronic joint disorder, especially in older adults, and is a leading cause of pain, disability, and reduced quality of life. Patients with OA often experience pain and functional limitations that may contribute to psychological factors such as anxiety, depression, and kinesiophobia (fear of movement). Kinesiophobia is defined as an excessive and irrational fear of movement due to the belief that it will cause pain or re-injury, and it may further limit mobility and daily functioning. The aim of this prospective, cross-sectional study is to investigate the prevalence of kinesiophobia among patients with primary knee osteoarthritis and to evaluate its relationship with pain severity and functional capacity. A total of 84 participants aged 40-85 years, diagnosed with knee OA, will be recruited from the Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital. Data collection will include demographic and clinical information, quadriceps muscle strength, range of motion, and radiographic staging using the Kellgren-Lawrence scale. Outcome measures include the Tampa Scale for Kinesiophobia (TSK), Visual Analogue Scale (VAS) for pain, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for function. This study will provide insights into the impact of kinesiophobia on pain and functional outcomes in knee OA and may help guide clinical strategies that address both physical and psychosocial factors in the management of this common condition.

Conditions

Knee Osteoarthritis (Knee OA); Kinesiophobia; OA

Keywords

Kinesiophobia; Pain; Functional Capacity; WOMAC; Visual Analogue Scale (VAS); Tampa Scale for Kinesiophobia (TSK); Kellgren-Lawrence Grading

Outcome Measures

Primary Outcomes (1)

• Kinesiophobia Score (Tampa Scale for Kinesiophobia - TSK)

  The TSK is a 17-item validated questionnaire assessing fear of movement. Scores range from 17 to 68, with higher scores indicating greater kinesiophobia.

  At baseline, single assessment (Day 1)

Secondary Outcomes (5)

• Pain Severity (Visual Analogue Scale - VAS)

  At baseline, single assessment (Day 1)

• Functional Status (Western Ontario and McMaster Universities Osteoarthritis Index - WOMAC)

  At baseline, single assessment (Day 1)

• Radiographic Stage (Kellgren-Lawrence Scale)

  At baseline, single assessment (Day 1)

• Knee Range of Motion (ROM)

  At baseline, single assessment (Day 1)

• Quadriceps Muscle Strength

  At baseline, single assessment (Day 1)

Study Arms (1)

Knee Osteoarthritis Patients

Adults aged 40-85 years with radiographically confirmed primary knee osteoarthritis. Participants will complete clinical examination, Kellgren-Lawrence radiographic grading, Visual Analogue Scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for function, and Tampa Scale for Kinesiophobia (TSK). Assessments are performed at a single visit; no interventions are applied.

Eligibility Criteria

• Age: 40 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adults aged 40-85 years with radiographically confirmed primary knee osteoarthritis, recruited from the Physical Medicine and Rehabilitation Clinic of Ankara Training and Research Hospital.

You may qualify if:

• Age between 40-85 years
• Diagnosis of unilateral or bilateral primary knee osteoarthritis
• Duration of knee pain ≥ 3 months
• Radiographic confirmation of tibiofemoral OA (Kellgren-Lawrence grading)

You may not qualify if:

• Prior knee surgery
• Deep vein thrombosis
• Neuromuscular disease or neurological disorder
• Mental illness preventing participation
• Active infection or osteomyelitis
• Chronic periarticular infection
• Rheumatologic disease
• Immunodeficiency or systemic inflammatory disease
• Pregnancy

Sponsors & Collaborators

• Ankara Training and Research Hospital: lead

Study Sites (1)

Department of Physical Therapy and Rehabilitation, University of Health Sciences, Ankara Training and Research Hospital

Ankara, Altindag, 06230, Turkey (Türkiye)

Location

Related Publications (17)

• Canzone A, Roggio F, Patti A, Giustino V, Mannucci C, Di Mauro D, Musumeci G, Bianco A, Trimarchi F. Classification of Physical Activity Programs Based on the Kellgren & Lawrence Scale for Knee Osteoarthritis: A Systematic Review. Musculoskeletal Care. 2024 Dec;22(4):e70019. doi: 10.1002/msc.70019.

  PMID: 39592397 BACKGROUND

• Ege F. The relationship between kinesiophobia severity and clinical parameters in patients with mechanical low back pain. J Back Musculoskelet Rehabil. 2024;37(2):285-294. doi: 10.3233/BMR-220365.

  PMID: 37482977 BACKGROUND

• Heller GZ, Manuguerra M, Chow R. How to analyze the Visual Analogue Scale: Myths, truths and clinical relevance. Scand J Pain. 2016 Oct;13:67-75. doi: 10.1016/j.sjpain.2016.06.012. Epub 2016 Jul 27.

  PMID: 28850536 BACKGROUND

• Peral Perez J, Mortensen SR, Lluch Girbes E, Gronne DT, Thorlund JB, Roos EM, Skou ST. Association between widespread pain and psychosocial factors in people with knee osteoarthritis: a cross-sectional study of patients from primary care in Denmark. Physiother Theory Pract. 2025 Apr;41(4):752-762. doi: 10.1080/09593985.2024.2372381. Epub 2024 Jul 1.

  PMID: 38946473 BACKGROUND

• Aydemir B, Huang CH, Foucher KC. Strength and physical activity in osteoarthritis: The mediating role of kinesiophobia. J Orthop Res. 2022 May;40(5):1135-1142. doi: 10.1002/jor.25151. Epub 2021 Aug 6.

  PMID: 34324222 BACKGROUND

• Molyneux J, Herrrington L, Riley B, Jones R. A single-arm, non-randomized investigation into the short-term effects and follow-up of a 4-week lower limb exercise programme on kinesiophobia in individuals with knee osteoarthritis. Physiother Res Int. 2020 Jul;25(3):e1831. doi: 10.1002/pri.1831. Epub 2020 Jan 24.

  PMID: 31975503 BACKGROUND

• Lisboa FSS, Benevento EM, Kaneko LO, Bertolucci V, Rosini Silva AA, Sardim AC, Ruiz VF, Dos Reis IGM, Porcari AM, Messias LHD. Plasma metabolites associated with biopsychosocial parameters in overweight/obese women with severe knee osteoarthritis. Front Cell Dev Biol. 2024 Sep 4;12:1454084. doi: 10.3389/fcell.2024.1454084. eCollection 2024.

  PMID: 39296935 BACKGROUND

• Nedder VJ, Raju AG, Moyal AJ, Calcei JG, Voos JE. Impact of Psychological Factors on Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Systematic Review. Sports Health. 2025 Mar;17(2):291-298. doi: 10.1177/19417381241256930. Epub 2024 Jul 23.

  PMID: 39041333 BACKGROUND

• Brown OS, Hu L, Demetriou C, Smith TO, Hing CB. The effects of kinesiophobia on outcome following total knee replacement: a systematic review. Arch Orthop Trauma Surg. 2020 Dec;140(12):2057-2070. doi: 10.1007/s00402-020-03582-5. Epub 2020 Aug 24.

  PMID: 32839826 BACKGROUND

• Fischer M, Nonnenmacher L, Sobau C, Zimmerer A. Postoperative hip bracing reduces kinesiophobia in patients undergoing hip arthroscopy: a randomized-controlled trial. Arch Orthop Trauma Surg. 2024 Jul;144(7):3205-3210. doi: 10.1007/s00402-024-05437-9. Epub 2024 Jul 9.

  PMID: 38980377 BACKGROUND

• Han S, Oh M, Lee H, Hopkins JT. The effects of kinesiophobia on postural control with chronic ankle instability. Gait Posture. 2024 Jan;107:269-274. doi: 10.1016/j.gaitpost.2023.10.014. Epub 2023 Oct 18.

  PMID: 37914561 BACKGROUND

• Reddy RS, Alshahrani MS, Tedla JS, Dixit S, Gular K, Kakaraparthi VN. Exploring the Interplay Between Kinesiophobia, Lumbar Joint Position Sense, Postural Stability, and Pain in Individuals With Chronic Low Back Pain: A Cross-Sectional Analysis. J Manipulative Physiol Ther. 2023 Jun-Dec;46(5-9):294-304. doi: 10.1016/j.jmpt.2024.09.004. Epub 2024 Oct 16.

  PMID: 39425703 BACKGROUND

• Asiri F, Reddy RS, Tedla JS, ALMohiza MA, Alshahrani MS, Govindappa SC, Sangadala DR. Kinesiophobia and its correlations with pain, proprioception, and functional performance among individuals with chronic neck pain. PLoS One. 2021 Jul 8;16(7):e0254262. doi: 10.1371/journal.pone.0254262. eCollection 2021.

  PMID: 34237105 BACKGROUND

• Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019 May;53(9):554-559. doi: 10.1136/bjsports-2017-098673. Epub 2018 Apr 17.

  PMID: 29666064 BACKGROUND

• Lozano-Meca J, Gacto-Sanchez M, Montilla-Herrador J. Association of kinesiophobia with pain, disability and functional limitation in adults with knee osteoarthritis: A systematic review and meta-analysis. Geriatr Nurs. 2024 Nov-Dec;60:481-490. doi: 10.1016/j.gerinurse.2024.10.013. Epub 2024 Oct 18.

  PMID: 39426272 BACKGROUND

• Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. Int J Mol Sci. 2021 Mar 5;22(5):2619. doi: 10.3390/ijms22052619.

  PMID: 33807695 BACKGROUND

• Wu Q, Xu Z, Ma X, Li J, Du J, Ji J, Ling X, Kan J, Zhao M. Association of low muscle mass index and sarcopenic obesity with knee osteoarthritis: a systematic review and meta-analysis. J Int Soc Sports Nutr. 2024 Dec;21(1):2352393. doi: 10.1080/15502783.2024.2352393. Epub 2024 May 22.

  PMID: 38775452 BACKGROUND

MeSH Terms

Conditions

Osteoarthritis, Knee; Kinesiophobia; Pain

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Phobic Disorders; Anxiety Disorders; Mental Disorders; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 31, 2025
• First Posted: September 9, 2025
• Study Start: May 1, 2025
• Primary Completion: January 15, 2026
• Study Completion: January 30, 2026
• Last Updated: February 3, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)