The Association Between Fear of Movement, Pain Catastrophizing, Pain Anxiety, and Protective Motor Behavior in Persons With Peripheral Joint Conditions of a Musculoskeletal Origin: A Systematic Review
Abstract
OBJECTIVE: The aim of the study was to investigate alterations in motor behavior related to pain-related beliefs in persons with peripheral joint conditions. DESIGN: This is a systematic review. RESULTS: Our database search (PubMed, Web of Science, Embase, PsycINFO) identified 7390 articles (until September 2019), and nine articles (344 participants) were selected based on the eligibility criteria for selecting studies, i.e., studies in adults with primary peripheral joint conditions, assessing the influence of fear of movement, catastrophizing or anxiety on motor behavior in terms of kinematics, kinetics, and muscle activity during active movements.In the acute stage after knee or radius surgery, more catastrophizing and fear were associated with less active joint motion in the operated and adjacent joints. In knee patients in the chronic stage after surgery, increased hip adduction and knee valgus were linked to increased fear of movement during the performance of challenging tasks. Similar results were found in persons with nonsurgical chronic knee pain. During gait, no relation between lower limb kinematics and fear of movement was observed. CONCLUSIONS: Kinematic alterations appear in tandem with pain-related perceptions in acute stages after surgery. Altered kinematics influenced by pain-related beliefs are also seen in persons with chronic nonsurgical and surgical knee pain, when challenging tasks are performed.
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Pain catastrophizing is associated with reduced physical activity and avoidance of movement, both of which are known to exacerbate central sensitization.
“Pain catastrophizing is associated with reduced physical activity and avoidance of movement, both of which are known to exacerbate central sensitization.42–44”
From Acceptance and commitment therapy for prevention of chronic pain after total knee arthroplasty. (2026) · cites this paper as [43]
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“This model posits that catastrophic interpretation of pain fuels fear of related activities, leading to avoidance behaviors, which in turn exacerbate disability through disuse and depression, creating a vicious cycle [28].”
- Authors
- De Baets, L., Matheve, T., & Timmermans, A.
- Affiliations
- Hasselt University (BE)
- Venue
- American Journal of Physical Medicine & Rehabilitation
- Published
- 2020-04-26
- Volume
- 99
- Issue
- 10
- Pages
- 941-949
- ISSN
- 0894-9115 (ISSN-L)
- 1537-7385
- OpenAlex
- W3020415752
- Cited by
- 30
- References
- 34
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 1
- FWCI
- 0.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physical Medicine & Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Document Server@UHasselt (UHasselt) (submittedVersion)
- Lirias (KU Leuven) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Keywords
- kinesiophobia, pain catastrophizing, pain-related anxiety, musculoskeletal pain, knee pain, knee surgery, hip adduction, genu valgum, gait kinematics, muscle activity, postoperative recovery, chronic knee pain
- MeSH terms
- Anxiety, Biomechanical Phenomena, Disability Evaluation, Extremities, Fear, Humans, Joint Diseases, Kinetics, Movement, Risk Factors, Catastrophization
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