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Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review
Open accessAbstract
OBJECTIVE: (1) To explore the level of association between kinesiophobia and pain, disability and quality of life in people with chronic musculoskeletal pain (CMP) detected via cross-sectional analysis and (2) to analyse the prognostic value of kinesiophobia on pain, disability and quality of life in this population detected via longitudinal analyses. DESIGN: A systematic review of the literature including an appraisal of the risk of bias using the adapted Newcastle Ottawa Scale. A synthesis of the evidence was carried out. DATA SOURCES: An electronic search of PubMed, AMED, CINAHL, PsycINFO, PubPsych and grey literature was undertaken from inception to July 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Observational studies exploring the role of kinesiophobia (measured with the Tampa Scale for Kinesiophobia) on pain, disability and quality of life in people with CMP. RESULTS: Sixty-three articles (mostly cross-sectional) (total sample=10 726) were included. We found strong evidence for an association between a greater degree of kinesiophobia and greater levels of pain intensity and disability and moderate evidence between a greater degree of kinesiophobia and higher levels of pain severity and low quality of life. A greater degree of kinesiophobia predicts the progression of disability overtime, with moderate evidence. A greater degree of kinesiophobia also predicts greater levels of pain severity and low levels of quality of life at 6 months, but with limited evidence. Kinesiophobia does not predict changes in pain intensity. SUMMARY/CONCLUSIONS: The results of this review encourage clinicians to consider kinesiophobia in their preliminary assessment. More longitudinal studies are needed, as most of the included studies were cross-sectional in nature. TRIAL REGISTRATION NUMBER: CRD42016042641.
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“which is consistently associated with a poor prognosis [60,94,95,96].”
From Digital Rehabilitation for Elbow Pain Musculoskeletal Conditions: A Prospective Longitudinal Cohort Study (2022) · cites this paper as [95]
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“evidence does point to an association between kinesiophobia and the development of disability over time; at least in adulthood [44].”
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“Importantly, the onset of MSK pain can result in a downward spiral of negative physical, social, and psychological consequences, which can lead to chronic MSK pain [4–9].”
From Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study (2022) · cites this paper as [5]
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“In contrast to the present study’s findings of a weak association in cardiac surgery patients, Luque-Suárez et al. (2019) re-ported that increased kinesiophobia was closely associated with decreased mobilization in individuals with chronic musculoskeletal pain [37].”
Pain Catastrophizing: Mechanisms and Clinical Implications
Zhang, Q. Y., Ma, Y. Y., Dai, Z., Wang, Q., Wen, Y., Liu, S., & Li, J. (2026) · Journal of Pain Research · doi:10.2147/jpr.s592713
“137,149 It remains challenging for patients to maintain consistent exercise routines and incorporate them into daily life.”
Müller-Thyssen-Uriarte, J., Lucha-López, M. O., Hidalgo-García, C., Sánchez-Rodríguez, R., Vicente-Pina, L., Ferrández-Laliena, L., Monti-Ballano, S., Vauchelles-Barré, P., & Tricás-Moreno, J. M. (2026) · Healthcare · doi:10.3390/healthcare14101427
“Chronic pain has been shown to induce escape and avoidance behaviors and is strongly associated with kinesiophobia [59].”
Atividade física na dor crônica reumatológica: estratégiaspara vencer a cinesiofobia
Mourão, K. D. S., Simão, V. C., & Borges, G. H. (2025) · Congresso Brasileiro de Medicina do Estilo de Vida · doi:10.61661/congresso.cbmev.8.2025.238
Burton, W. M., Ma, Y., Long, C. R., McCarey, J., Vining, R., Manor, B. D., Hausdorff, J. M., Kowalski, M., & Wayne, P. M. (2026) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-026-09990-9
“Pain-related cognitive-behavioral factors, such as kinesiophobia (fear of physical movement due to a perceived vulnerability to pain or reinjury) can further complicate physical function [16, 17].”
InfluentialFreitas, G. M. D., Lopes, G. T., Bueno, G. B., Coelho, M. L., Gomes, J., Venturini, C. L., Louzada, M. E., Peres, S. M., França, B. R., Torres, I. L. D. S., et al. (2026) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe16060072
Selhorst, M., Hoehn, J., Benedict, J., Joshi, S., & Yang, J. (2026) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2026.14057
Salvador-Huerta, C., Jordán-López, J., Azanon-Nogueira, P., García-Lucas, C., Amer-Cuenca, J. J., & Lisón, J. F. (2026) · PLoS ONE · doi:10.1371/journal.pone.0348346
AKINOĞLU, B., Arikan, Z., Yılmaz, A. E., Örsçelik, A., & Kocahan, T. (2026) · Turkish Journal of Sports Medicine · doi:10.47447/tjsm.0936
“Luque-Suarez et al. stated that kinesiophobia, being a complex, multifactorial condition, may be related to occupational use profiles (32).”
Gibler, R. C., Kashikar‐Zuck, S., Selhorst, M., Stinson, J., Simons, L. E., & Ittenbach, R. F. (2026) · Pain · doi:10.1097/j.pain.0000000000004019
Chiu, M., Queenan, K., Bono, C. M., & Harteveld, C. (2026) · Designing Interactive Systems Conference · doi:10.1145/3800645.3813035
“These include patient motivation and compliance to therapeutic and training protocols [77], escalating stress due to nonlinear progress [56], and kinesiophobia (fear of movement) [61].”
Palliative care for individuals with Duchenne muscular dystrophy
Noritz, G. H., & Humphrey, L. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-41598-2.00009-3
Metadata
- Authors
- Luque-Suarez, A., Martinez-Calderon, J., & Falla, D.
- Affiliations
- University of Birmingham (GB)
- ORCID
- Falla, Deborah
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2018-04-17
- Volume
- 53
- Issue
- 9
- Pages
- 554-559
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2800915060
- Cited by
- 546
- References
- 116
- Citations by year
- 2026: 98 · 2025: 93 · 2024: 80 · 2023: 87 · 2022: 86 · 2021: 58 · 2020: 33 · 2019: 11
- FWCI
- 2.98
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
- Funders
- Universidad de Málaga
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- kinesiophobia, chronic musculoskeletal pain, disability, quality of life, pain intensity, Tampa Scale for Kinesiophobia, prognostic value, disability progression
- MeSH terms
- Cross-Sectional Studies, Fear, Disabled Persons, Persons with Disabilities, Humans, Quality of Life, Musculoskeletal Pain, Observational Studies as Topic
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