Search Results (154)

Chronic musculoskeletal pain negatively affects patients’ quality of life, and pain perceptions may significantly influence rehabilitation outcomes. This study investigated the relationships among pain intensity, pain perceptions, and kinesiophobia in individuals with chronic musculoskeletal pain. No previous studies have examined these variables in combination. A cross-sectional observational study was conducted with 37 participants with non-specific chronic musculoskeletal pain for at least 6 months, affecting the neck (n = 8), lower back (n = 18), upper limbs (n = 5), lower limbs (n = 5), or shoulder (n = 1). The following validated tools were used: (a) Pain Beliefs and Perceptions Inventory (PBPI), (b) the Tampa Scale for Kinesiophobia (TSK), and (c) the Short-Form McGill Pain Questionnaire (SF-MPQ). Spearman r correlation analyses were performed. Total kinesiophobia scores were positively correlated with (a) total pain intensity (McGill score) (r = 0.37, p = 0.022), (b) present pain intensity (PPI) (r = 0.52, p = 0.001), (c) pain duration (r = 0.51, p = 0.001), (d) the “mystery” factor of pain perception (r = 0.41, p = 0.013), and (e) the Visual Analogue Scale (VAS) (r = 0.42, p = 0.009). The total pain perception scores were positively associated with the “fear of injury” factor of kinesiophobia (r = 0.36, p = 0.028). The McGill pain scores were strongly correlated with both PPI (r = 0.63, p = 0.001) and VAS (r = 0.51, p = 0.001). There is a significant relationship between pain perception and kinesiophobia levels in patients with chronic musculoskeletal pain. Limitations of the study include a small and heterogeneous sample regarding pain localization. Further research is required using larger, more homogeneous populations to confirm the present findings. Full article

Introduction: Overactive bladder (OAB) and urinary incontinence (UI) are prevalent, particularly in older adults, and affect quality of life. OAB involves urgency, frequency, nocturia, and urgency incontinence, often linked to involuntary detrusor contractions. Treatment guidelines recommend a stepwise approach, starting with pelvic floor muscle training (PFMT), followed by pharmacological or minimally invasive therapies, such as neuromodulation. However, the combined effects of PFMT and neuromodulation have not been well established. This study aimed to evaluate the impact of combining pelvic floor exercises with neuromodulation versus PFMT with sham neuromodulation or standard physiotherapy after a 12-week intervention in individuals with OAB and UI. Methods/Materials: A double-blind, randomized controlled trial was designed with three groups: PFMT + neuromodulation, PFMT + sham, and conventional physiotherapy (control) in a 1:1:1 ratio. This study followed the CONSORT guidelines and was registered at ClinicalTrials.gov (NCT06783374). The sample size was calculated using GPower^® software, assuming a Cohen’s effect size of 1.04, a power of 0.80, an alpha of 0.05, and a 15% dropout rate, totaling 63 participants (21 per group). Participants attended 24 sessions over 12 weeks (2 sessions per week). The interventions were based on previously validated protocols. Outcomes: The primary outcomes included health-related quality of life, pelvic floor muscle function, pain, adherence, and general health. The secondary outcomes included Incontinence Quality of Life questionnaire, 3-day bladder diary, International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, kinesiophobia, and electromyographic data. Full article

Background: The phenomenon of fear of movement is called kinesiophobia. Kinesiophobia is a significant factor that complicates the treatment process. Fear of movement and physical activity is a risk factor for the transformation of acute pain into chronic pain. Therefore, the assessment of the level of kinesiophobia is a prognostic factor for disability and mental stress, thus having a significant impact on the quality of life of people with lower back pain. One of the psychometric diagnostic tools for assessing the level of kinesiophobia is the Kinesiophobia Causes Scale (KCS). The aim of the study was to assess the reliability of the KCS test used in people suffering from chronic nonspecific lower back pain (nsLBP). Methods: The study included a group of 112 people suffering from chronic nsLBP. The subjects completed the same Polish version of the KCS questionnaire 4 weeks apart. Results: Good internal consistency was recorded for both domains—the biological and psychological one—as well as the general KCS index (Cronbach’s alpha index α from 0.8 to 0.9). Reliability was excellent for both domains (95% CI of ICC_3.1 biological domain: 0.86–0.93 and for psychological domain: 0.92–0.96) and for the total score of the Kinesiophobia Causes Scale (95% CI of ICC_3.1: 0.91–0.93). Conclusions: These results indicate very good measurement reliability of the Polish version of the KCS questionnaire among people suffering from chronic nsLBP. Full article

Background: Chronic musculoskeletal disorders (CMDs) represent a leading cause of global disability and diminished quality of life, and they are often resistant to conventional physiotherapy. Emerging technologies such as virtual reality (VR), augmented reality (AR), and exergaming are increasingly used to enhance rehabilitation outcomes, yet their comparative effectiveness remains unclear. Objective: To systematically evaluate the effectiveness of VR, AR, and exergaming interventions in improving pain, function, balance, and psychological outcomes among adults with CMDs. Methods: This systematic review and exploratory meta-analysis followed PRISMA 2020 guidelines and was prospectively registered (PROSPERO: CRD42024589007). A structured search was conducted in PubMed, Cochrane CENTRAL, Scopus, and PEDro (up to 1 May 2025). Eligible studies were randomized controlled trials (RCTs) involving adults (≥18 years) with CMDs receiving VR, AR, or exergaming-based rehabilitation. Risk of bias was assessed using the PEDro scale and the Downs and Black checklist. Where feasible, standardized mean differences (SMDs) for pain outcomes were pooled using a random-effects model. Results: Thirteen RCTs (n = 881 participants) met the inclusion criteria. Interventions spanned immersive VR, AR overlays, exergaming platforms (e.g., Kinect, Wii), and motion-tracking systems. Pain, function, and quality of life improved in most studies. An exploratory meta-analysis of eight RCTs (n = 610) yielded a significant pooled effect favoring VR/AR interventions for pain reduction (SMD = −1.14; 95% CI: −1.63 to −0.75; I² = 0%). Exergaming showed consistent improvements in physical performance, while immersive VR was more effective for kinesiophobia and psychological outcomes. AR was underrepresented, with only one study. Risk of bias was generally low; however, publication bias could not be excluded due to limited funnel plot power (n < 10). Conclusions: VR, AR, and exergaming are effective adjuncts to conventional rehabilitation for CMDs, improving pain and function with high patient adherence. Nevertheless, gaps in long-term data, economic evaluation, and modality comparison persist. Future RCTs should address these limitations through standardized, inclusive, and longitudinal design. Full article

Background: Arthrogenic muscle inhibition (AMI), anterior knee laxity, and kinesiophobia are key barriers to recovery after anterior cruciate ligament reconstruction (ACLR). While each has been independently studied, their interrelationships during the early postoperative phase remain unclear. Methods: This cross-sectional study included 56 patients (mean age: 26.5 ± 5.7 years) who underwent ACLR using hamstring autografts. Clinical AMI grading, GNRB^® arthrometer measurements of anterior tibial translation, and the Tampa Scale for Kinesiophobia-11 (TSK-11) were used to assess neuromuscular inhibition, mechanical laxity, and psychological fear, respectively. All evaluations were performed at 34.9 ± 4.2 postoperative days. Statistical analyses included one-way ANOVA, Kruskal–Wallis, and Spearman correlation. Results: No significant differences in TSK-11 scores were observed across AMI grades (p = 0.327). Similarly, anterior laxity did not differ significantly between AMI groups (p = 0.182). Correlation between GNRB measurements and TSK-11 scores was non-significant (rho = −0.220, p = 0.103). Conclusions: In the early phase following ACLR, AMI, anterior laxity, and kinesiophobia appear to be independent domains. These findings suggest that early postoperative rehabilitation should address each dimension individually. Further longitudinal studies are needed to explore their potential interactions over time. Full article

Ehlers-Danlos Syndromes (EDS) and Generalized Hypermobility Spectrum disorders (G-HSD) are a group of genetic, connective multi-systemic disorders that can affect the musculoskeletal, gastrointestinal, cardiovascular, and respiratory systems. Respiratory manifestations in EDS/G-HSD can contribute to decrements in health-related quality of life (HRQL); however, these relationships have not been previously characterized. We aimed to review the association of respiratory manifestations with the physical, psychological, and social domains of HRQL in EDS/G-HSD. A comprehensive search was conducted using Ovid Medline, Embase, and CINAHL with the following terms: “Ehlers-Danlos Syndrome”, “Hypermobility Spectrum Disorders”, and “Quality of Life”. Selected studies in English that investigated the relationship between respiratory manifestations and HRQL domains in EDS/G-HSD were included in this narrative review from inception to March 2024. Twelve studies described the physical, psychological, or social domains of HRQL relating to respiratory manifestations. Dyspnea, wheezing, and expiratory flow limitations were associated with limitations in physical function and exercise intolerance. Respiratory manifestations were associated with increased fatigue, pain, anxiety, kinesiophobia, and deconditioning. This review highlights the consequences that respiratory manifestations have on the physical domains of HRQL, through limitations on physical activity and exercise. Future studies should aim to identify the impact that respiratory manifestations have on the psychosocial domains of HRQL and develop disease-specific patient-reported measures to evaluate these relationships. Full article

Background/Objectives: Total hip arthroplasty (THA) improves quality of life in patients with hip osteoarthritis (OA) by alleviating pain and restoring mobility. Kinesiophobia (i.e., fear of performing specific movements to avoid pain and re-injury) negatively affects the quality of life after THA, while social support impacts postoperative quality of life by influencing recovery and well-being. This cross-sectional study investigates the effects of kinesiophobia and social support, as well as their interaction, on the quality of life after THA. Methods: A total of 125 patients participated in the study, all of whom had undergone THA for end-stage hip OA. The Tampa Scale for Kinesiophobia (TSK), the Oslo Social Support Scale (OSSS), and the Total Quality of Life scale (T-QoL) were used for the assessment of the study variables. Multiple linear regression was conducted considering the T-QoL subscales (emotional and physical well-being, functional engagement, resilience, and peri-traumatic experience) as dependent variables. Results: Kinsesiophobia correlated negatively with physical and emotional well-being, peri-traumatic experience, and resilience. Social support was positively correlated with emotional well-being, functional engagement, and resilience; however, it also buffered the negative relationship between kinesiophobia and peri-traumatic experience. Age was negatively correlated with emotional and physical well-being, functional engagement, and resilience, while the patient being female also correlated negatively with emotional well-being and functional engagement. Finaly, self-perception of mental health problems was negatively correlated with resilience. Conclusions: Future studies may further investigate the pathway between kinesiophobia and social support on the one hand and quality of life on the other hand, as well as the interaction between social support and kinesiophobia. Full article

Background and Objectives: The objective of our study was to describe the biopsychosocial profile of individuals diagnosed with axial spondyloarthritis (AxSpA) and to analyze how their clinical characteristics interact with disease activity. Materials and Methods: An observational study was conducted, involving 28 participants diagnosed with AxSpA. We evaluated clinical outcomes (perceived pain, range of motion [RoM], pressure pain threshold [PPT], and proprioceptive acuity), psychosocial outcomes (the Pain Catastrophizing Scale [PCS], Tampa Scale of Kinesiophobia [TSK-11], and the Fear-Avoidance Beliefs Questionnaire [FABQ]), and AxSpA-specific indices (the Bath Ankylosing Spondylitis Metrology Index [BASMI], Bath Ankylosing Spondylitis Functional Index [BASFI], and Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]). Data were analyzed using Spearman’s correlation coefficients and simple and multiple linear regression models. Results: Cervical and lumbar RoM values were reduced compared to established normative values for the general population. Significant associations were found between perceived pain, pain catastrophizing, and FABQ scores with both BASDAI and BASFI (p < 0.05). The interaction between perceived pain and pain catastrophizing (p < 0.001) accounted for 45.7% of the variance in BASDAI, while the interaction between perceived pain and FABQ (p < 0.001) explained 52.1% of the variance in BASDAI. Conclusions: The biopsychosocial profile of patients with AxSpA is characterized by moderate-intensity perceived pain and reduced cervical and lumbar mobility. The observed associations between BASDAI, pain catastrophizing, and fear-avoidance beliefs underscore the influence of psychosocial factors on disease progression. Full article

Background/Objectives: Non-specific low back pain represents a high number of primary care consultations, generating a great social and economic cost. There is a higher prevalence in women, and it may be associated with multiple factors. One of the most innovative tools in rehabilitation is virtual reality-based therapy. Virtual reality positively affects the motivation of participants and generates greater adherence to treatment, so this factor could lead to long-term functional improvement. The objective of this review is to update the effectiveness of virtual reality programs on pain, disability, kinesiophobia, and changes in the thoracoabdominal musculature in patients with chronic nonspecific low back pain. Methodology: PubMed, PEDro, SCOPUS, Web of Science, and the Cochrane Library were used in this systematic review. The research question was formulated using PICOS. The Physiotherapy Evidence Database (PEDro) scale was used. Inclusion criteria were randomized clinical trials, participants were men and/or women over 18 years of age who were diagnosed with chronic non-specific low back pain, and articles that included virtual reality as a treatment. Articles with a level of evidence lower than 5/10 on the PEDro scale were excluded. Results: A total of 14 studies were included with sample sizes between 34 and 188 participants. Studies showed significant improvements in pain reduction, kinesiophobia, and disability (inflammation and motor control). Some studies showed long-term benefits, with effects maintained up to 18 months post-intervention, especially in the reduction in pain and its interference with daily activities. Conclusions: The findings of this systematic review support the efficacy of virtual reality as an effective and safe therapeutic option for the treatment of chronic non-specific low back pain. Full article

Objectives: Knee osteoarthritis (KOA) rehabilitation aims to assess the impact of pain reduction on kinesiophobia and outpatient welfare, emphasizing the interconnectedness of biopsychosocial factors in the rehabilitative process. Methods: The study involved a sample of KOA patients undergoing outpatient physical therapy. Forty patients (n = 40), aged 40–88, with acute or chronic knee osteoarthritis (Kellegren-Lawrence staging score I–II–III) were collected in Patients undergoing physical therapy using quantum molecular resonance (QMR) technology. The analysis employed a cross-lagged panel model to examine the relationships between perceived pain, kinesiophobia, and quality of life during the rehabilitative plan. Results: Rehabilitation significantly reduced pain levels and kinesiophobia while improving the quality of life for outpatients. The analysis demonstrated that pain reduction had a substantial causal influence on kinesiophobia and life conditions, both immediately following treatment and during follow-up. Conclusions: The findings underscore the importance of considering biopsychosocial factors in KOA rehabilitative treatment, highlighting the dynamic interplay between pain perception, kinesiophobia, and quality of life throughout the rehabilitation process. Full article

(1) Background: Pain experiences are shaped by both physical injury and psychological distress, posing challenges for orthopedic care. While surgery may alleviate injury-related distress, the extent of psychological improvement post surgery remains unclear. Thus, the purpose of this study was to evaluate changes in general and pain-specific psychological distress after surgical intervention for musculoskeletal injury. (2) Methods: A retrospective review was conducted on 133 patients who underwent musculoskeletal surgery between February 2020 and August 2022 by a single sports medicine fellowship-trained surgeon. Psychological distress was assessed using the Optimal Screening for Prediction of Referral and Outcome Yellow-Flag (OSPRO-YF) tool, both before and at least six months after surgery. Pre- and postoperative scores were compared using paired t-tests, and clinically meaningful changes were evaluated using a distribution-based minimal clinically important difference (MCID) threshold. (3) Results: Significant reductions were found in total OSPRO-YF scores and several subdomains including fear avoidance (physical activity and work), kinesiophobia, and pain anxiety. However, 88% of patients showed no meaningful change in overall psychological distress. In patients with high baseline distress, over 20% showed meaningful improvement in six subdomains. (4) Conclusions: Psychological distress often persists after musculoskeletal surgery. Targeted psychological interventions may benefit patients with high preoperative distress. Full article

Background: Vagus nerve stimulation (VNS) is a frequently used neuromodulation method in recent years. While the mechanism of improvement in diseases such as epilepsy, dementia, and depression is being studied, its potential effect on vestibular dysfunction is also being investigated. The aim of our study was to investigate the effect of transcutaneous auricular VNS (taVNS) on the vestibular symptoms of unilateral vestibular hypofunction (UVH). Methods: Forty patients diagnosed with UVH were randomly divided into two groups. Group 1 received vestibular rehabilitation. Group 2 received taVNS and vestibular rehabilitation. Both groups received treatment one day a week for eight weeks. Before and after the treatment, balance of the participants was assessed with modified-CTSIB (m-CTSIB), limit of stability (LOS), Tandem and One-Leg Stance (OLS) tests; visual acuity was assessed with dynamic visual acuity (DVA), dizziness severity, and fatigue severity with a visual analog scale (VAS); kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK); depression and anxiety was assessed with the Hospital Anxiety and Depression Scale (HADS); and quality of life was assessed with the Dizziness Handicap Inventory (DHI). Results: At the end of eight weeks, patients in Group 2 showed significantly greater improvement in balance, dizziness, fatigue, kinesiophobia, anxiety, and depression. There was no significant difference in visual acuity and quality of life between the groups. Conclusions: The positive effects of taVNS on vestibular symptoms have been observed. As a new approach, taVNS can be included in the treatment of patients with UVH in addition to vestibular rehabilitation. Full article

Background/Objectives: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition that causes anterior knee pain, often linked to increased joint stress. Rehabilitation typically includes education, strength training, and functional exercises. Recently, telerehabilitation has become a promising alternative, particularly useful in improving access to care in rural areas. This study compares the effects of supervised (SE), web-based (WBE), and self-guided (SGE) exercise programs on pain, functionality, and fear of movement (kinesiophobia) in individuals with PFPS. Materials and Methods: Sixty female patients with PFPS participated in this randomized controlled trial. They were randomly assigned to one of three groups: SE, WBE, or SGE. Each program lasted six weeks, with exercises adjusted based on individual tolerance. Outcomes were assessed using the Kujala Anterior Knee Pain Scale, the visual analog scale (VAS) for pain, the Timed Up and Go Test (TUG) for mobility, and the Tampa Kinesiophobia Scale. Results: All groups showed significant improvements in pain, functionality, and kinesiophobia (p < 0.05). The SE group achieved the greatest improvements across all measures, reducing pain and kinesiophobia while enhancing functionality (p < 0.017). The WBE group also showed significant improvements, outperforming the SGE group in all outcomes (p < 0.017). The SGE group demonstrated the least improvement but still achieved positive changes. Conclusions: Supervised exercise programs were the most effective in managing PFPS symptoms. However, the web-based programs also provided substantial benefits, making them a viable option when in-person supervision is not feasible. Future research should aim to enhance digital interventions for broader accessibility and engagement. Trial Registration: The study protocol was also registered on ClinicalTrials.gov (NCT06625086). Full article

Fibromyalgia syndrome is a chronic pain condition involving altered nociceptive processing, which requires multidisciplinary management. Photobiomodulation therapy (PBMT) has recently emerged as a promising non-pharmacological approach, but its clinical effectiveness and optimal application methods remain unclear. This systematic review evaluated the efficacy of PBMT in managing Fibromyalgia symptoms, including pain, physical function, sleep quality, and overall well-being, while comparing localized and whole-body delivery. A systematic review was conducted in accordance with the PRISMA guidelines and previously registered on PROSPERO (CRD42024626368). Literature searches were performed across MEDLINE ((PubMed)), PEDro, SPORTDiscus, Scopus, Elsevier (ScienceDirect), and Web of Science (WOS), identifying 17 eligible studies (n = 857 participants). PBMT was applied via low-level laser, infrared, or LED-based devices, delivered either locally or to the whole body. The methodological quality of the studies was assessed using the PEDro scale, and the risk of bias was evaluated using the RoB 2.0 tool. PBMT showed significant clinical benefits, including reduced pain intensity, improved physical function, decreased fatigue, and enhanced quality of life. Whole-body PBMT showed greater and more sustained effects than localized applications, likely due to its systemic modulation of nociceptive pathways and autonomic regulation. Improvements were also observed in terms of psychological well-being, sleep quality, and reduced kinesiophobia. In conclusion, PBMT appears to be an effective therapeutic option for Fibromyalgia syndrome, with whole-body applications offering superior benefits. However, the variability in treatment parameters and study methodologies underscores the need for standardized protocols and high-quality clinical trials to support its integration into multidisciplinary pain management strategies. Full article

Background/Objective: Inconsistencies exist regarding the exact multidimensional structure underlying the Fear-Avoidance Beliefs Questionnaire (FABQ), with no prior study examining the internal structure of the Arabic FABQ. This study aimed to examine validity evidence of the Arabic FABQ in patients with low back pain (LBP), based on two sources: validity evidence based on the internal structure (dimensionality and reliability) and validity evidence based on relations with other variables (i.e., pain intensity and disability). Methods: Participants (N = 112) with LBP were recruited from physical therapy clinics. Data were collected through the completion of FABQ and other measures of pain and disability. CFA was performed using a diagonally weighted least squares estimation. The fit of the two-factor model recommended by the original scale developer was assessed using multiple fit indices. Reliability of FABQ subscale scores was assessed using McDonald’s omega (ω) and Average Variance Extracted (AVE). Results: One hundred and twelve patients with LBP with mostly chronic complaints participated in the study. The CFA supported the two-factor model with modifications to account for residual correlations between items 4–5 and 6–7, yielding improved fit indices (χ²(41) = 77.82; p < 0.001; TLI = 0.98, CFI = 0.99, RMSEA = 0.09 (90% CI = 0.06–0.12), and SRMR = 0.08). All factor loadings were salient and significant with values ranging from 0.43 to 0.96. The two underlying factors reflecting physical activity-related and work-related fear avoidance beliefs showed a significant positive correlation of 0.58. These findings confirm the hypothesized dimensionality of the Arabic FABQ. The FABQ work subscale scores demonstrated higher reliability (ω = 0.86; AVE = 0.54) compared to the physical activity subscale scores (ω = 0.63; AVE = 0.44), with both factors measuring related but distinct constructs. The latent scores for the FABQ related to physical activity demonstrated stronger positive correlations with pain intensity (r = 0.37; p < 0.001) and disability (r = 0.43; p < 0.001), compared to the latent scores for work-related FABQ, which showed weaker correlations with pain intensity (r = 0.22; p < 0.001) and disability (r = 0.26; p < 0.001). Conclusions: This study provides evidence to support the two-factor structure of the Arabic FABQ and the common scoring method for the FABQ and facilitates the interpretation of the FABQ subscale scores as reflecting related but distinct domains of fear avoidance beliefs. Full article