Contribution of Kinesiophobia in Individuals with Mild Traumatic Brain Injury and Chronic Pain

Document Type


Publication Date


Publication Title

American Journal of Physical Medicine and Rehabilitation



First page number:


Last page number:



Disclosures: Armando S. Miciano, Jr., MD: No financial relationships or conflicts of interest. Objective : 1) Quantify and determine inter-relationships between kinesiophobia level (KI) and activity limitations (AL) of individuals with mild Traumatic Brain Injury (mTBI) and chronic pain (CP); and, 2) Correlate KI with other WHO-ICF body functions (BF): fatigue, anxiety, depression, and sleep disturbance. Design: Retrospective cross-sectional study. Setting : PMR clinic. Participants : 20 community-dwelling participants [11 males; ages 35-85; mean (SD) age 49.6(13)] identified as having mTBI and CP (define pain >6 months) with kinesiophobia. Interventions: n/a. Main Outcome Measures: Subjects completed patient-reported outcomes (PRO) as surrogates for body functions: 1) Tampa Scale for Kinesiophobia (‘TSK’ cut-off scores 34-37) to determine fear-avoidance of movement/(re)injury; 2) PROMIS-29v2.0-Fatigue (FA); 3) PROMIS-29v2.0-Sleep-Disturbance (SL); 4) PROMIS-29v2.0-Anxiety (AN); 5) PROMIS-29v2.0-Depression (DE); and, 6) PROMIS-29v2.0-Pain-Intensity (PI). The PROMIS-29v2.0-Physical-Function (PF) quantified AL. Results: Mean (SD) scores were: TSK 47.65(7.72); PF T-score 36.66(3.35); FA T-score 63.67(5.88); SL T-score 62.91(6.36); AN T-score 65.99(6.84); DE T-score 62.62(10.11); and PI NRS 6.48(1.88). Non-parametric methods analyzed small data set with large kurtosis for some variables. Mann-Whitney U tests showed no significant differences in any variables as a function of gender. KI significantly correlated with DE (r=0.49,p=0.032 Spearman’s rho). Conclusions: Individuals with mTBI, CP, and KI tend to have moderate levels of FA, SL, AN/DE, and PI, yet while having severe activity limitations. Their kinesiophobia significantly associated with their depression symptoms. The study supports that the WHO-ICF components (i.e. body functions and activity limitations) can be assessed via patient-reported outcomes such as PROMIS, hence being applicable to clinical practice. Future research is needed to determine inter-relationships between BF (such as fatigue) and AL in other neurologic syndromes such as stroke with pain. Level of Evidence: Level II


Kinesiophobia level; Activity limitations; Mild Traumatic Brain Injury; MTBI; Chronic pain; Body functions


Medicine and Health Sciences | Rehabilitation and Therapy



Search your library