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

Armando S. Miciano, Jr., MD (Nevada Rehabilitation Institute, Las Vegas, Nevada); Chad L. Cross, PhD, MFT, PStat(R), C-MDI

Meeting: AAPM&R Annual Assembly 2020

Categories: Neurological Rehabilitation (2020)

Session Information

Session Title: Virtual Poster Hall

Session Time: None. Available on demand.

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

To cite this abstract in AMA style:

Miciano AS. Contribution of Kinesiophobia in Individuals with Mild Traumatic Brain Injury and Chronic Pain [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/contribution-of-kinesiophobia-in-individuals-with-mild-traumatic-brain-injury-and-chronic-pain/. Accessed May 9, 2025.
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