Association of Kinesiophobia with Pain, Disability, Fall Self-Efficacy and Quality of Life in Patients with Knee Osteoarthritis: A Correlational Study

Abstract

Background: Knee osteoarthritis (KOA) is a chronic progressive degenerative joint disease affecting more than 250 million people worldwide. Kinesiophobia—an excessive, irrational fear of physical movement resulting from perceived vulnerability to reinjury— is increasingly recognised as a major biopsychosocial determinant of outcomes in KOA. Increased fear of movement related to pain, FSE, disability, and Quality of life may lead to poor OA prognosis. Despite growing global evidence, the relationship between kinesiophobia and multidimensional outcomes in the Indian population remains underexplored. Objective: To determine the association of kinesiophobia with pain intensity, disability, fall self-efficacy, and quality of life in patients with knee osteoarthritis. Methods: 152 patients with chronic knee osteoarthritis were screened for this study, with a mean age of 50.8 ± 5.62 years. The Numeric Pain Rating Scale, Tampa scale for kinesiophobia, fall-efficacy scale, WOMAC scale, and SF-36 were used to measure pain intensity, kinesiophobia, fall self-efficacy, disability, and quality of life, respectively. Data normality was assessed with the Shapiro–Wilk test; correlation analyses employed Spearman's rho (non-normal data) and Pearson's r (normal data) at α = 0.05. Results: The participants were 71% female and 29% male, with no gender difference. Mean TSK score was 47.8 ± 11.3 (indicative of kinesiophobia). Kinesiophobia showed a strong positive correlation with pain (r = 0.657, p < 0.001), a moderate positive correlation with disability (r = 0.575, p < 0.001) and fall self-efficacy (r = 0.447, p < 0.001), and significant negative correlations with multiple SF-36 quality-of-life domains (r = −0.201 to −0.354, p < 0.05). Conclusion: Osteoarthritis-related psychological distress affects both genders. There is a significant correlation between kinesiophobia and associated factors. Moreover, comorbidity worsens psychological distress among people with osteoarthritis. In light of these results, routine assessment of kinesiophobia is warranted in clinical physiotherapy practice to guide holistic, biopsychosocial management of KOA.