Fear avoidance model of kinesiophobia and rehabilitation

Purva Gulrandhe, Vaishnavi Warutkar, Neha Chitale, Sakshi P. Arora, Pratik Phansopkar*

Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.

ABSTRACT

Kinesiophobia is defined as "an irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury" by those who coined the term. Pain catastrophizing and kinesiophobia (fear of movement and re-injury) magnify somatosensory perceptions, overstating this perception in terms of a pain-related exaggeration of fearful anticipation of the pain getting worse and worse. Fear of pain has a high prognostic value when it comes to the development of chronic musculoskeletal pain and impairment. Kinesiophobia is most closely linked to higher order brain mechanisms linked to anxiety. The Fear-Avoidance Model of Exaggerated Pain Perception, suggested by Lethem et al, represented the impact of fear on outcomes. They proposed that the sensory and emotional aspects of pain can contribute to the development of chronic musculoskeletal pain syndromes by inducing a fear of pain. The Tampa Scale is used to assess kinesiophobia, and patients with scores higher than 40 are considered to have a high degree of kinesiophobia “Psychological therapy” was the therapy include (1) psychological education; (2) cognition-behavior therapy; (3) perceptive stimulation in non-injured body areas such as virtual reality equipment, laser, and relaxation; (4) therapeutic milieu involves interpersonal communication such as group session and feedback session. One of the main reason of kinesiophobia is fear avoidance, sensory and emotional both factors are responsible. Depending on the cause of kinesiophobia the treatment will differ and different approaches should be considered.

Keywords:

inesiophobia, Rehabilitation, Fear-Avoidance Model, Tampa Scale.