(Research Hub Theater) Trajectories of Kinesiophobia and Recovery from Musculoskeletal Injury in Recreational Runners

Background and/or Objectives: The relationship of kinesiophobia status and recovery in recently injured runners is unknown. Understanding the impact of kinesiophobia on recovery is important for identification of individuals needing additional support for successful rehabilitation and return-to-run. To determine differences in perceived well-being and physical function among recently-injured runners with different kinesiophobia trajectories during recovery.

Design: Prospective observational study

Setting: Academic medical center

Participants: Recreational runners with recent lower body injury who were followed through return-to-run. (N=41; 34.0±10.9 yrs).

Interventions: NA

Main Outcome Measures: Modified Tampa Scale of Kinesiophobia (TSK-11); State Trait Anxiety Inventory (STAI); Positive and Negative Affect Schedule (PANAS); University of Wisconsin Running Injury and Recovery Index (UWRI), and quality of life measures (general health, days of anxiety/tension, disrupted sleep). Participants were stratified by TSK-11 trajectories during the recovery period (reduced TSK-11 [n=21], increased TSK-11 [n=9], fluctuated TSK-11 [n=10]).

Results: More participants successfully returned-to-run in the reduced kinesiophobia trajectory group compared to the increased and fluctuated trajectory groups (81.8% vs 33.3% and 40.0%; p=.013). Months of participation was 5.6±4.0 (reduced trajectory) , 7.2±4.7 (increased trajectory) and 8.9±6.1 (fluctuated trajectory; p=.206) Compared to the increased and fluctuated kinesiophobia groups, the reduced kinesiophobia trajectory group demonstrated lower STAI score (31.0 vs 40.8 and 38.4 points), higher PANAS positive score (37.5 vs 31.1 and 29.9 points), LEFS score (96.3 vs 85.4 and 85.5 points), and UWRI score (27.8 vs 17.1 and 19.6 points; all p<.05) by the final time point of study participation. General health, quality sleep and tension/worry were not different by kinesiophobia trajectory over time.

Conclusions: Modulating fear response may be a useful target to directly impact rehabilitation success. The physiatry team may consider screening injured runners for kinesiophobia early in the recovery process, which can help identify runners with higher likelihood of a challenging or protracted recovery.