Association of kinesiophobia with physical function, mental health and health-related quality of life in patients with obstructive airway disease: a cross-sectional study

The study aimed to evaluate the relationship of kinesiophobia with functional capacity, psychological distress, pulmonary function, and quality of life in individuals with obstructive airway disease and to determine the variables that independently predict kinesiophobia. A total of 111 clinically stable patients with obstructive airway disease were assessed using the Tampa Scale for Kinesiophobia (TSK), Numerical Rating Scale (NRS), Modified Medical Research Council Dyspnea Scale (mMRC), Fatigue Severity Scale (FSS), 6-Minute Walk Test (6MWT), International Physical Activity Questionnaire (IPAQ), arm curl test, 30-second sit-to-stand and flexibility tests, pulmonary function test, Depression Anxiety Stress Scale-21 (DASS-21), WHO Quality of Life-BREF (WHOQOL-BREF), and WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Clinically significant kinesiophobia (TSK>37) was observed in 64.8% of participants. TSK scores showed significant positive correlations with NRS (r=0.431), FSS (r=0.554), DASS-21 (r=0.456), WHODAS 2.0 (r=0.434), mMRC (r=0.309), and flexibility (back scratch test (r=0.281); and significant negative correlations with arm curl (r=–0.427), sit-to-stand (r=–0.433), 6MWT (r=–0.421), IPAQ (r=–0.421), and WHOQOL-BREF (r=–0.538), all with p<0.005. In multiple regression, lower forced vital capacity (β=–0.360, p<0.001), lower WHOQOL-BREF scores (β=–0.302, p<0.001), higher fatigue severity (β=0.230, p=0.007), and lower 6MWT percentage of predicted distance (β=–0.165, p=0.023) independently predicted higher kinesiophobia. The model explained 60.3% of the variance (R²=0.603). These findings highlight the high prevalence and multi-dimensional impact of kinesiophobia in obstructive airway disease, emphasizing the importance of addressing fear of movement to improve physical activity, functional capacity, and quality of life in pulmonary rehabilitation settings.