Is the cause of kinesiophobia in stroke patients pain, or is it due to a lack of postural control, the affected side, and depression?

Objectives: This study aimed to examine the relationship between kinesiophobia and postural control, depression, pain, and affected side in stroke patients. Patients and methods: The cross-sectional study was conducted between February 2019 and July 2019. Patients who had a stroke at least six months ago and had a Functional Ambulation Scale score of Level 2 or above were included. In the study, the patients' kinesiophobia scores (Tampa Kinesiophobia Scale [TKS] and Visual Analog Scale [VAS] kinesiophobia assessment), postural control (Postural Assessment Scale for Stroke [PASS]), depression severity (Beck Depression Inventory), pain (VAS) were evaluated. Results: Thirty patients (20 females, 10 males; mean age: 62.5±5.9 years; range, 48 to 70 years) were included in the study. A moderate negative correlation was found between PASS and VAS-kinesiophobia (r=–0.662, p<0.05), a moderate positive correlation was found between Beck Depression Inventory and TKS (r=0.368, p<0.045), and a high positive correlation was found between VAS-pain and TKS (r=0.719, p<0.05). While there was a significant difference in TKS (p<0.001) between the groups of patients with and without pain, there was no significant difference in VAS-kinesiophobia assessment (p>0.05). No association was found between kinesiophobia and the affected side (p>0.05). Conclusion: Tampa Kinesiophobia Scale includes an assessment of pain-focused kinesiophobia. There is a need to develop other scales to evaluate kinesiophobia by questioning findings such as loss of postural control and severity of depression. Identifying kinesiophobia and its etiology in stroke patients could positively affect the rehabilitation process.