Kinesiophobia in Patients with Chronic Obstructive Pulmonary Disease: A Concept Analysis

Huifang Yin, Rongrong Li, Yidan Hu, Lihua Huang Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of ChinaCorrespondence: Lihua Huang, Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China, Tel +86 13867129329, Email [email protected]: Kinesiophobia (fear of movement) is a significant barrier to pulmonary rehabilitation and functional recovery in patients with Chronic Obstructive Pulmonary Disease (COPD). Despite its considerable impact on clinical outcomes, this concept currently lacks a unified definition and comprehensive theoretical framework.Objective: To clarify the concept of kinesiophobia in COPD by identifying its defining attributes, antecedents, and consequences, and to integrate these elements into a cohesive conceptual framework.Methods: A comprehensive literature search was performed in CNKI, Wanfang, VIP, Web of Science, PubMed, CINAHL, and Cochrane Library databases from inception to April 1, 2025. Following Rodgers’ evolutionary methodology, two researchers independently screened studies and conducted a systematic thematic synthesis.Results: Twenty-nine studies met inclusion criteria. Kinesiophobia in COPD is characterized by four defining attributes: symptom hypervigilance, maladaptive cognition, complex emotional responses, and behavioral avoidance. These are influenced by sociodemographic, disease-related, and psychological antecedents, and lead to functional decline and reduced quality of life.Conclusion: This analysis synthesizes a unified conceptual framework that integrates dyspnea-related and pain-related kinesiophobia, addressing a critical gap in the literature. This framework provides the foundation for developing precise assessment tools and mechanism-based interventions tailored to specific fear subtypes, ultimately aiming to disrupt the debilitating cycle of fear and avoidance in COPD.Plain Language Summary: What was known:Fear of movement (kinesiophobia) makes exercise and recovery very difficult for patients with chronic obstructive pulmonary disease (COPD). However, research on this problem has been split, looking separately at fear of breathlessness or fear of pain.What this study adds:Our research brings these ideas together into one clear framework. This framework helps to explain the key parts, causes, and results of movement fear in COPD.What this means:This new understanding is a critical step toward helping healthcare professionals better identify movement fear and create personalized strategies to break the cycle of fear and inactivity, improving patients’ lives.Keywords: kinesiophobia, chronic obstructive pulmonary disease, concept analysis, fear of movement, symptom catastrophizing, activity avoidance, pulmonary rehabilitation