Prevalence and associated factors of kinesiophobia in postoperative patients with breast cancer: A systematic review and meta-analysis

<h2>Abstract:</h2><h3>Objective</h3> To comprehensively review the prevalence and associated factors of kinesiophobia in postoperative patients with breast cancer. <h3>Methods</h3> Two reviewers independently screened the literature and extracted the data. Methodological quality assessment of the included studies was performed using the Joanna Briggs Institute critical appraisal checklists. A random-effects model was applied to estimate the pooled prevalence. We used subgroup analyses and narrative synthesis to explore the sources of heterogeneity and identify the associated factors, respectively. <h3>Results</h3> A total of 21 studies comprising 2,773 patients met the inclusion criteria. Of these, 14 studies involving 2,007 postoperative patients with breast cancer were analyzed, showing a pooled kinesiophobia prevalence of 56.5% (95% CI: 39.5%–72.8%). Subgroup analyses revealed that the prevalence of kinesiophobia, as measured using the Tampa Scale for Kinesiophobia (TSK; 48.4%), was lower than that measured using the Fear-Avoidance Components Scale (FACS; 64.3%). A total of 45 factors associated with kinesiophobia were identified and categorized into biological (<i>n</i> = 20), psychological (<i>n</i> = 17), and social (<i>n</i> = 8) domains based on the biopsychosocial (BPS) model. <h3>Conclusions</h3> The findings indicate a high prevalence of kinesiophobia in postoperative patients with breast cancer, which is associated with multiple factors. This high prevalence underscores the clinical significance of the issue in their postoperative care. Future studies should identify predictors of kinesiophobia in these patients and explore more effective tailored interventions to help them benefit from exercise. <h3>Systematic review registration</h3> CRD42025641017