Outcome measures for fear of movement in individuals with musculoskeletal disorders: a systematic review with meta- analysis

INTRODUCTION: Fear of movement is a significant psychological factor in musculoskeletal disorders, negatively impacting clinical outcome. Currently there are many assessment tools measuring the fear of movement. This systematic review aims to analyze and compare the psychometric properties of the main scales used to measure fear of movement in populations with musculoskeletal disorders. METHODS: A systematic literature review was conducted following the PRISMA criteria, analyzing studies published in the following databases: MEDLINE (via PubMed), CINAHL (via EBSCO), Web of Science and Scopus. Study quality was assessed using the COSMIN checklist. For the meta-analysis, studies reporting the internal consistency were analyzed. RESULTS: 99 studies were included in the selection, which identified a total of 29 assessment tools. Most of these instruments have demonstrated good reliability and validity, althoughthere is significant heterogeneity in methodological quality and a notable lack of reporting on measurement error and responsiveness across the included studies. CONCLUSIONS: Numerous assessment tools for fear of movement are available in the literature, with some scales distinguished by high levels of reliability and validity across different clinical and linguistic contexts. These findings provide useful guidance for selecting appropriate tools for clinical practice and research, helping to improve the assessment and management of fear of movement in patients with musculoskeletal pain. PROTOCOL REGISTRATION: http://www.crd.york.ac.uk/prospero identifier is CRD420251009756.