Chronic neck pain (CNP) incidence in the general population is high and contributes to a significant health problem. Kinesiophobia (fear of pain to movement or re-injury) combined with emotions and physical variables may play a vital role in assessing and managing individuals with CNP. The study’s objectives are 1) to evaluate the relationship between kinesiophobia, neck pain intensity, proprioception, and functional performance; 2) to determine if kinesiophobia predicts pain intensity, proprioception, and functional performance among CNP individuals. Sixty-four participants with CNP (mean age 54.31 ± 9.41) were recruited for this cross-sectional study. The following outcome measures were evaluated: Kinesiophobia using the Tampa Scale of Kinesiophobia (TSK), neck pain intensity using the visual analog scale (VAS), cervical proprioceptive joint position errors (in flexion, extension, and rotation directions) using cervical range of motion (CROM) device and handgrip strength as a measure of functional performance using the Baseline® hydraulic hand dynamometer. Kinesiophobia showed a strong positive correlation with neck pain intensity (r = 0.81, p<0.001), a mild to a moderate positive correlation with proprioception joint position errors (JPE) in extension, rotation left and right directions (p<0.05), but no correlation in flexion direction (p = 0.127). Also, there was a moderate negative correlation with handgrip strength (r = -0.65, p<0.001). Regression analysis proved that kinesiophobia was a significant predictor of pain intensity, proprioception, and functional performance (p<0.05). This study infers that kinesiophobia in individuals with CNP predicts pain, proprioception, and functional performance. Kinesiophobia assessment should be considered in regular clinical practice to understand the barriers that can influence rehabilitation outcomes in CNP individuals.

In current clinical practice, fear of movement has been considered a significant factor affecting patient disability and needs to be evaluated and addressed to accomplish successful rehabilitation strategies. Therefore, the study aims (1) to establish the association between kinesiophobia and knee pain intensity, joint position sense (JPS), and functional performance, and (2) to determine whether kinesiophobia predicts pain intensity, JPS, and functional performance among individuals with bilateral knee osteoarthritis (KOA). This cross-sectional study included 50 participants (mean age: 67.10 ± 4.36 years) with KOA. Outcome measures: The level of kinesiophobia was assessed using the Tampa Scale of Kinesiophobia, pain intensity using a visual analog scale (VAS), knee JPS using a digital inclinometer, and functional performance using five times sit-to-stand test. Knee JPS was assessed in target angles of 15°, 30°, and 60°. Pearson’s correlation coefficients and simple linear regressions were used to analyze the data. Significant moderate positive correlations were observed between kinesiophobia and pain intensity (r = 0.55, p < 0.001), JPS (r ranged between 0.38 to 0.5, p < 0.05), and functional performance (r = 0.49, p < 0.001). Simple linear regression analysis showed kinesiophobia significantly predicted pain intensity (B = 1.05, p < 0.001), knee JPS (B ranged between 0.96 (0° of knee flexion, right side) to 1.30 (15° of knee flexion, right side)), and functional performance (B = 0.57, p < 0.001). We can conclude that kinesiophobia is significantly correlated and predicted pain intensity, JPS, and functional performance in individuals with KOA. Kinesiophobia is a significant aspect of the recovery process and may be taken into account when planning and implementing rehabilitation programs for KOA individuals.

Background Stroke is the foremost cause of death and disability worldwide. Improving upper extremity function and quality of life are two paramount therapeutic targets during rehabilitation. Aim of the study To investigate the effects of transcranial direct current stimulation (tDCS) combined with trunk-targeted proprioceptive neuromuscular facilitation (PNF) on impairments, activity limitations, and participation restrictions of subjects with subacute stroke. Methodology Fifty-four subjects with subacute stroke were divided into three groups using block randomization. All three groups received rehabilitation sessions lasting 90 min in duration, four times per week, for 6 weeks. Group 1 (n = 18) received conventional physical therapy (CPT); group 2 (n = 18) received CPT, trunk-targeted PNF, and sham tDCS; and group 3 (n = 18) received CPT, trunk-targeted PNF, and bihemispheric motor cortex stimulation with tDCS. Changes in motor impairment, motor activity, and health-related quality of life assessments were outcome measures. Results A two-way linear mixed model analysis revealed interaction effects (group × time) for all outcome measurements (Trunk Impairment Scale, Fugl-Meyer Assessment of Motor Recovery after stroke upper extremity subsection, Wolf Motor Function Test, 10-Meter Walk Test, and the Stroke-Specific Quality of Life scale; all p < 0.01 or lower). Overall, post–pre mean differences demonstrate more substantial improvement in the active tDCS group, followed by sham stimulation associated with the PNF group and the group that received CPT alone. Conclusion Trunk-targeted PNF combined with bihemispheric tDCS along with CPT engender larger improvements in upper extremity and trunk impairment, upper limb function, gait speed, and quality of life in the subacute stroke population.

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