The effect of fear of movement on gait characteristics in patients with knee osteoarthritis

Abstract Background Knee osteoarthritis (KOA) is a disease with a high prevalence in the elderly population, it has placed a significant burden on families and society.To investigate the relationship between fear of movement(FOM) and gait characteristics in KOA patients. Methods Cross-sectional data...

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Bibliographic Details
Main Authors: Bixuan Duan, Yuxuan Zhang, Pei Ma, Fangmin Chen, Wei Li
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08920-5
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Summary:Abstract Background Knee osteoarthritis (KOA) is a disease with a high prevalence in the elderly population, it has placed a significant burden on families and society.To investigate the relationship between fear of movement(FOM) and gait characteristics in KOA patients. Methods Cross-sectional data from 30 elderly patients with KOA (age 40–65 years) were used. They were divided into a high-fear group (n = 15) and a low-fear group (n = 15) on the basis of the discriminative question (Q9) on the Tampa Scale for Kinesiophobia (TSK-17). Additionally, 15 healthy subjects were selected as the control group. All participants were instructed to cross an obstacle with a height of 20% of the leg length. Gait parameters including hip, knee, and ankle joint angles and moments of both lower extremities were assessed using a 3D motion capture system. Results In within-group comparisons, difference between unaffected and affected sides in high-fear group were revealed for knee flexion angle(KFA, P = 0.04, ES = 0.70), peak ankle adduction /abduction moment(PAAM, P = 0.001, ES = 0.90)and peak knee adduction /abduction moment(PKAM, P = 0.006, ES = 0.97) during swing phase. Difference were revealed for peak hip internal /external rotation moment(PHIM, P = 0.005, ES = 0.87)and PKAM(P<0.001, ES = 0.91) during stance phase.In between-group comparisons, difference between high-fear and low-fear group were revealed for SInorm of HAA(P = 0.003)during swing phase. The control group were greater than high-fear group for SInorm of PAAM(P = 0.004)、PHIM(P = 0.002)during stance phase. Correlation analysis revealed that TSK-17 scores were strongly correlated with the SInorm of PKAM (r = 0.80, P < 0.01) and PHIM (r = 0.81, P < 0.01). Conclusion High-fear KOA patients might perform a protective movement strategy, which may lead to asymmetry in movement patterns by reducing weight bearing on the affected side. FOM can significantly affect patients’ kinematic and kinetic parameters, especially PHIM and PKAM.Therefore, psychology-related interventions for treating KOA must be valued to improve patients’ overall sports function and quality of life. Trial registration The study was retrospectively registered on Chinese Trial Registry (PID: 246580).
ISSN:1471-2474