Kinesiophobia and its association with pain and function in adolescent idiopathic scoliosis: Findings from a controlled study

Abstract

Background

Adolescent idiopathic scoliosis (AIS) is frequently accompanied by spinal pain, but the underlying mechanisms remain unclear. Psychological factors such as kinesiophobia may play a key role in shaping pain perception and limiting physical activity in this population.

Objective

To compare kinesiophobia levels between adolescent idiopathic scoliosis and age-matched healthy controls, and to examine the associations among kinesiophobia, pain, and quality of life.

Methods

This cross-sectional controlled study included 128 participants (72 with AIS and 56 healthy controls), all of whom had experienced spinal pain at some point in their lives. Pain intensity was evaluated using the Visual Analogue Scale (VAS), kinesiophobia with the Tampa Scale for Kinesiophobia (TSK-17), and quality of life with the refined Scoliosis Research Society-22 (SRS-22r). Cobb measurements were used to assess deformity severity. Statistical analyses were performed to determine intergroup differences and correlations between variables.

Results

Kinesiophobia scores were similar between groups but showed a significant positive correlation with pain intensity both in the AIS group (r = 0.34, p = 0.003) and in controls (r = 0.27, p = 0.044). In AIS patients, those reporting pain had significantly lower SRS-22r pain and function scores (p < 0.05). No correlation was observed between Cobb angle and either pain or TSK scores.

Conclusion

Adolescents with idiopathic scoliosis experience kinesiophobia primarily as a response to pain rather than as a function of deformity severity. Early pain management, reassurance, and motivational strategies to reduce movement-related fear may enhance adherence to exercise therapy and improve rehabilitation outcomes.