Association of kinesiophobia with muscle performance, balance, and dual-task performance in individuals with non-specific chronic neck pain: a comparative cross-sectional study

Abstract

Kinesiophobia is an important psychological factor associated with impaired physical performance in individuals with non-specific chronic neck pain. This study aimed to investigate the relationships between kinesiophobia and muscle performance, balance, and dual-task performance in individuals with non-specific chronic neck pain, and to compare these parameters with asymptomatic controls. A total of 99 participants were included in the study (55 participants had non-specific chronic neck pain and 44 were asymptomatic). Pain intensity was assessed using the visual analogue scale, kinesiophobia was assessed with the Tampa Scale of Kinesiophobia, deep cervical flexor muscle performance was assessed using pressure biofeedback, and disability was assessed with the Neck Disability Index. Balance was evaluated using the Timed Up and Go test and the Single-Leg Stance Test. Dual-task performance was assessed using a dual-task Timed Up and Go protocol. Individuals with non-specific chronic neck pain demonstrated significantly lower deep cervical flexor performance, poorer balance and poorer dual-task performance compared to the healthy controls ( P =0.001). Within the non-specific chronic neck pain group, higher kinesiophobia was significantly associated with lower muscle performance, poorer dual-task performance and greater disability ( P =0.002, P =0.004, P =0.002), but not with muscle endurance ( P >0.05). Regression analyses showed that kinesiophobia explained 14.7% of the variance in muscle performance, 11.8% in dual-task performance and 16.9% in disability. Kinesiophobia is significantly associated with impaired muscle performance, poorer dual-task performance and greater disability in individuals with non-specific chronic neck pain, highlighting the importance of addressing psychological factors in clinical assessment and rehabilitation. The findings indicate that in individuals with non-specific chronic neck pain, kinesiophobia is associated with impaired muscle performance, poorer dual-task performance, and higher levels of disability. As a result, physiotherapists and clinicians should think about evaluating kinesiophobia in addition to functional and physical assessments, such as dual-task and balance tests. They may also incorporate neck muscular workouts with techniques meant to alleviate the fear of movement.