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Background <p>Fear of movement is considered a strong psychological predictor of chronic pain and disability. The purpose of this study was to systematically review the association between fear of movement, pain intensity, and disability in patients with chronic neck pain.</p> Methods <p>A systematic review of the literature, including an appraisal of the risk of bias using the adapted Newcastle - Ottawa Scale (NOS) was performed. PubMed, AMED, CINAHL, PsycINFO, PubPsych, and the grey literature were searched from January 1950 to October 2023. Observational studies reporting cross-sectional and longitudinal associations between fear of movement and pain intensity and disability in people with chronic neck pain were selected. This review included studies that used the Tampa Scale of Kinesiophobia (TSK) to measure fear of movement and the Neck Disability Index (NDI) to measure disability. GRADE criteria were used to evaluate the overall quality and strength of evidence in terms of risk of bias, inconsistency, indirectness, imprecision, and publication bias.</p> Results <p>Fifteen articles (1 longitudinal study, 14 cross-sectional studies, total sample = 1371) were included. Based on the NOS, of the 15 studies examined, 12 (80%) were found to have a moderate risk of bias, while the remaining 3 (20%) had a low risk. Evidence has shown that there is an association between higher levels of fear of movement with pain intensity and greater levels of disability. 9 studies showed a significant association, and 2 studies showed a non-significant relationship between fear of movement and disability. Eight studies showed a significant association, and three studies showed a non-significant association between fear of movement and pain intensity in patients with chronic neck pain. However, the quality and strength of the evidence was low according to the GRADE criteria. The quality of the evidence was low due to methodological limitations (predominantly cross-sectional design).</p> Conclusions <p>Greater fear of movement was associated with greater disability and pain intensity. The results of this study can help psychotherapist and psychotherapist in planning and designing therapeutic interventions considering the factor of fear of movement. The number of prospective longitudinal studies is very small, thus, the prognosis could not be determined. Therefore, more longitudinal cohort studies that analyze the predictive value of the fear of movement in the chronic neck pain are needed. Prospero registration number: CRD42023474724.</p>

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Is there an association between fear of movement and pain intensity and disability in people with chronic neck pain? a systematic review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月10日

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  • Norollah Javdaneh,
  • Roohollah Mohammadi Mirzaei,
  • Arash Shams,
  • AmirHossein Barati,
  • Sadredin Shojaedin,
  • Tadeusz Ambroży,
  • Mateusz Stefanek,
  • Łukasz Rydzik

摘要

Background

Fear of movement is considered a strong psychological predictor of chronic pain and disability. The purpose of this study was to systematically review the association between fear of movement, pain intensity, and disability in patients with chronic neck pain.

Methods

A systematic review of the literature, including an appraisal of the risk of bias using the adapted Newcastle - Ottawa Scale (NOS) was performed. PubMed, AMED, CINAHL, PsycINFO, PubPsych, and the grey literature were searched from January 1950 to October 2023. Observational studies reporting cross-sectional and longitudinal associations between fear of movement and pain intensity and disability in people with chronic neck pain were selected. This review included studies that used the Tampa Scale of Kinesiophobia (TSK) to measure fear of movement and the Neck Disability Index (NDI) to measure disability. GRADE criteria were used to evaluate the overall quality and strength of evidence in terms of risk of bias, inconsistency, indirectness, imprecision, and publication bias.

Results

Fifteen articles (1 longitudinal study, 14 cross-sectional studies, total sample = 1371) were included. Based on the NOS, of the 15 studies examined, 12 (80%) were found to have a moderate risk of bias, while the remaining 3 (20%) had a low risk. Evidence has shown that there is an association between higher levels of fear of movement with pain intensity and greater levels of disability. 9 studies showed a significant association, and 2 studies showed a non-significant relationship between fear of movement and disability. Eight studies showed a significant association, and three studies showed a non-significant association between fear of movement and pain intensity in patients with chronic neck pain. However, the quality and strength of the evidence was low according to the GRADE criteria. The quality of the evidence was low due to methodological limitations (predominantly cross-sectional design).

Conclusions

Greater fear of movement was associated with greater disability and pain intensity. The results of this study can help psychotherapist and psychotherapist in planning and designing therapeutic interventions considering the factor of fear of movement. The number of prospective longitudinal studies is very small, thus, the prognosis could not be determined. Therefore, more longitudinal cohort studies that analyze the predictive value of the fear of movement in the chronic neck pain are needed. Prospero registration number: CRD42023474724.