Clinical Research Directory

The Impact of Osteosarcopenia on Falls, Kinesiophobia, and Quality of Life in Postmenopausal Women

Osteosarcopenia (OSP) is defined as the coexistence of sarcopenia and osteoporosis/osteopenia. There is an intense and complex interaction-both mechanical (the "mechanostat" hypothesis) and biochemical (involving factors such as estrogen, testosterone, GH, IGF-1, IL-6, and osteocalcin)-between osteoporosis and sarcopenia. The general consensus is that sarcopenia leads to a reduction in bone mineral density. OSP is associated with significant physical disability, which poses a major threat to the future loss of independence. The increased propensity for falls-a consequence of sarcopenia-compounds the risk of fractures associated with osteoporosis, further exacerbating adverse health outcomes. Kinesiophobia, or the "fear of movement," is an excessive and irrational dread of performing physical movements or activities, stemming from the fear of a painful injury or the possibility of re-injury; this often leads to restrictions in activities of daily living. In a clinical setting, kinesiophobia is a critical issue that must be addressed to effectively manage a patient's disability, as it directly influences rehabilitation strategies. While there is some limited literature exploring the individual associations of osteoporosis and sarcopenia with kinesiophobia, no research has yet examined the relationship between osteosarcopenia and kinesiophobia. Our study aims to determine the impact of osteosarcopenia on kinesiophobia and quality of life in postmenopausal women.

Does MI Have a Therapeutic Role in Arthroscopic Rotator Cuff Repair?

Objective: The aim of this study is to investigate the effect of motor imagery on muscle activity, pain, and function in arthroscopic rotator cuff repair. Methods: As a result of the power analysis (G-Power), 36 participants are planned to be included in this study Block randomization will be used to divide participants into 2 groups, each with at least 18 participants: Group 1 (MI group) and Group 2 (Control group) (Randomizer.org). Both groups will receive a 4-week physical therapy program. MI (Motor Imagination) group will receive a motor imagination program in addition to the physical therapy program. Data will collect using the visual analog scale (VAS), goniometric measurement, circumference measurement, Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), Kinesthetic and Visual Imagery Questionnaire- KVIQ-20, Tampa Kinesiophobia Scale, 3-question satisfaction questionnaire, superficial Electromyography (EMG) (BTS Bioengineering Free EMG 100 RT). Practice Implications: The current study will contribute to understanding how motor imagination affects muscle activity and muscle atrophy.

Anatomical Axis on X-Ray and Its Relationship With Pain and Kinesiophobia in Knee Osteoarthritis

Knee osteoarthritis is a common joint disease that causes pain, stiffness, and limitations in daily activities, especially in older adults. Changes in the alignment of the lower limb, called the anatomical axis, can increase the mechanical load on the knee joint and may affect pain and mobility. This study aims to investigate the relationship between the anatomical axis measured on knee X-rays and patients' pain levels, functional status, quality of life, and fear of movement (kinesiophobia). This is a single-center, observational, cross-sectional study. Adult patients diagnosed with knee osteoarthritis who have a standard knee X-ray taken within the last 6 months and who volunteer to participate will be included. Pain will be measured with the Visual Analog Scale (VAS), functional status with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), quality of life with the 36-Item Short Form Health Survey (SF-36), and kinesiophobia with the Tampa Scale for Kinesiophobia (TSK). The femoro-tibial angle and joint space width will be measured on X-rays by two independent observers. By examining the relationship between radiographic alignment and clinical findings, this study may provide new insights into the comprehensive evaluation of knee osteoarthritis and help guide treatment planning for patients.

Kinesiophobia, Postoperative Pain, and Early Mobilization After Elective Abdominal Surgery

This study examines the level of kinesiophobia (fear of movement) in patients undergoing elective abdominal surgery and its relationship with postoperative pain severity and early mobilization. In this descriptive, cross-sectional study, adult patients who have undergone elective abdominal surgery under general anesthesia at two centers (Agri Training and Research Hospital and Taksim Training and Research Hospital) will be assessed after completing their first postoperative mobilization (typically postoperative day 1). Kinesiophobia will be measured with the Turkish version of the Tampa Scale for Kinesiophobia (TSK), postoperative pain with the Numeric Rating Scale (NRS), and early mobilization with a researcher-developed Early Mobilization Record Form (time to first ambulation, standing duration, and first walking distance/duration). The investigators hypothesize that patients' kinesiophobia levels will be positively associated with postoperative pain severity and with delayed/reduced early mobilization, and that patients without prior surgical experience will have higher kinesiophobia levels than those with prior surgical experience.

The Effect of Foot Reflexology in Women With Migraine

This prospective randomized controlled study aims to investigate the effects of foot massage on pain, anxiety, kinesiophobia, and postural control in women aged 18-45 years diagnosed with migraine who attend the Neurology Outpatient Clinic of Karabük University Karabük Training and Research Hospital. Participants who meet the inclusion and exclusion criteria will be randomly allocated into either a foot massage group or a control group using a simple randomization method. The foot massage group will receive a total of 10 sessions of foot massage over 5 weeks, with two sessions per week, while no massage intervention will be applied to the control group. All participants will be assessed at baseline, immediately after the intervention period, and two weeks following the completion of treatment. The findings of this study are expected to provide evidence regarding the effectiveness of foot massage in the management of symptoms in women with migraine.

Active Coping: Interdisciplinary Program for Chronic Pain, Physiotherapy Unit (Spain)

The goal of this observational intervention study is to evaluate the impact of a multidisciplinary active coping program for chronic back pain in adults referred from Primary Care to the Physiotherapy Unit of Teruel Ensanche. The main questions it aims to answer are: * Does the program improve physical function, measured through gait speed, balance, and chair stand tests? * Does it reduce pain-related psychological factors such as kinesiophobia, catastrophizing, anxiety, and depression? * Does it improve quality of life and sleep quality, and reduce analgesic medication use? Participants will attend group sessions on pain neuroscience education, followed by sessions on healthy habits, nutrition and sleep hygiene and group psychological intervention focused on emotional wellbeing tools, and will complete therapeutic exercise sessions over the course of the program. They will also complete validated questionnaires and physical assessments at three timepoints: at baseline, at the end of the program, and at a 6-month follow-up.

Kinesiophobia Associated With Fatigue in Patients With Multiple Sclerosis.

This study aims to investigate the presence of kinesiophobia and the factors associated with kinesiophobia in patients diagnosed with multiple sclerosis. Adult volunteer patients aged 18-65 years with a diagnosis of multiple sclerosis who present to the Physical Medicine and Rehabilitation and Neurology outpatient clinics, meet the inclusion criteria, and provide written informed consent will be enrolled in the study. For each patient, Expanded Disability Status Scale (EDSS) scores, spasticity scores according to the Modified Ashworth Scale (MAS), and the Timed 25-Foot Walk Test will be assessed. In addition, the Functional Ambulation Scale, Visual Analog Scale (VAS) for pain, VAS for sleep, Tampa Scale for Kinesiophobia-Fatigue, International Physical Activity Questionnaire, and the Turkish versions of the Hospital Anxiety and Depression Scale will be completed for each patient.

Action Observation and Motor Imagery Training in Cervical Disc Herniation

Cervical disc herniation is a common degenerative spinal disorder associated with chronic neck pain, impaired cervical function, reduced motor control, and decreased quality of life. Although conventional physiotherapy is widely used, innovative rehabilitation strategies that enhance motor learning may improve treatment outcomes. This randomized controlled trial aims to investigate the clinical effectiveness of Action Observation (AO) and Motor Imagery (MI) training as an adjunct to conventional physiotherapy in individuals with cervical disc herniation and chronic neck pain. Thirty-six participants diagnosed with cervical disc herniation will be randomly assigned to one of two groups. The control group will receive conventional physiotherapy combined with sham observation consisting of neutral nature videos, while the experimental group will receive conventional physiotherapy plus AO and MI training. The intervention period will last six weeks. Clinical outcomes will be assessed before and after the intervention. Primary and secondary outcome measures will include pain intensity, pressure pain threshold, neck disability, kinesiophobia, cervical motor control and endurance, and cervical proprioception using validated assessment tools. The findings of this study are expected to provide evidence regarding the effectiveness of AO and MI training as complementary rehabilitation approaches for individuals with cervical disc herniation and to support the integration of motor learning-based interventions into clinical physiotherapy practice.

The Effect of Cognitive Behavioral Therapy and Virtual Reality Use in Inured Athletes

In this study, which aimed to develop a Cognitive Behavioral Therapy (CBT) protocol enriched with Virtual Reality (VR) to address the psychological responses that arise after ACL surgery, and to examine the effectiveness of this protocol. The effectiveness of the protocol was assessed using pre-test, post-test, and two follow-up measurements with the Re-Injury Anxiety Inventory (RIAI), the Sport Injury Rehabilitation Adherence Scale (SIRAS), the Tampa Scale for Kinesiophobia (TSK), the Athletic Injury Self-Efficacy Questionnaire (AISEQ), the Return to Sport After Serious Injury Questionnaire (RSSIQ), and the Anterior Cruciate Ligament Return to Sport Scale (ACL-RSI). Anxiety levels during VR exposure sessions were measured through biofeedback and the Subjective Units of Distress Scale (SUDS).

The Italian Version of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD)

This observational, cross-sectional study aims to translate, culturally adapt, and psychometrically validate the Italian version of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD-ITA). Patients referred to the TMD outpatient clinic of the Department of Maxillofacial Surgery, San Paolo Hospital (Milan, Italy), will complete the translated questionnaire along with measures of pain, disability, catastrophizing, anxiety/depression, stress, and central sensitization. The study will assess the factor structure, internal consistency, test-retest reliability, and convergent/discriminant validity of the TSK-TMD-ITA in the Italian TMD population.

Kinesiophobia in Women With Stress Urinary Incontinence

All women included in the study will be administered the Causes of Kinesiophobia Scale (KCS), the International Physical Activity Questionnaire (Short), the International Incontinence Consultation Questionnaire-Short Form (ICIQ-SF), and the Pittsburgh Sleep Quality Questionnaire (PSQI). Subsequent analysis will determine the causes of kinesiophobia in women with urinary incontinence.

RELATIONSHIP BETWEEN ULTRASONOGRAPHIC QUADRICEPS MUSCLE THICKNESS AND SARCOPENIA MARKERS (HANDGRIP STRENGTH, SARC-F) AND KINESIOPHOBIA IN STROKE PATIENTS

The aim of this study is to evaluate the relationship between ultrasonography-measured quadriceps muscle thickness and the sarcopenia markers SARC-F questionnaire and handgrip strength in patients diagnosed with ischemic stroke. In addition, the relationship between quadriceps muscle thickness and the level of kinesiophobia will be quantitatively assessed. This study is a cross-sectional clinical study conducted between August 1, 2025, and August 1, 2026, at the Physical Medicine and Rehabilitation Clinic of the University of Health Sciences İstanbul Physical Medicine and Rehabilitation Training and Research Hospital. Fifty volunteer participants with ischemic stroke and a lower-extremity Brunnstrom motor stage of 3 or higher, who presented to the clinic during the study period, were included. Bilateral quadriceps femoris muscle thickness, including the rectus femoris and vastus intermedius muscles, was measured using ultrasonography. The SARC-F questionnaire was used to assess sarcopenia risk, handgrip strength measurement was used to evaluate muscle strength, and the Tampa Scale for Kinesiophobia was used to determine the level of kinesiophobia. Motor recovery stage was assessed using the Brunnstrom Staging system; motor and cognitive independence were assessed using the Functional Independence Measure; walking independence was assessed using the Functional Ambulation Scale; and independence in activities of daily living was assessed using the Barthel Index of Activities of Daily Living. Because balance impairment, muscle weakness, and limited mobility are common after stroke, physical performance tests may be difficult to administer safely and consistently in this patient population. Therefore, the relationship between quadriceps muscle thickness and physical performance tests was not evaluated in this study. The Chair Stand Test, which requires repeated sit-to-stand movements as well as adequate balance and lower-extremity muscle strength, was also not included because it may increase the risk of falls in patients with limited mobility. This study aims to demonstrate the clinical potential of ultrasonography in the assessment of post-stroke sarcopenia and to support a more holistic approach to stroke rehabilitation planning that considers both physical and psychological factors.

Comparative Effect of Combined Strength, Core and Balance Training on Kinesiophobia, Ankle Instability, Functional Outcomes, and Performance in Table Tennis Players With Functional Ankle Instability

This randomized controlled trial investigates the comparative effect of combined strength and balance training versus balance and core training on kinesiophobia (fear of movement), ankle instability, functional outcomes, and athletic performance in adolescent table tennis players with functional ankle instability (FAI). Participants will be randomly allocated into two groups over a 6-week intervention (3 sessions/week). The Experimental Group will receive combined strength and balance training, while the Control Group will receive balance and core training. Outcomes will be measured using validated tools: TSK-17, CAIT, FAAM, Y-Balance Test, Single-Leg Hop Test, T-Test, and Illinois Agility Test.

Comparison of Early Postoperative Functional Capacity and Kinesiophobia in Patients Undergoing Thoracic Surgery Via Thoracotomy or VATS

This observational cross-sectional study aims to compare early postoperative functional capacity and kinesiophobia in patients undergoing thoracic surgery via thoracotomy or video-assisted thoracic surgery (VATS). Patients aged 18-75 years who underwent thoracic surgery and agreed to participate will be evaluated during the early postoperative period, after chest tube removal and before hospital discharge. Functional capacity will be assessed using the 1-minute sit-to-stand test. Kinesiophobia will be evaluated using the Tampa Scale for Kinesiophobia. Pain, dyspnea, fatigue, and coronavirus-related anxiety will also be assessed using validated scales and questionnaires. The study will investigate the relationship between kinesiophobia and postoperative functional and symptom-related outcomes.

Investigation of the Effectiveness of Dynamic Neuromuscular Stabilization Exercises After Lumbar Disc Herniation Surgery

The aim of the study is to investigate the effects of dynamic neuromuscular stabilization exercises on pain, functionality and fear in individuals who have undergone lumbar disc herniation surgery.

Simulation-Based Preoperative Education in Total Knee Arthroplasty

This randomized controlled trial aims to evaluate the effect of simulation-based preoperative education on surgical fear and kinesiophobia in patients undergoing total knee arthroplasty. Eligible patients are randomly assigned to either a simulation-based education group or a standard verbal education (control) group. Surgical fear, kinesiophobia, and postoperative pain are assessed using validated measurement tools. The findings of this study are expected to contribute to evidence-based nursing practices by informing the development of effective preoperative education strategies to improve postoperative recovery outcomes.

Kinesiophobia in Chronic Neck Pain

In this study, the effect of kinesiophobia on pain, disability, and quality of life in individuals with chronic neck pain will be evaluated. Neck pain is a common musculoskeletal disorder that can become chronic in some individuals. Kinesiophobia may lead to a reduction in physical activity due to fear of movement and re-injury, thereby increasing pain and disability. In this cross-sectional study, 57 participants will be assessed using the Visual Analog Scale (VAS), Tampa Scale for Kinesiophobia (TSK), Neck Disability Index (NDI), and the SF-36 Quality of Life Scale. Participants will be selected from individuals aged 18-59 who have experienced neck pain for at least 3 months, and those with a history of neurological disorders, spinal surgery, or pain treatment in the last 3 months will be excluded. This research aims to determine the effects of kinesiophobia on chronic neck pain, thereby contributing to the development of more effective treatment strategies. Written informed consent will be obtained from all participants.

Rehabilitation Interventions After Cardiac Surgery in Older Adults

This randomized controlled trial aims to investigate the effects of foot massage and kinesio taping on functional performance and kinesiophobia in older adults following cardiac surgery. Early mobilization after cardiac surgery is essential for improving recovery outcomes; however, pain, fear of movement (kinesiophobia), and reduced functional capacity may delay rehabilitation in older patients. Participants aged 65 years and older who have undergone cardiac surgery will be randomly assigned to either a foot massage group or a kinesio taping group. The foot massage group will receive daily bilateral foot massage for seven consecutive days, while the kinesio taping group will receive standardized kinesio taping applications to the foot and ankle region during the same period. Functional performance, kinesiophobia, pain intensity, cognitive status, and delirium will be assessed using validated outcome measures, including the Timed Up and Go test, Tampa Scale for Kinesiophobia, Visual Analog Scale, Standardized Mini-Mental Test, and Nursing Delirium Screening Scale. Assessments will be conducted preoperatively and on the seventh postoperative day. The study aims to determine whether non-pharmacological, easily applicable interventions such as foot massage and kinesio taping can enhance functional recovery, reduce fear of movement, and support early mobilization in older adults after cardiac surgery.

Mindfulness-based Stress Reduction Combined With Aerobic Training in Cardiac Rehabilitation After Percutaneous Coronary Intervention: A Dual Impact on Kinesiophobia and Heart Rate Variability

To evaluate the effectiveness of mindfulness-based stress reduction (MBSR) combined with aerobic training on treatment adherence, kinesiophobia, heart rate variability (HRV), exercise tolerance, and psychological stress response in patients with coronary heart disease (CHD) post-percutaneous coronary intervention (PCI). Post-PCI patients (n = 150) were randomly assigned to an observation group (receiving combined MBSR and aerobic training) and a control group (receiving aerobic training only). Treatment adherence, the Tampa Scale for Kinesiophobia-Heart (TSK-SV Heart), HRV parameters, exercise tolerance, and psychological stress responses were assessed before and after the intervention. Psychological assessments included the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS).

Effect of Intraoperative Live Video Viewing on Kinesiophobia After ACL Reconstruction

The purpose of this randomized controlled trial is to investigate whether intraoperative live arthroscopic video viewing improves postoperative psychological and functional outcomes in patients undergoing primary anterior cruciate ligament (ACL) reconstruction under spinal anesthesia Participants are randomly assigned to either a video-viewing group, where they watch their surgery in real-time, or a control group receiving standard care without visual feedback The primary objective is to determine whether this patient-specific visual biofeedback reduces postoperative kinesiophobia at 24 weeks. Secondary objectives aim to evaluate the intervention's effects on state anxiety, illness perception, postoperative pain, and patient-reported functional recovery, including IKDC, Lysholm, and SF-36 scores .

The Investigation of Kinesiophobia in Conservative Distal Radius Fractures

This study aimed to investigate the predictability of kinesiophobia on functional outcomes in conservatively treated patients with distal radius fractures. For this purpose, patients' level of kinesiophobia will be assessed using the Tampa Kinesiophobia Scale. To assess the functional status of patients, joint range of motion and upper extremity weight bearing measurements will be performed. Patients' functionality will be additionally assessed with the Patient Rated Wrist Evaluation Questionnaire.

Effect of Home-based Exercise Plan Mediated by Use of Digital Health App on Kinesiophobia and Functional Capacity

To evaluate the effect of home-based exercise plan mediated by a digital health application on kinesiophobia and functional capacity in sedentary post myocardial infarction patients. Evidence suggest that digital health application significantly improve physical activity level in patient following cardiac event by providing personalized exercise plan, real time feed back, progress tracking and motivational features which enhanced adherence and engagement in rehabilitation program. This study could offer a viable le solution for overcoming barrier to rehabilitation particularly for those unable to access traditional clinic-based program

Effect of Anticipated Pain on Corticospinal Excitability

The purpose of this study is to investigate how the anticipation of pain, in the absence of real pain, affects the excitability of the corticospinal pathway. Corticospinal excitability reflects how responsive the motor areas of the brain are when sending signals to muscles. In this study, healthy adult participants will be randomly assigned to one of two groups. Both groups will receive the application of an inert cream on the forearm. Participants in the experimental group will be told that the cream may cause pain, while participants in the control group will be informed that the cream is completely inactive. In reality, the cream has no physical effect in either group. This design allows the researchers to isolate the effect of pain anticipation (a nocebo effect) without exposing participants to actual pain. Corticospinal excitability will be measured using transcranial magnetic stimulation (TMS), a non-invasive technique that stimulates the motor cortex to assess brain-to-muscle communication. Measurements will be taken before and after the application of the cream. In addition, psychological factors related to catastrophizing and fear of movement will be assessed using validated questionnaires, and physiological responses associated with stress will be measured through heart rate variability. The main question this study aims to answer is whether anticipating pain, even without experiencing real pain, alters corticospinal excitability, and whether this effect is influenced by fear of movement and catastrophizing. By improving our understanding of how pain-related expectations affect brain function, this research may contribute to better strategies for preventing maladaptive motor changes associated with chronic pain.

Sedentary Status and Multidimensional Outcomes in Fibromyalgia

Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and functional limitations. Pain, fatigue, and fear of movement often lead individuals with FMS to adopt sedentary behaviors, which may further exacerbate symptoms and reduce physical capacity. Factors such as impaired body awareness, reduced respiratory muscle strength, kinesiophobia, central sensitization, poor functional status, and sleep disturbances play an important role in disease severity and quality of life in individuals with FMS. Although physical inactivity is common in fibromyalgia, limited evidence exists regarding the differences in these multidimensional clinical parameters between sedentary and non-sedentary individuals with FMS. Therefore, the aim of this study is to compare body awareness, respiratory muscle strength, kinesiophobia, central sensitization, functional status, and sleep quality between sedentary and non-sedentary individuals diagnosed with fibromyalgia syndrome. The findings of this study may contribute to a better understanding of the impact of sedentary behavior on clinical outcomes in fibromyalgia and help guide more comprehensive and individualized rehabilitation approaches.