# Close association of kinesiophobia with physical performance in patients with systemic sclerosis

## TL;DR

This study found that fear of movement in systemic sclerosis patients is closely linked to poor physical performance and balance issues.

## Contribution

The study identifies specific physical performance metrics strongly associated with kinesiophobia in systemic sclerosis patients.

## Key findings

- Kinesiophobia was present in 36.1% of systemic sclerosis patients.
- Patients with kinesiophobia had worse balance and slower walking speed.
- Static imbalance and reduced mobilization capacity are independently linked to kinesiophobia severity.

## Abstract

The aim of this study is to identify factors associated with kinesiophobia in patients with systemic sclerosis (SSc). A total of 72 adult patients diagnosed with SSc were included in this cross-sectional study. Clinical parameters reflecting disease severity, organ involvement, and inflammatory status were recorded. Kinesiophobia level was assessed using the Tampa Scale for Kinesiophobia (TSK). The Berg Balance Scale (BBS), Y Balance Test (YBT), Timed Up and Go Test (TUG), and 10-Meter Walk Test (10MWT) were used to evaluate balance and functional capacity. Factors associated with kinesiophobia was analyzed using multiple linear regression analysis. Kinesiophobia (TSK ≥ 37) was identified in 26 patients (36.1%). Disease related parameters, including disease duration, disease activity, comorbidity burden, skin and other organ involvement (lung, gastrointestinal) were higher in patients with kinesiophobia (p < 0.05, for all). Patients with kinesiophobia had significantly lower BBS score, slower walking speed, longer TUG duration, and were unable to perform the YBT, compared to those without kinesiophobia (all p < 0.001). In the multivariable regression analysis, (β = − 1.26, CI − 1.59 to − 0.94, p < 0.001) and TUG (β = 1.24, CI 0.04–2.43, p = 0.043) showed to be associated with kinesiophobia severity independently. The multivariable model accounted for 65% of the variance in kinesiophobia (adjusted R² = 0.65). In patients with SSc, static imbalance and decreased mobilization capacity are closely associated with kinesiophobia. Monitoring these parameters should be prioritized for the management of kinesiophobia in patients with SSc.

The online version contains supplementary material available at 10.1007/s00296-026-06072-w.