Kinesiophobia vs. Task-Specific Fear: Defining Movement-Related Fear in ACL Reconstruction Patients

NCT ID: NCT07190456

Last Updated: 2025-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

21 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-01

Study Completion Date

2026-12-01

Brief Summary

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Kinesiophobia, defined as an excessive and irrational fear of physical movement due to perceived vulnerability to injury, has gained significant attention in clinical and scientific communities. This condition can act as a barrier to physical activity, negatively impacting patients' disability, quality of life, and the implementation of rehabilitation programs. It is particularly prevalent after anterior cruciate ligament reconstruction (ACLR), affecting physical function, return to sport rates, and patient performance.

While the Tampa Scale for Kinesiophobia (TSK) is considered a gold standard for assessing kinesiophobia, recent studies have raised concerns about its validity, especially in ACLR patients. The TSK may not adequately capture fear of specific sports activities, which is more common in ACLR patients than a general phobia of movement. Some researchers argue for an assessment approach similar to that used for pain experiences, emphasizing the subjective nature of fear.

Based on the specific phobia model, assessing kinesiophobia in the presence of a trigger, such as visualizing or confronting the movement associated with the injury, may be more relevant. This approach is supported by evidence showing that sports situations evoking the greatest fear after ACLR are cutting, jumping, and contact. Further research is needed to investigate alternative methodologies for assessing fear of movement in ACLR patients, considering the prevalence and repercussions of kinesiophobia in this population.

The objectives of this study are threefold:

* To compare the magnitude of kinesiophobia through the TSK, the subjective feeling of fear when visualising feared movements, and the subjective feeling of fear in anticipation of the feared situation.
* Evaluate the impact of focusing on feared activities on motor behavior and Autonomic Nervous System (ANS) markers.
* To assess the relation between the three methods of assessing fear of movement and indicators of motor behaviour, ANS activity, fear-avoidance beliefs, anxiety, avoidance behaviour, and physical function.

Detailed Description

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Conditions

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ACL Reconstruction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Neutral images

The patient will have to walk on a treadmill at their preferential walking speed for 10 minutes while visualizing neutral images (landscapes, monuments...)

Group Type SHAM_COMPARATOR

Exposure to neutral images visualization

Intervention Type OTHER

The patient will have to walk on a treadmill at their preferential walking speed for 10 minutes while visualizing neutral images (landscapes, monuments...)

Nocive images

The patient will have to walk on a treadmill at their preferential walking speed for 10 minutes while visualizing images interpreted as nocive (cutting, jumping, contact...)

Group Type EXPERIMENTAL

Exposure to nocive images visualisation

Intervention Type OTHER

The patient will have to walk on a treadmill at their preferential walking speed for 10 minutes while visualizing images interpreted as nocive (cutting, jumping, contact...)

Antecipation feared movement

Before the start of the experimental condition, the patient will be asked to think about their willingness to perform the first movement visualised in the video, while a researcher places a jumping platform inside the laboratory.

During the test, the patient will have to walk on a treadmill at their preferred speed for 10 minutes, while watching a video showing a drop jump followed by images interpreted as nocive for the rest of the time.

Group Type EXPERIMENTAL

Exposure to anticipated realisation of a feared movement

Intervention Type OTHER

Before the start of the experimental condition, the patient will be asked to think about their willingness to perform the first movement visualised in the video, while a researcher places a jumping platform inside the laboratory. During the test, the patient will have to walk on a treadmill at their preferred speed for 10 minutes, while watching a video showing a drop jump followed by images interpreted as nocive for the rest of the time.

Interventions

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Exposure to neutral images visualization

The patient will have to walk on a treadmill at their preferential walking speed for 10 minutes while visualizing neutral images (landscapes, monuments...)

Intervention Type OTHER

Exposure to nocive images visualisation

The patient will have to walk on a treadmill at their preferential walking speed for 10 minutes while visualizing images interpreted as nocive (cutting, jumping, contact...)

Intervention Type OTHER

Exposure to anticipated realisation of a feared movement

Before the start of the experimental condition, the patient will be asked to think about their willingness to perform the first movement visualised in the video, while a researcher places a jumping platform inside the laboratory. During the test, the patient will have to walk on a treadmill at their preferred speed for 10 minutes, while watching a video showing a drop jump followed by images interpreted as nocive for the rest of the time.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* The patient must have given their informed consent and signed the consent form.
* The patient must have enough comprehension of the Portuguese language to complete the written questionnaires.
* The patient must have suffered an ACL injury, with or without a history of concomitant meniscal pathology, while playing or training for sport (recreational or organized).
* The patient must have undergone anterior cruciate ligament reconstruction surgery.
* The patient must be between 18 and 35 years old.
* The patient must still be under medical care/rehabilitation due to the ACL injury.
* The patient must have started jump landing tasks.

Exclusion Criteria

* The subject has a history of repeated ACLR.
* The subject has not injured the ACL while playing sports.
* The subject presents a concurrent psychiatric disorder
* The subject has a history of heart disease and/or peripheral vascular disease and/or metabolic disease and/or Raynaud´s Syndrome.
* The subject is taking any medications known to affect heart rate or blood pressure
* The subject is currently a smoker.
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Egas Moniz - Cooperativa de Ensino Superior, CRL

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Clínica de Fisioterapia Egas Moniz

Caparica, Almada, Portugal

Site Status RECRUITING

Egas Moniz School of Health & Science

Almada, Monte Da Caparica, Portugal

Site Status RECRUITING

Countries

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Portugal

Central Contacts

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Vanessa B Alpalhão, MSc

Role: CONTACT

965844339 ext. +351

João R. Vaz, PhD

Role: CONTACT

967096444 ext. +351

Facility Contacts

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João R. Vaz, PhD

Role: primary

(+351) 21 294 68 80

Vanessa B. Alpalhão, Msc

Role: backup

+351 965844339

João R. Vaz, PhD

Role: primary

967096444 ext. +351

Other Identifiers

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1476

Identifier Type: -

Identifier Source: org_study_id