Kinesiophobia in Multiple Sclerosis: Associations with Age, Anxiety, and Physical Activity

BACKGROUND Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system characterized by inflammation, demyelination, gliosis, and neuroaxonal loss. This study aimed to evaluate the factors associated with kinesiophobia (fear of movement) in multiple sclerosis patients, including disability, fatigue, anxiety, depression, physical activity, and quality of life. MATERIAL AND METHODS A cross-sectional study was conducted in Prešov between March 2021 and March 2024 enrolling 148 patients with MS (105 women and 43 men; mean age 42.21±9.84 years; range 21-71). Disability was assessed using the Expanded Disability Status Scale (EDSS) (median [IQR] 4.00 [2.50]; range 1-6). Kinesiophobia was measured using the Tampa Scale for Kinesiophobia, physical activity with the Godin Leisure-Time Exercise Questionnaire, and health-related quality of life with the Short Form-36 Health Survey. Fatigue was evaluated using the Modified Fatigue Impact Scale, while depressive and anxiety symptoms were assessed using the Zung Self-Rating Depression Scale and the Beck Anxiety Inventory. RESULTS In the final adjusted model, higher anxiety levels (ß=0.252, 95% CI: 0.053 to 0.331), lower physical activity (ß=-0.353, 95% CI: -0.208 to -0.086), and older age (ß=0.205, 95% CI: 0.022 to 0.258) emerged as significant independent predictors of kinesiophobia in MS patients. CONCLUSIONS These findings highlight kinesiophobia as a clinically relevant problem in MS. Its severity is strongly influenced by anxiety, as well as reduced physical activity and older age, underscoring the need for integrated behavioral and rehabilitative approaches.