Frequency of kinesiophobia in Parkinson's disease; its impact on quality of life, balance and emotional status

Objective: The aim of this study is to determine the prevalence of kinesiophobia in individuals with Parkinson's disease and to examine its effects on balance, quality of life, and emotional state. It is well known that both motor and non-motor symptoms of Parkinson's disease negatively impact patients' daily activities. Kinesiophobia is a significant psychological condition, particularly associated with symptoms like fear of falling and movement restriction in these individuals. In this context, the research aims to analyze the effects of kinesiophobia on balance and motor skills in Parkinson's patients, as well as its impact on their quality of life and emotional state. Additionally, understanding the potential relationship between kinesiophobia and other parameters based on the stages of Parkinson's disease will contribute to developing new approaches to treatment processes. Ultimately, this study aims to examine kinesiophobia, a factor influencing the management of Parkinson's disease, in more detail and to contribute to the development of early intervention strategies for this condition. Methods: A total of 42 patients aged 50–80 who met the inclusion and exclusion criteria were recruited from the Physical Medicine and Rehabilitation and Neurology outpatient clinics of Dicle University Faculty of Medicine between March 2024 and August 2024. The control group consisted of 42 volunteers aged 50–80. Demographic information of both the patient and control groups was recorded. Balance was assessed using the Berg Balance Scale (BBS), emotional state using the Hospital Anxiety and Depression Scale (HADS), and quality of life using the Short Form-36 (SF-36) questionnaire. Kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia (TSK). In the patient group, the Hoehn-Yahr staging was used to determine the stage of Parkinson's disease, and the severity of motor symptoms was assessed using Part III of the Unified Parkinson's Disease Rating Scale (UPDRS-III). Results: In the patient group, 40,5% were female, and 59,5% were male, while in the control group, 47,6% were female, and 52,4% were male, with no significant difference between them (p=0.510). The mean age of the patient group was 65.4±7.6 years, while the control group's mean age was 65.0±7.8 years, with no statistical difference observed (p=0.832). Kinesiophobia, balance, quality of life, depression, and anxiety outcomes were significantly worse in the patient group compared to the control group, and this difference was statistically significant. The mean UPDRS-III score in the patient group was 46.4±26.5, indicating moderate motor impairment. A strong positive correlation was found between UPDRS-III and HADS-D scores and TSK in the patient group. A moderate positive correlation was identified between TSK and HADS-A, disease duration, and age. A strong negative correlation was observed between BBS and TSK, and a moderate negative correlation was noted between the eight subdomains of SF-36 and TSK. Regression analysis revealed that depression was the most influential factor affecting kinesiophobia in Parkinson's patients. Conclusion: The findings of this study demonstrate that kinesiophobia is more prevalent in individuals with Parkinson's disease compared to the general population and is an important factor in disease management. Kinesiophobia was found to have significant effects on balance, quality of life, and emotional state. Additionally, it was observed that this condition varies according to the stage of the disease. The results indicate that early detection and intervention for kinesiophobia in Parkinson's patients can contribute significantly to both disease management and improved quality of life.