Kinesiophobia is associated with symptom severity and worse function in women with Carpal Tunnel Syndrome

Authors

  • Darlisson Bueno Paranhos Federal University of Triângulo Mineiro image/svg+xml https://orcid.org/0000-0002-0979-8966
  • Victor Hermon Lameira Braga Federal University of Triângulo Mineiro image/svg+xml
  • Bruna Roberta Tavares Araújo Mário Palmério Hospital Universitário
  • Flavio Romão Silva de Oliveira Mário Palmério Hospital Universitário https://orcid.org/0009-0003-9544-8894
  • Silvio Alexandre Doná Mário Palmério Hospital Universitário
  • Luciane Fernanda Rodrigues Martinho Fernandes Federal University of Triângulo Mineiro image/svg+xml

DOI:

https://doi.org/10.11606/issn.2317-0190.v33e242558

Keywords:

Kinesiophobia, Pain, Cognition, Carpal Tunnel Syndrome

Abstract

Objective: This study aimed to determine whether there is an association between kinesiophobia and pain, function, and grip strength in women diagnosed with carpal tunnel syndrome (CTS). Methods: This was a cross-sectional study with a sample of 26 women. The instruments used included the Tampa Scale for Kinesiophobia (TSK), the Boston Carpal Tunnel Questionnaire (BCTQ), the Patient-Rated Wrist Evaluation (PRWE), and a Jamar dynamometer to assess grip strength. Results: The sample consisted predominantly of middle-aged women (52.2 ± 9.4 years) and those with bilateral CTS (65.4%). There was a significant association between TSK scores and BCTQ Symptom Severity (r= 0.466; p < 0.016) and BCTQ Functional Status (r= 0.429; p < 0.029). Conclusion: Kinesiophobia was more strongly associated with symptom severity and function as measured by the BCTQ. These findings reinforce the importance of including the assessment of psychosocial factors in the clinical management of CTS, contributing to more effective and individualized therapeutic strategies.

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References

Nora DB, Becker J, Ehlers JA, Gomes I. What symptoms are truly caused by median nerve compression in carpal tunnel syndrome? Clin Neurophysiol. 2005;116(2):275-83. Doi: https://doi.org/10.1016/j.clinph.2004.08.013

Dale AM, Harris-Adamson C, Rempel D, Gerr F, Hegmann K, Silverstein B, et al. Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. Scand J Work Environ Health. 2013;39(5):495-505. Doi: https://doi.org/10.5271/sjweh.3351

Nazari G, Shah N, MacDermid JC, Woodhouse L. The Impact of Sensory, Motor and Pain Impairments on Patient- Report-ed and Performance Based Function in Carpal Tunnel Syn-drome. Open Orthop J. 2017;11:1258-1267. Doi: https://doi.org/10.2174/1874325001711011258

Ghasemi-Rad M, Nosair E, Vegh A, Mohammadi A, Akkad A, Lesha E, et al. A handy review of carpal tunnel syndrome: From anatomy to diagnosis and treatment. World J Radiol. 2014;6(6):284-300. Doi: https://doi.org/https://doi.org/10.4329/wjr.v6.i6.284

Bickel KD. Carpal tunnel syndrome. J Hand Surg Am. 2010;35(1):147-52. Doi: https://doi.org/10.1016/j.jhsa.2009.11.003

Campos CC, Manzano GM, Andrade LB, Castelo Filho A, Nóbrega JAM. Tradução e validação do questionário de avaliação de gravidade dos sintomas e do estado funcional na síndrome do túnel do carpo. Arq Neuro-Psiquiatr. 2003;61(1):51-5. Doi: https://doi.org/10.1590/S0004-282X2003000100009

Schulze DG, Nilsen KB, Killingmo RM, Zwart JA, Grotle M. Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel Syndrome. Front Neurol. 2021;12:683807. Doi: https://doi.org/10.3389/fneur.2021.683807

Forcelini CM, Chichelero ER, Oliveira AT, Tres da Silva F, Durigan PHB, Ramos NO, et al. Boston Carpal Tunnel Questionnaire and Severity of Carpal Tunnel Syndrome. J Clin Neuromuscul Dis. 2022;23(4):183-188. Doi: https://doi.org/10.1097/CND.0000000000000409

Sarilar AÇ, Gök DK. Value of Boston Questionnaire in Carpal Tunnel Syndrome. Neurol Sci Neurophys. 2021;38(4):245-249. Doi: https://doi.org/10.4103/nsn.nsn_82_21

Sarhan FMA, Al-Jasim A, Abu Al-Halawa D, Dukmak ON, Ayyad R, Odeh MA. The applicability of Boston Carpal Tunnel Questionnaire as a screening tool for carpal tunnel syndrome among potential high-risk female population in the West Bank: a cross-sectional study. Ann Med Surg (Lond). 2023;85(4):650-654. Doi: https://doi.org/10.1097/MS9.0000000000000026

MacDermid JC. Development of a scale for patient rating of wrist pain and disability. J Hand Ther. 1996;9(2):178-83. Doi: https://doi.org/10.1016/s0894-1130(96)80076-7

Hudak PL, Amadio PC, Bombardier C, Beaton D, Cole D, Davis A, et al. Development of an upper extremity outcome measure: The DASH (disabilities of the arm, shoulder, and head). Am J Ind Med. 1996;29(6):602-608.

Atroshi I, Lyrén PE, Ornstein E, Gummesson C. The six-item CTS symptoms scale and palmar pain scale in carpal tunnel syndrome. J Hand Surg Am. 2011;36(5):788-94. Doi: https://doi.org/10.1016/j.jhsa.2011.02.021

Miller RP, Kori SH, Todd DD. The Tampa Scale: A Measure of Kinisophobia. Clin J Pain. 1991;7(1):51.

Tseli E, Boersma K, Stålnacke BM, Enthoven P, Gerdle B, Äng BO, et al. Prognostic Factors for Physical Functioning After Multidisciplinary Rehabilitation in Patients With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis. Clin J Pain. 2019;35(2):148-173. Doi: https://doi.org/10.1097/AJP.0000000000000669

Bartlett O, Farnsworth JL. The Influence of Kinesiophobia on Perceived Disability in Patients With an Upper-Extremity Injury: A Critically Appraised Topic. J Sport Rehabil. 2021;30(5):818-823. Doi: https://doi.org/10.1123/jsr.2020-0179

Villalobos-García A, Cruz-Gambero L, Ucero-Lozano R, Valdes K, Cantero-Téllez R. Kinesiophobia and Its Correlation with Upper Limb and Hand Functionality Among Individuals with Wrist/Hand Injury: A Cross-Sectional Study. J Clin Med. 2024;13(24):7604. Doi: https://doi.org/10.3390/jcm13247604

Siqueira FB, Teixeira-Salmela LF, Magalhães LC. Análise das propriedades psicométricas da versão brasileira da escala Tampa de cinesiofobia. Acta Ortop Bras. 2007;15(1):19-24. Doi: https://doi.org/10.1590/S1413-78522007000100004

Silva Rodrigues EK, Cássia Registro Fonseca M, MacDermid JC. Brazilian version of the Patient Rated Wrist Evaluation (PRWE-BR): Cross-cultural adaptation, internal consistency, test-retest reliability and construct validity. J Hand Ther. 2015;28(1):69-75. Doi: https://doi.org/10.1016/j.jht.2014.09.008

Campos CC, Manzano GM, Andrade LB, Castelo Filho A, Nóbrega JAM. Tradução e validação do questionário de avaliação de gravidade dos sintomas e do estado funcional na síndrome do túnel do carpo. Arq Neuro-Psiquiatr. 2003;61(1):51-5. Doi: https://doi.org/10.1590/S0004-282X200300010000

Fess EE, Moran CA. Clinical Assessment Recommendations. Mount Laurel: American Society of Hand Therapists; 1981.

Núñez-Cortés R, Carrasco JJ, Salazar-Méndez J, Torreblanca-Vargas S, Pérez-Alenda S, Calatayud J, et al. Psychological factors are associated with pain extent in patients with carpal tunnel syndrome. Physiother Theory Pract. 2025;41(1):187-196. Doi: https://doi.org/10.1080/09593985.2024.2315251

Erickson M, Lawrence M, Jansen CWS, Coker D, Amadio P, Cleary C. Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome. J Orthop Sports Phys Ther. 2019;49(5):CPG1-CPG85. Doi: https://doi.org/10.2519/jospt.2019.0301

Dale AM, Harris-Adamson C, Rempel D, Gerr F, Hegmann K, Silverstein B, et al. Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. Scand J Work Environ Health. 2013;39(5):495-505. Doi: https://doi.org/10.5271/sjweh.3351

Anandacoomarasamy A, Caterson I, Sambrook P, Fransen M, March L. The impact of obesity on the musculoskeletal system. Int J Obes (Lond). 2008;32(2):211-22. Doi: https://doi.org/10.1038/sj.ijo.0803715

Ghasemi-Rad M, Nosair E, Vegh A, Mohammadi A, Akkad A, Lesha E, et al. A handy review of carpal tunnel syndrome: From anatomy to diagnosis and treatment. World J Radiol. 2014;6(6):284-300. Doi: https://doi.org/10.4329/wjr.v6.i6.284

Mazaheri S, Poorolajal J, Mazaheri A. Sensitivity and speci-ficity of electrodiagnostic parameters in diagnosing carpal tunnel syndrome. Bone Jt Open. 2024;5(10):898-903. Doi: https://doi.org/10.1302/2633-1462.510.BJO-2024-0025.R1

Paiz F, Midroni G, Kassardjian CD. Pain perception during electrodiagnostic studies and the impact of learners. Muscle Nerve. 2022;66(5):621-624. Doi: https://doi.org/10.1002/mus.27712

Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273-1284. Doi: https://doi.org/10.1016/S1474-4422(16)30231-9

Afifi M, Santello M, Johnston JA. Effects of carpal tunnel syndrome on adaptation of multi-digit forces to object texture. Clin Neurophysiol. 2012;123(11):2281-90. Doi: https://doi.org/10.1016/j.clinph.2012.04.013

Nazari G, Shah N, MacDermid JC, Woodhouse L. The Impact of Sensory, Motor and Pain Impairments on Patient Reported and Performance Based Function in Carpal Tunnel Syndrome. Open Orthop J. 2017;11:1258-1267. Doi: https://doi.org/10.2174/1874325001711011258

Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153-8. Doi: https://doi.org/10.1001/jama.282.2.153

Lundberg M, Styf J, Jansson B. On what patients does the Tampa Scale for Kinesiophobia fit? Physiother Theory Pract. 2009;25(7):495-506. Doi: https://doi.org/10.3109/09593980802662160

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Published

2026-02-25

Issue

Vol. 33 (2026)

Section

Original Article

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How to Cite

1.
Paranhos DB, Braga VHL, Roberta Tavares Araújo B, Oliveira FRS de, Alexandre Doná S, Fernandes LFRM. Kinesiophobia is associated with symptom severity and worse function in women with Carpal Tunnel Syndrome. Acta Fisiátr. [Internet]. 2026 Feb. 25 [cited 2026 Aug. 12];33:e242558. Available from: https://revistas.usp.br/actafisiatrica/article/view/242558