Latent profiles of kinesiophobia and associated factors in patients with rheumatoid arthritis: a cross-sectional study

Why clinicians should know about it

• Picked for Rheumatology (paper of the day, 17 August 2026): Latent profiles of kinesiophobia identified in RA patients

Abstract

BACKGROUND: Patients with rheumatoid arthritis (RA) frequently experience kinesiophobia, driven by concerns that movement may worsen pain or cause joint damage. This fear can reduce physical activity and adversely affect functional outcomes. Conventional approaches that classify patients solely based on overall kinesiophobia scores may fail to capture important differences in symptom presentation and behavioral responses. OBJECTIVE: This study aimed to identify distinct latent profiles of kinesiophobia among patients with RA using the Tampa Scale of Kinesiophobia-11 (TSK-11) and to compare subgroup characteristics to inform targeted, individualized intervention strategies. METHODS: A convenience sample of patients with RA was recruited from three tertiary hospitals in Henan Province between May 1 and June 30, 2023. Data collected included demographic characteristics and responses to the Tampa Scale of Kinesiophobia-11 (TSK-11), Brief Pain Inventory-Short Form (BPI-SF), Pain Anxiety Symptoms Scale (PASS), Patient Activation Measure (PAM), Social Support Rating Scale (SSRS), International Physical Activity Questionnaire-Short Form (IPAQ-SF), and WHOQOL-BREF. Latent profile analysis was performed using Mplus 8.0 to identify distinct kinesiophobia profiles, followed by univariate analyses and post hoc comparisons in SPSS 27.0. RESULTS: A total of 604 patients with RA were enrolled, with a mean age of 57.04 ± 12.52 years; 76.8% were female. Four distinct kinesiophobia profiles were identified: Class 1, low cognition-attitude with moderate behavior (13.7%); Class 2, low cognition with high attitude-behavior (18.0%); Class 3, high cognition with high attitude-behavior (60.8%); and Class 4, extremely high cognition-attitude-behavior (7.5%). Significant differences were observed among the profiles in gender, monthly income, disease activity, physical activity, pain intensity, pain interference, quality of life, social support, pain anxiety, and patient activation. Post hoc analyses indicated that Class 4 showed the greatest pain intensity, pain interference, and pain anxiety, along with the highest proportion of low physical activity and the lowest level of social support. Class 1 demonstrated more favorable disease status, quality of life, and social support, while patient activation was significantly higher in Classes 2 and 3 than in Class 1. CONCLUSION: Kinesiophobia among patients with RA is heterogeneous, with distinct profiles differing in sociodemographic, clinical, psychosocial, and self-management characteristics. Latent profile analysis provides a useful approach for identifying cognitive, attitudinal, and behavioral subgroups, facilitating the development of personalized interventions to reduce fear of movement and encourage safe participation in physical activity.

Abstract as published, via PubMed.