Post-discharge kinesiophobia trajectories and rehabilitation outcomes in post-stroke hemiplegia.
BackgroundMethodsResultsConclusionsKinesiophobia may reduce participation in post-stroke rehabilitation and impede functional recovery, but its course after discharge and its clinical significance remain unclear. This study identified 6-month trajectories of kinesiophobia in patients with post-strok...
| Publicado en: | Physiotherapy Theory & Practice pp. 1 - 16 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Taylor & Francis Ltd
Jul2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195741484&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195741484 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09593985 BCJ jtl: Physiotherapy Theory & Practice issn: 09593985 maglogo: Y pubinfo: dt: Jul2026 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 195741484 10.1080/09593985.2026.2708226 195741484 ppf: 1 ppct: 15 formats: fmt: @attributes: type: P tig: atl: Post-discharge kinesiophobia trajectories and rehabilitation outcomes in post-stroke hemiplegia. aug: au: Ge, Hongjin Zhang, Xinyu Chen, Wei Zhang, Jiayi He, Xiaoyang Li, Haiyue Wang, Yafei Chen, Peng Zheng, Xinying Jia, Rufu affil: North China University of Science and Technology sug: ab: BackgroundMethodsResultsConclusionsKinesiophobia may reduce participation in post-stroke rehabilitation and impede functional recovery, but its course after discharge and its clinical significance remain unclear. This study identified 6-month trajectories of kinesiophobia in patients with post-stroke hemiplegia and examined their associations with motor recovery and rehabilitation exercise adherence.In this single-center prospective longitudinal study, 296 patients with post-stroke hemiplegia were assessed at discharge and at 1, 3, and 6 months after discharge. Baseline discharge assessment occurred a mean of 18.7 ± 5.8 days after stroke onset, so the follow-up window captured both early subacute and later community recovery phases. Kinesiophobia was measured with the validated Chinese Tampa Scale for Kinesiophobia (TSK-17), motor recovery with the Fugl-Meyer Assessment (FMA), and rehabilitation exercise adherence with the validated Chinese Engagement in Exercise Rehabilitation Scale for Patients with Stroke (EERS), assessed from month 1 onward. Self-report measures could be completed by standardized face-to-face or telephone interview when outpatient attendance was not possible, whereas FMA was assessed only by trained raters during outpatient or home-based in-person visits. Kinesiophobia trajectories were identified using latent class growth analysis. Associations with repeated FMA and EERS outcomes were analyzed using adjusted linear mixed-effects models, and baseline predictors of trajectory membership were examined with a bias-adjusted three-step multinomial logistic model.A three-class solution showed the best fit: persistent-low (138/296, 46.6%), decreasing-moderate (112/296, 37.8%), and persistent-high (46/296, 15.5%). Trajectory membership was significantly associated with both motor recovery and rehabilitation exercise adherence over time (time-by-class interaction, both <italic>p</italic> <.001). At 6 months, adjusted mean FMA scores were 74.2, 65.9, and 50.6 across the three classes, and corresponding EERS scores were 70.5, 66.8, and 55.8. Compared with the persistent-low class, the persistent-high class had markedly poorer motor recovery (mean difference, 23.6 points; 95% CI, 19.2–28.0) and lower exercise adherence (mean difference, 14.7 points; 95% CI, 10.8–18.6), while the decreasing-moderate class showed intermediate deficits. Older age, history of falls, higher anxiety and depression, and lower exercise self-efficacy independently predicted unfavorable trajectories.Post-discharge kinesiophobia follows heterogeneous trajectories in patients with post-stroke hemiplegia. Persistently high kinesiophobia identifies a vulnerable subgroup with poorer motor recovery and lower rehabilitation exercise adherence. Early screening and targeted support may improve post-discharge rehabilitation outcomes. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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