Physiotherapy Department, Convalesce Unit, CVP, Vila Viçosa, Portugal.
Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.
J Geriatr Phys Ther. 2022;45(4):207-214. doi: 10.1519/JPT.0000000000000354. Epub 2022 Aug 5.
In light of the fear avoidance model, kinesiophobia and fear avoidance (FA) can lead to physical inactivity and disability. Previous studies regarding kinesiophobia and FA in older adults have reported conflicting results. The purpose of this review was to identify the reported constructs and assessment instruments used in published studies on kinesiophobia and FA in older adults and to verify the alignment between the instruments used and the constructs under study.
Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 statement (PRISMA-2020), 4 databases were searched from January 2005 to March 2020. All study types, except qualitative, were eligible for inclusion. The participants were 65 years and older. Studies were excluded in the absence of sufficient data on participant age. Study characteristics, constructs related to kinesiophobia, fear and/or avoidance, and instruments used were extracted independently by 2 reviewers.
Fourteen articles were selected for inclusion in the study, in which 7 constructs were identified. The most reported constructs were "fear avoidance beliefs" (FAB) (50%; n = 7), "kinesiophobia" (35.7%; n = 5), and "fear of falling" (14.3%; n = 2). The remaining constructs were only approached, each in 7.1% (n = 1) of the included studies. Seven instruments were used to assess the constructs. The Fear Avoidance Beliefs Questionnaire (FABQ) was the most used instrument (n = 3) to evaluate "FAB," and the Tampa Scale for Kinesiophobia-11 (TSK-11) was the most reported (n = 3) to assess "kinesiophobia."
This review identified a large diversity in the constructs and instruments used to study kinesiophobia and FA among older adults. Some constructs are used interchangeably although they do not share the same conceptual definition. There is poor standardization in the use of assessment tools in accordance with the construct under study. Clinical evaluation and study results can be biased owing to this ambiguity.
根据恐惧回避模型，运动恐惧症和恐惧回避（FA）会导致身体活动减少和残疾。先前关于老年人运动恐惧症和 FA 的研究结果相互矛盾。本综述的目的是确定已发表的关于老年人运动恐惧症和 FA 的研究中报告的结构和评估工具，并验证所使用的工具与研究结构之间的一致性。
根据 2020 年系统评价和荟萃分析的首选报告项目（PRISMA-2020）声明，从 2005 年 1 月至 2020 年 3 月检索了 4 个数据库。除定性研究外，所有研究类型均符合纳入标准。参与者年龄为 65 岁及以上。如果缺乏足够的参与者年龄数据，则将研究排除在外。由 2 名审查员独立提取研究特征、与运动恐惧症、恐惧和/或回避相关的结构以及使用的工具。
纳入了 14 篇研究文章，其中确定了 7 个结构。报告最多的结构是“恐惧回避信念”（FAB）（50%；n=7）、“运动恐惧症”（35.7%；n=5）和“恐摔”（14.3%；n=2）。其余结构仅在 7.1%（n=1）的纳入研究中得到探讨。使用了 7 种工具来评估结构。恐惧回避信念问卷（FABQ）是评估“FAB”最常用的工具（n=3），而坦帕运动恐惧症量表-11（TSK-11）是报告最多的（n=3）评估“运动恐惧症”的工具。
本综述发现，老年人运动恐惧症和 FA 的研究中，所使用的结构和工具存在很大的多样性。尽管某些结构具有相同的概念定义，但它们是可互换使用的。根据研究结构，评估工具的使用缺乏标准化。由于这种模糊性，临床评估和研究结果可能会产生偏差。
