Incidence and Risk Factors of Kinesiophobia in Children Following Fracture Surgery: A Prospective Cohort Study

Dan Xiao^1,2,3Lanxing Li^1,3Xin Lin^1,3Haisu Li^3,4*Xiaoping Jiang^1,3*

• ¹Nursing Department, Children’s Hospital of Chongqing Medical University, Chongqing, China
• ²Department of orthopedics, Children’s Hospital of Chongqing Medical University, Chongqing, China
• ³Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, China
• ⁴Department of Anesthesiology, Children‘s Hospital of Chongqing Medical University, Chongqing, China

Kinesiophobia following pediatric fracture surgery may adversely affect rehabilitation outcomes. This prospective cohort study therefore investigated the incidence and risk factors of kinesiophobia among 176 children aged 7-15 years who underwent fracture treatment at a tertiary hospital between November 2023 and June 2024. Data were collected using the General Information Questionnaire, Tampa Scale for Kinesiophobia (TSK-11), Pain Rating Scale, and Eysenck Personality Questionnaire (EPQ) to assess demographic characteristics, personality traits, family background, postoperative pain levels, and kinesiophobia incidence, followed by univariate intergroup comparisons and logistic regression analysis. Results showed that the incidence of kinesiophobia in school-aged children after fracture surgery was 59.7% (105/176), with multivariate analysis identifying male gender [2.75 (1.23– 6.15), OR (95% CI), p = 0.014], previous fracture history [6.62 (1.41–31.12), p = 0.017], moderate [4.82 (1.19 – 19.44), p = 0.027] and severe [5.14 (1.13 – 23.37), p = 0.034] postoperative pain, and neurotic personality traits [1.12 (1.04–1.22), p = 0.004] as significant risk factors for postoperative kinesiophobia. Given the high incidence of kinesiophobia in school-aged children after fracture surgery, healthcare providers should enhance early screening and implement targeted interventions for risk factors to mitigate its impact on recovery.