Kinesiophobia and alexithymia in knee osteoarthritis: association with radiological severity
Abstract
[p] Background: Pain and disability in knee osteoarthritis (KO) are influenced by both structural and psychosocial factors. However, the roles of kinesiophobia and alexithymia in KO remain poorly understood. Objective: To investigate the relationships among kinesiophobia, alexithymia, and radiographic severity in patients with KO. Methods: In this cross-sectional study, 109 adults with clinically and radiographically confirmed KO were recruited from two tertiary care centers. Demographic and clinical data were also collected. Pain intensity was measured using the Visual Analog Scale (VAS), kinesiophobia with the Tampa Scale of Kinesiophobia (TSK), and alexithymia with the Toronto Alexithymia Scale (TAS). Radiographic severity was graded according to the Kellgren–Lawrence (KL) classification. Correlation and logistic regression analyses were conducted. Results: Kinesiophobia increased significantly with advancing KL stage, whereas total alexithymia scores did not correlate with radiographic severity. However, scores on the TAS subscale for difficulty identifying feelings (TAS-DIF) increased with higher KL stages. Kinesiophobia also correlated with movement-related pain, body mass index, education level, and comorbidity. Alexithymia was associated with movement-related pain, lower education, and female sex. Logistic regression analysis did not identify any variable as a significant independent predictor of alexithymia. Conclusion: Kinesiophobia progresses in parallel with radiological severity, while alexithymia appears to be primarily influenced by psychosocial variables. These findings highlight the importance of integrating psychosocial assessment and interventions—targeting fear of movement and emotional awareness—into comprehensive KO management strategies.