Kinesiophobia, Fear of Falling, Functional Independence, and Psychological Status in Spinal Cord Injury

N/ANot Yet RecruitingNCT07549217

Istanbul Physical Medicine Rehabilitation Training and Research Hospital70 enrolled

Overview

Individuals aged 18-65 years who have been clinically diagnosed with spinal cord injury and have developed paraplegia will be included in the study. Demographic and clinical data of the participants, including age, sex, height, weight, etiology of injury, level of injury, duration of injury, and comorbidities, will be recorded. In addition, disease-specific characteristics such as ambulation status, wheelchair use, presence of incontinence, and presence and severity of pain will be assessed. Kinesiophobia levels of the patients will be evaluated using the Tampa Scale for Kinesiophobia (TSK). Functional independence will be assessed using the Spinal Cord Independence Measure-III Self-Report (SCIM-III SR). Fall-related concerns will be evaluated using the Spinal Cord Injury-Falls Concern Scale (SCI-FCS). Pain severity will be assessed using the Visual Analog Scale (VAS), and the presence of neuropathic pain will be evaluated using the DN4 Neuropathic Pain Questionnaire. Symptoms related to anxiety and depression will be assessed using the Hospital Anxiety and Depression Scale (HADS). All assessments will be conducted through face-to-face interviews. The collected data will be analyzed to investigate the relationship between kinesiophobia and functional independence, fear of falling, pain, and psychological status in individuals with paraplegic spinal cord injury. Validated Turkish versions of all scales used in the study will be employed.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Spinal Cord Injuries

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged between 18 and 65 years * Clinically diagnosed with spinal cord injury * Presence of paraplegia * Injury duration of at least 3 months (to exclude acute phase effects) * Medically stable condition * Ability to understand and respond to questionnaires * Willingness to participate and provide written informed consent Exclusion Criteria: * Tetraplegia or other neurological conditions affecting motor function * Severe cognitive impairment or psychiatric disorders that may interfere with assessments * Presence of active infection, malignancy, or severe systemic disease * Severe visual or hearing impairment preventing participation in assessments * Current participation in another interventional clinical study * Recent surgery or acute medical condition within the last 3 months * Incomplete clinical data or inability to complete questionnaires

Outcomes

Primary Outcomes

Tampa Scale for Kinesiophobia (TSK)

The TSK is a self-reported questionnaire used to assess fear of movement/re-injury. It consists of 17 items scored on a 4-point Likert scale, with total scores ranging from 17 to 68. Higher scores indicate greater kinesiophobia.

Time frame: Baseline

Secondary Outcomes

Spinal Cord Independence Measure-III Self-Report (SCIM-III SR)

The SCIM-III SR evaluates functional independence in individuals with spinal cord injury. It includes domains such as self-care, respiration and sphincter management, and mobility. Total scores range from 0 to 100, with higher scores indicating greater independence.

Time frame: Baseline

Spinal Cord Injury-Falls Concern Scale (SCI-FCS)

The SCI-FCS assesses concerns about falling during daily activities in individuals with spinal cord injury. Higher scores indicate greater fear of falling.

Time frame: Baseline

Visual Analog Scale (VAS)

Pain intensity is measured using a 10-cm visual analog scale, where 0 indicates no pain and 10 indicates the worst imaginable pain.

Time frame: Baseline

DN4 Neuropathic Pain Questionnaire

The DN4 questionnaire is used to identify neuropathic pain. A score of ≥4 suggests the presence of neuropathic pain.

Time frame: Baseline

Hospital Anxiety and Depression Scale - Anxiety Subscale (HADS-A)

The HADS-A subscale consists of 7 items assessing anxiety symptoms. Scores range from 0 to 21, with higher scores indicating greater anxiety levels.

Time frame: Baseline

Hospital Anxiety and Depression Scale - Depression Subscale (HADS-D)

The HADS-D subscale consists of 7 items assessing depressive symptoms. Scores range from 0 to 21, with higher scores indicating greater depression levels.

Time frame: Baseline