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Updated: Jan 20, 2026

Visualization of Intensity Levels to Reduce the Gap Between Self-Reported and Directly Measured Physical Activity
Published on: March 7, 2019
The relationships between kinesiophobia and clinical outcomes after ACL reconstruction differ by self-reported
Grant E Norte1, Haley Solaas2, Susan A Saliba3
1University of Toledo, School of Exercise and Rehabilitation Sciences, Athletic Training Program, 2801 W. Bancroft St.Health and Human Services 2505H, Mail Stop 119, Toledo, OH, 43606, United States.
Objectives:
To investigate whether relationships between kinesiophobia, lower extremity function, and patient-reported function differ by self-reported physical activity engagement after ACL reconstruction (ACLR).
Design:
Cross-sectional.
Setting:
Laboratory.
Participants:
Seventy-seven patients with a primary, unilateral ACLR.
Main Outcome Measures:
Kinesiophobia (TSK-17) was the primary outcome. Lower extremity function included quadriceps and hamstrings strength, fatigue, and hop performance. Patient-reported function included regional function (IKDC, KOOS subscales) and physical activity engagement (Godin Leisure-Time Exercise). Patients were evaluated together, then stratified by LOW and HIGH physical activity. Correlations and multiple regression analyses identified relationships between kinesiophobia and outcome measures.
Results:
Greater kinesiophobia was associated with lesser hamstrings strength, hop performance, and patient-reported function. Greater hamstrings fatigue and lesser KOOSADL explained greater kinesiophobia in patients reporting LOW physical activity. Lesser triple hop symmetry, crossover hop distance, and IKDC explained greater kinesiophobia in patients reporting HIGH physical activity.
Conclusions:
Greater kinesiophobia associated with worse outcomes after ACLR. Relationships differed by self-reported physical activity engagement. Interventions that improve the ability to perform knee-related activities of daily living may be appropriate to minimize the impact of fear in less active patients, while those targeting hop performance and knee-related sport activities may be better suited for more active patients.
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