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The Effect of Mindfulness-Based Cognitive Therapy on Kinesiophobia in Older Adults with Chronic Knee Osteoarthritis:
Zahra Kheirkhah1, Fatemeh Fallahi1, Khadijeh Sharifi1
1Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.
Purpose:
To determine the effect of mindfulness-based cognitive therapy on kinesiophobia in older adults with chronic knee osteoarthritis.
Patients And Methods:
This randomized clinical trial conducted among 56 older patients with knee osteoarthritis at health centers in Kashan, Iran, in 2024. Participants were selected via consecutive sampling and randomly assigned to either an intervention (n = 28) or a control (n = 28) group using block randomization. The intervention group participated in eight 90 minute sessions of Mindfulness Based Cognitive Therapy, while the control group received routine care. Kinesiophobia was measured with the Tampa Scale for Kinesiophobia (TSK11) at baseline, week 4 (immediately post intervention), and week 8 (four week follow up). Covariate adjusted repeated measures ANCOVA was performed, adjusting for age, number of children, and baseline pain intensity. Statistical significance was set at p < 0.05. All participants completed follow up.
Results:
The mean kinesiophobia score decreased from 29.46 ± 3.81 at baseline to 25.68 ± 3.22 at week 8 in the intervention group and from 28.64 ± 4.78 to 26.68 ± 5.15 in the control group. The adjusted repeated-measures analysis showed a significant group-by-time interaction (Wilks' Λ = 0.88, F(2.50) = 3.34, p = 0.040, ηp2 = 0.11), indicating different trajectories of change between groups. However, adjusted between-group differences were not statistically significant at baseline, week 4, or week 8 (all p > 0.05). The adjusted difference in change from baseline to week 8 was -1.60 points (95% CI -3.25 to 0.05; p = 0.05). Within-group Bonferroni-adjusted comparisons showed significant reductions across all time intervals in the intervention group (all p < 0.001) and from baseline to week 4 and week 8 in the control group (p = 0.0022 and p = 0.0028, respectively), but not between weeks 4 and 8 (p = 0.13).
Conclusion:
Four weeks of MBCT may influence the trajectory of kinesiophobia over time in older adults with knee osteoarthritis.
Trial Registration:
Registered in the Iranian Registry of Clinical Trials (IRCT20231105059961N1).