Association of Kinesiophobia with Functional Independence in Post-Operative Breast Cancer Patients

Abstract

Background: Post-operative breast cancer patients often experience long-term upper limb dysfunction and reduced quality of life due to pain, fatigue, and fear of movement, known as kinesiophobia. While physical limitations are well-documented, the psychological barrier of kinesiophobia and its impact on functional independence remains underexplored, particularly in low-resource settings. Objective: To evaluate the association between kinesiophobia and functional independence in post-operative breast cancer patients using validated clinical assessment tools, and to determine whether fear of movement significantly impairs daily functional capabilities. Methods: This analytical cross-sectional study included 301 female patients aged 18–60 years who underwent primary breast cancer surgery at least three months prior. Participants were recruited through non-probability convenience sampling from four tertiary hospitals in Pakistan. Inclusion criteria encompassed stages I–III breast cancer, while patients with comorbid neurological, psychiatric, or musculoskeletal conditions were excluded. Kinesiophobia was measured using the Tampa Scale for Kinesiophobia, and functional independence was assessed via the Functional Independence Measure (FIM). Ethical approval was obtained from the University of South Asia (Ref: USA/FAHS/2023/796), adhering to the Declaration of Helsinki. Data were analyzed using SPSS v26, and the Chi-square test was employed to assess statistical associations. Results: A significant inverse relationship was observed between kinesiophobia and functional independence (p < 0.001). Among young adults (n = 121), 73.9% of patients with mild kinesiophobia were completely independent, whereas 55.2% with severe kinesiophobia required moderate or complete assistance. Middle adults (n = 180) demonstrated similar patterns, with 74.4% of patients with severe kinesiophobia requiring support in ADLs. The findings suggest a clinically relevant trend where higher fear of movement correlates with decreased functional autonomy. Conclusion: Kinesiophobia is significantly associated with impaired functional independence in post-operative breast cancer patients. Early identification and intervention targeting fear of movement may enhance recovery, reduce long-term disability, and improve quality of life. Integrating psychological screening and tailored physiotherapy into survivorship care is essential for holistic rehabilitation.