Association of Kinesiophobia with Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings

Banu Çiçek Doğan; Ali Faruk Özyaşar; Süleyman Kasar; Ezgi Vural; Ömer Doğan

doi:10.56766/ntms.1904031

Association of Kinesiophobia with Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings

Abstract

Objective: To determine whether kinesiophobia independently predicts stroke-specific health-related quality of life (HRQoL) in patients with mild acute stroke and to explore its association with amygdala volumetry. Methods: This cross-sectional study included 26 patients aged 25–70 years with ischemic stroke and Modified Rankin Scale (mRS) ≤2. Kinesiophobia was assessed using the Tampa Kinesiophobia Scale (TKS). Pain intensity was measured with the Visual Analog Scale (VAS), depressive symptoms with the Beck Depression Inventory (BDI), anxiety with the Beck Anxiety Inventory (BAI), and HRQoL with the Stroke-Specific Quality of Life Scale (SSQOL). Amygdala volumes were obtained from T1-weighted MRI images using automated volBrain segmentation. Spearman correlation and multiple linear regression analyses were performed. Results: Kinesiophobia showed a moderate negative correlation with SSQOL (r =-0.56, p = 0.003). In multivariable regression analysis, both kinesiophobia (β =-0.41, 95% CI: -0.07 to -0.01, p = 0.021) and functional disability (mRS; β =-0.52, p = 0.004) independently predicted HRQoL. The model explained 48% of the variance in SSQOL (Adjusted R² = 0.48) with a large effect size (Cohen’s f² = 0.92). In hierarchical regression analysis, kinesiophobia remained an independent predictor even after controlling for mood variables (ΔR² = 0.029, p = 0.018). Conclusion: Kinesiophobia is an independent and clinically meaningful determinant of stroke-specific quality of life in patients with mild acute stroke. Movement-related fear may represent a modifiable psychological barrier in rehabilitation. Structural amygdala volumetry was not associated with kinesiophobia, highlighting the need for future functional neuroimaging studies.

Keywords

Supporting Institution

This study was supported by Bayburt State Hospital and Karadeniz Technical University Faculty of Medicine through institutional infrastructure and administrative facilitation. No external funding was received.

Ethical Statement

This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Scientific Research Ethics Committee of Karadeniz Technical University Faculty of Medicine (Protocol No: 2021/332). Written informed consent was obtained from all participants prior to enrollment. Participant confidentiality was maintained, and all data were analyzed anonymously. MRI data were obtained retrospectively from hospital records, and all identifiers were removed before analysis.

Thanks

The authors thank all patients who voluntarily participated in this study. We also thank the staff of the Bayburt State Hospital Neurology and Radiology departments for their assistance in facilitating access to clinical and MRI data required for the analyses.

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Details

Primary Language

English

Subjects

Anatomy

Journal Section

Research Article

Authors

Banu Çiçek Doğan
0000-0001-5690-0188
Türkiye

Ali Faruk Özyaşar ^*
0000-0002-5396-9486
Türkiye

Süleyman Kasar
0000-0002-8650-3033
Türkiye

Ezgi Vural
0000-0002-6853-1495
Türkiye

Ömer Doğan
0000-0002-2334-520X
Türkiye

Publication Date

October 29, 2026

Submission Date

March 8, 2026

Acceptance Date

July 24, 2026

Published in Issue

Year 2026 Volume: 7 Number: 3

DOI

https://doi.org/10.56766/ntms.1904031

IZ

https://izlik.org/JA69XU83FB

Cite

RIS / Bibtex

APA

Çiçek Doğan, B., Özyaşar, A. F., Kasar, S., Vural, E., & Doğan, Ö. (2026). Association of Kinesiophobia with Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings. New Trends in Medicine Sciences, 7(3), 72-80. https://doi.org/10.56766/ntms.1904031

AMA

1.Çiçek Doğan B, Özyaşar AF, Kasar S, Vural E, Doğan Ö. Association of Kinesiophobia with Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings. New Trend Med Sci. 2026;7(3):72-80. doi:10.56766/ntms.1904031

Chicago

Çiçek Doğan, Banu, Ali Faruk Özyaşar, Süleyman Kasar, Ezgi Vural, and Ömer Doğan. 2026. “Association of Kinesiophobia With Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings”. New Trends in Medicine Sciences 7 (3): 72-80. https://doi.org/10.56766/ntms.1904031.

EndNote

Çiçek Doğan B, Özyaşar AF, Kasar S, Vural E, Doğan Ö (October 1, 2026) Association of Kinesiophobia with Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings. New Trends in Medicine Sciences 7 3 72–80.

IEEE

[1]B. Çiçek Doğan, A. F. Özyaşar, S. Kasar, E. Vural, and Ö. Doğan, “Association of Kinesiophobia with Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings”, New Trend Med Sci, vol. 7, no. 3, pp. 72–80, Oct. 2026, doi: 10.56766/ntms.1904031.

ISNAD

Çiçek Doğan, Banu - Özyaşar, Ali Faruk - Kasar, Süleyman - Vural, Ezgi - Doğan, Ömer. “Association of Kinesiophobia With Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings”. New Trends in Medicine Sciences 7/3 (October 1, 2026): 72-80. https://doi.org/10.56766/ntms.1904031.

JAMA

1.Çiçek Doğan B, Özyaşar AF, Kasar S, Vural E, Doğan Ö. Association of Kinesiophobia with Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings. New Trend Med Sci. 2026;7:72–80.

MLA

Çiçek Doğan, Banu, et al. “Association of Kinesiophobia With Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings”. New Trends in Medicine Sciences, vol. 7, no. 3, Oct. 2026, pp. 72-80, doi:10.56766/ntms.1904031.

Vancouver

1.Banu Çiçek Doğan, Ali Faruk Özyaşar, Süleyman Kasar, Ezgi Vural, Ömer Doğan. Association of Kinesiophobia with Pain, Anxiety, Depression, and Quality of Life in Acute Stroke Patients: An Investigation Using Brain Magnetic Resonance Imaging Findings. New Trend Med Sci. 2026 Oct. 1;7(3):72-80. doi:10.56766/ntms.1904031