Investigation of the Relationship Between Kinesiophobia, Physical Activity Level and Functionality in Young Adults with Pes Planus

Yıl 2026, Cilt: 28 Sayı: 1 , 147 - 154 , 30.04.2026

Muhammed Samed Dalakçı , Büşra Aydın

https://doi.org/10.15314/tsed.1762690

https://izlik.org/JA26CA36HN

Öz

Objective: Pes planus (PP) is a common condition among young adults and is often associated with musculoskeletal pain. Individuals with PP may also exhibit low physical activity levels, reduced functionality, and kinesiophobia. The aim of this study was to investigate the relationship between physical activity level, kinesiophobia, and functionality in young adults aged 18–24 years diagnosed with PP.
Methods: A total of 112 participants were included in the study. Demographic data were recorded. The severity of PP was assessed using the Feiss Line method, physical activity level using the International Physical Activity Questionnaire (IPAQ), kinesiophobia using the Tampa Kinesiophobia Scale, and functionality using the Foot Function Index.
Results: No significant relationship was found between physical activity level and kinesiophobia (p=0.821) or functionality (p=0.057). However, a significant positive relationship was observed between kinesiophobia and loss of functionality (p<0.001).
Conclusion: Although physical activity level was not associated with either kinesiophobia or functionality in young adults with pes planus, increased kinesiophobia was strongly linked to decreased foot function. These findings highlight the importance of targeting fear of movement as a modifiable psychological factor to prevent functional deterioration and improve outcomes in this population.

Anahtar Kelimeler

pes planus , physical activity , kinesiophobia , functionallity

Etik Beyan

I hereby declare that this study is an original work; that I have conducted all stages of the study—preparation, data collection, analysis, and presentation of information—in full compliance with scientific ethical principles and rules; that I have cited all data and information not obtained within the scope of this study and included the corresponding sources in the reference list; that no alterations have been made to the used data; and that I fully accept all terms and conditions of the Committee on Publication Ethics (COPE), adhering strictly to ethical duties and responsibilities. I further declare that if any situation contrary to this statement is detected at any time regarding the study, I willingly accept all moral and legal consequences that may arise.

Pes Planus Tanılı Genç Yetişkinlerde Kinezyofobi, Fiziksel Aktivite Düzeyi ve Fonksiyonellik Arasındaki İlişkinin İncelenmesi

https://izlik.org/JA26CA36HN

Öz

Amaç: Pes planus (PP), genç yetişkinler arasında yaygın bir durumdur ve genellikle kas-iskelet sistemi ağrıları ile ilişkilidir. PP tanısı konan bireylerde düşük fiziksel aktivite düzeyi, azalmış fonksiyonellik ve kinezyofobi (hareket korkusu) da görülebilir. Bu çalışmanın amacı, 18–24 yaş arasındaki genç yetişkinlerde PP tanısı almış bireylerde fiziksel aktivite düzeyi, kinezyofobi ve fonksiyonellik arasındaki ilişkiyi araştırmaktır.

Yöntemler: Çalışmaya toplam 112 katılımcı dahil edilmiştir. Demografik veriler kaydedilmiştir. PP şiddeti Feiss Çizgisi yöntemi ile, fiziksel aktivite düzeyi Uluslararası Fiziksel Aktivite Anketi (IPAQ) ile kinezyofobi Tampa Kinezyofobi Ölçeği ile fonksiyonellik ise Ayak Fonksiyon İndeksi ile değerlendirilmiştir.

Bulgular: Fiziksel aktivite düzeyi ile kinezyofobi (p=0,821) ve fonksiyonellik (p=0,057) arasında anlamlı bir ilişki bulunmamıştır. Ancak kinezyofobi ile fonksiyonellik kaybı arasında anlamlı pozitif bir ilişki gözlenmiştir (p<0,001).

Sonuç: PP tanılı genç yetişkinlerde fiziksel aktivite düzeyinin kinezyofobi ve fonksiyonellikle ilişkili olmamasına rağmen artan kinezyofobinin ayak fonksiyonunda belirgin bir azalmayla güçlü şekilde bağlantılı olduğu görülmüştür. Bu bulgular, hareket korkusunun modifiye edilebilir bir psikolojik faktör olarak hedef alınmasının, fonksiyonel bozuklukları önleme ve bu popülasyondaki sonuçları iyileştirme açısından önemini vurgulamaktadır.

Anahtar Kelimeler

pes planus , fiziksel aktivite , kinezyofobi , fonksiyonellik

Etik Beyan

Bu çalışmanın, özgün bir çalışma olduğunu; çalışmanın hazırlık, veri toplama, analiz ve bilgilerin sunumu olmak üzere tüm aşamalarından bilimsel etik ilke ve kurallarına uygun davrandığımı; bu çalışma kapsamında elde edilmeyen tüm veri ve bilgiler için kaynak gösterdiğimi ve bu kaynaklara kaynakçada yer verdiğimi; kullanılan verilerde herhangi bir değişiklik yapmadığımı, çalışmanın Committee on Publication Ethics (COPE)' in tüm şartlarını ve koşullarını kabul ederek etik görev ve sorumluluklara riayet ettiğimi beyan ederim. Herhangi bir zamanda, çalışmayla ilgili yaptığım bu beyana aykırı bir durumun saptanması durumunda, ortaya çıkacak tüm ahlaki ve hukuki sonuçlara razı olduğumu bildiririm.

Kaynakça

• 1. A R, Malar A, H J, S G. The cause and frequency of PES Planus (Flat Foot) problems among young adults. Asian J Med Sci. 2021;12:107–11. doi:10.3126/ajms.v12i7.35410.
• 2. Aydemir B, Huang CH, Foucher KC. Gait speed and kinesiophobia explain physical activity level in adults with osteoarthritis: A cross- sectional study. J Orthop Res. 2023 Dec;41(12):2629-2637. doi:10.1002/jor.2562.
• 3. Aydoğdu O, Özçelik Y, Güneş G, Çetin M, Hassanzadeh Bakhshkandi J, Sarı Z. Pes Planus Düzeyinin Dorsi ve Plantar Fleksör Kas Kuvveti ile Gastroknemius ve Hamstring Kas Esnekliğine Etkileri. IGUSABDER. 2024;:97–111. https://doi.org/10.38079/igusabder.1336778.
• 4. Baj-Korpak J, Zaworski K, Szymczuk E, Shpakou A. Gender as a determinant of physical activity levels and mental health of medical students from Poland and Belarus in the context of the COVID-19 pandemic. Front Public Health. 2023;11:1192068. doi:10.3389/fpubh.2023.1192068.
• 5. Benca E, Listabarth S, Flock FKJ, Pablik E, Fischer C, Walzer SM, Dorotka R, Windhager R, Ziai P. Analysis of Running-Related Injuries: The Vienna Study. Journal of Clinical Medicine. 2020;9(2):438. https://doi.org/10.3390/jcm9020438.
• 6. Beynnon BD, Murphy DF, Alosa DM. Predictive Factors for Lateral Ankle Sprains: A Literature Review. J Athl Train. 2002 Dec;37(4):376–80. PMID: 12937558.
• 7. Botta AFB, Neogi T, Collins JE, Jafarzadeh SR, Losina E, Katz JN. Patellofemoral pain over time: Protocol for a prospective, longitudinal study investigating physical and non-physical features. Front Sports Act Living. 2022;4:1081943. doi:10.3389/fspor.2022.1081943.
• 8. Budiman-Mak E, Conrad KJ, Roach KE. The Foot Function Index: a measure of foot pain and disability. J Clin Epidemiol. 1991;44(6):561–70. doi:10.1016/0895-4356(91)90220-4.
• 9. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95. doi: 10.1249/01.MSS.0000078924.61453.FB.
• 10. Dunlop DD, Song J, Semanik PA, Sharma L, Chang RW. Physical activity levels and functional performance in the osteoarthritis initiative: a graded relationship. Arthritis Rheum. 2011 Jan;63(1):127-36. doi: 10.1002/art.27760. PMID: 20862681; PMCID: PMC3010474.
• 11. Fallon Verbruggen, F., Marenčáková, J. & Zahálka, F. The relationship of three-dimensional foot morphology to clinical assessments and postural stability in adolescent male footballers. J Foot Ankle Res 16, 50 (2023). https://doi.org/10.1186/s13047-023-00636- w.
• 12. Febriyanti I, Setijono H, Wijaya FJM, Kusuma IDMAW. Foot health and physical fitness: investigating the interplay among flat feet, body balance, and performance in junior high school students. Pedagog Phys Cult Sport. 2024 Jun;28(3):168–74. doi:10.15561/26649837.2024.0301.
• 13. Haughton McNeill L, Wyrwich KW, Brownson RC, Clark EM, Kreuter MW. Individual, social environmental, and physical environmental influences on physical activity among black and white adults: A Structural Equation Analysis. Ann Behav Med. 2006 Feb;31(1):36–44. doi:10.1207/s15324796abm3101_7.
• 14. He Y, Verleyen M, Callewaert B, Burssens A, Audenaert E. Unraveling the Genetic Landscape of Foot Arch Morphology: A Systematic Review of Single Nucleotide Polymorphisms. Clin Genet. 2025 May;107(5):485- 494. doi: 10.1111/cge.14730.
• 15. Hermansen L, Saltin B. Oxygen uptake during maximal treadmill and bicycle exercise. J Appl Physiol. 1969 Jan;26(1):31–7. doi:10.1152/jappl.1969.26.1.31.
• 16. Kim K, Kim Y, Do Y. Effects of foot muscle strengthening exercise on medial longitudinal arch and dynamic balance in adults with flexible flatfoot: a systematic review and meta-analysis. PLoS One. 2022;17(4):e0266525. doi:10.1371/journal.pone.0266525.
• 17. Keskin Aktan A, Kutlay Ö. The Relationship between Body Mass Index and Pes Planus, Balance, Quality of Life and Pain Levels in Sedentary Female and Male. Sağlık Bilim Değer. 2022;12(1):58–64. doi:10.33631/sabd.1055295.
• 18. Külünkoğlu, B, Fırat, N, Yıldız, N. T, & Alkan, A (2018). Reliability and validity of the Turkish version of the Foot Function Index in patients with foot disorders. Turkish Journal of Medical Sciences 48 (3): 476-483. https://doi.org/10.3906/sag-1705-143.
• 19. López-López D, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Rodríguez-Sanz D, Calvo-Lobo C, Palomo-López P. Impact of quality of life related to foot problems: a case–control study. Sci Rep. 2021;11(1):14515. doi:10.1038/s41598-021-93902-5.
• 20. Lozano-Meca J, Gacto-Sánchez M, Montilla-Herrador J. Association of kinesiophobia with pain, disability and functional limitation in adults with knee osteoarthritis: A systematic review and meta-analysis. Geriatr Nurs. 2024;60:481–90. doi:10.1016/j.gerinurse.2024.10.013.
• 21. Lundberg MKE, Styf J, Carlsson SG. A psychometric evaluation of the Tampa Scale for Kinesiophobia — from a physiotherapeutic perspective. Physiother Theory Pract. 2004 Jan;20(2):121–33. doi:10.1080/09593980490453002.
• 22. Michaudet C, Edenfield KM, Nicolette GW, Carek PJ. Foot and Ankle Conditions: Pes Planus. FP Essent. 2018 Feb;465:18–23. PMID: 29381041.
• 23. Morrison SC, Tait M, Bong E, Kane KJ, Nester C. Symptomatic pes planus in children: a synthesis of allied health professional practices. J Foot Ankle Res. 2020;13:1–7. doi: 10.1186/s13047-020-0372-8.
• 24. Oguoma VM, Daniel M, Schroers RD, Abu-Farha M, Al-Refaei FH, Al- Mulla F, Coffee NT, Alsharrah S. Physical activity patterns and environmental influences: Findings from the Kuwait diabetes epidemiology program. Glob Epidemiol. 2025 Nov 12;10:100232. doi: 10.1016/j.gloepi.2025.100232.
• 25. Özgü İnal, Berke Aras & Sinem Salar (2020) Investigation of the relationship between kinesiophobia and sensory processing in fibromyalgia patients, Somatosensory & Motor Research, 37:2, 92-96, doi: 10.1080/08990220.2020.1742104)
• 26. Peng Y, Zhang Y, Yu J, Zhang M, Zhang X. Influence of arch support heights on the internal foot mechanics of flatfoot during walking: A muscle-driven finite element analysis. Comput Biol Med. 2021;132:104355.doi: 10.1016/j.compbiomed.2021.
• 27. R. C. Kluetsch et al., “Alterations in default mode network connectivity during pain processing in borderline personality disorder.,” Arch. Gen. Psychiatry, vol. 69, no. 10, pp. 993–1002, Oct. 2012, doi: 10.1001/archgenpsychiatry.2012.476.
• 28. Razeghi M, Batt ME. Foot type classification: a critical review of current methods. Gait Posture. 2002 Jun;15(3):282–91. doi:10.1016/s0966-6362(01)00151-5.
• 29. Reinoso-Cobo A, Ortega-Avila AB, Ramos-Petersen L, García- Campos J, Banwell G, Gijon-Nogueron G, Lopezosa-Reca E. Relationship between kinesiophobia, foot pain and foot function, and disease activity in patients with rheumatoid arthritis: a cross-sectional study. Medicina (Kaunas). 2023;59(1):147. doi:10.3390/medicina59010147. PMID: 36676771; PMCID: PMC9864291.
• 30. Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, Tokgozoglu L. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010 Aug;111(1):278-84. doi: 10.2466/06.08.PMS.111.4.278-284.
• 31. Salinas-Torres VM, Salinas-Torres RA, Carranza-García LE, Herrera- Orozco J, Tristán-Rodríguez JL. Prevalence and Clinical Factors Associated With Pes Planus Among Children and Adults: A Population- Based Synthesis and Systematic Review. J Foot Ankle Surg. 2023 Sep- Oct;62(5):899-903. doi: 10.1053/j.jfas.2023.05.007.,
• 32. Shen J, Xue C, Liu X, Liang F, Fan B, Lv Z. Prevalence of flatfoot and gender differences in plantar pressure among third-year high school students in Tongzhou district Beijing. BMC Musculoskelet Disord. 2025 Apr 21;26(1):389. doi: 10.1186/s12891-025-08634-8.
• 33. Stebbins J, Mifsud M. The pediatric foot. Foot and ankle biomechanics. Elsevier; 2023;477–87.
• 34. Şahin FN, Sarıtaş N, Yalçınkaya EY, Yıldız Y, Göktepe AS. Examining the Relationship between Pes Planus Degree, Balance and Jump Performances in Athletes. Int J Environ Res Public Health. 2022;19(18):11602. doi:10.3390/ijerph191811602.
• 35. Tajdini H, Letafatkar A, Brewer BW, Hosseinzadeh M. Association between Kinesiophobia and Gait Asymmetry after ACL Reconstruction: Implications for Prevention of Reinjury. Int J Environ Res Public Health. 2021;18(6):3264. doi:10.3390/ijerph18063264.
• 36. Van Boerum DH, Sangeorzan BJ. Biomechanics and pathophysiology of flat foot. Foot Ankle Clin. 2003 Sep;8(3):419–30. doi:10.1016/S1083-7515(03)00084-6.
• 37. Yildiz S, Kirdi E, Bek N. Comparison of the lower extremity function of patients with foot problems according to the level of kinesiophobia. Somatosens Mot Res. 2020 Oct;37(4):284–7. doi:10.1080/08990220.2020.1823362.
• 38. Yılmaz, Ö. T., YAKUT, Y., UYGUR, F., & ULUĞ, N. (2011). Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability. Turkish Journal of Physiotherapy and Rehabilitation, 22(1), 44-50.