Kinesiophobia in Collegiate Athletes and Nonathletes With and Without Chronic Ankle Instability

• DOI: 10.1123/jsr.2024-0276
• Publication Date: 2025-02-21T18:00:23Z
• Authors: Nadia M. Perez; L. Kent Griffin; Randall E. Osborne; Rachel M. Koldenh...

Context: Kinesiophobia is a substantial psychological factor that may impact sport performance and activities of daily living for individuals with chronic ankle instability (CAI). The purpose of this study was to determine the levels of kinesiophobia between collegiate athletes and nonathletes with and without CAI using quantitative and qualitative analyses. Design: Cross-sectional survey. Methods: A Qualtrics survey was distributed to college students. Ankle health status was evaluated using the Foot and Ankle Ability Measure Sport subscale, Identification of Functional Ankle Instability, and history questions. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia-11. A 4 × 2 analysis of variance was used to assess differences in athlete status (NCAA Division 1, intramural, club, and nonathlete) and ankle health status (CAI and healthy). An open-ended question was added to understand how kinesiophobia impacts individuals CAI. Data were analyzed via content analysis. Results: Of the 531 respondents who completed the survey, 140 (116 = CAI and 24 = healthy) met the inclusion criteria for the study. There was a significant main effect for ankle health status for the Foot and Ankle Ability Measure Sport (CAI = 62.68 [15.11]%, healthy = 99.57 [0.01]%), Identification of Functional Ankle Instability (CAI = 21.63 [5.34], healthy = 2.42 [2.93]), and Tampa Scale of Kinesiophobia-11 (CAI = 26.04 [6.22], healthy = 16.75 [5.50]). There were no significant main effects for athlete status or interactions for any variables. Perceptual and behavioral responses were to major categories identified with the qualitative analysis. Fear, pain, and instability were higher order themes within perceptual responses. Activity avoidance and bracing were higher order themes within behavioral responses. Conclusion: This study highlights the significant role of kinesiophobia in individuals with CAI, with those affected reporting higher levels of fear, pain, and instability compared with healthy individuals. Behavioral adaptations such as activity avoidance and bracing were common among qualitative responses. While no differences were observed across athlete statuses, these findings underscore the need for tailored interventions addressing both physical and psychological factors to improve outcomes for individuals with CAI.