Kinesiophobia in Patients with Chronic Obstructive Pulmonary Disease: A Concept Analysis

Abstract

Background: Kinesiophobia (fear of movement) is a significant barrier to pulmonary rehabilitation and functional recovery in patients with Chronic Obstructive Pulmonary Disease (COPD). Despite its considerable impact on clinical outcomes, this concept currently lacks a unified definition and comprehensive theoretical framework. Objective: To clarify the concept of kinesiophobia in COPD by identifying its defining attributes, antecedents, and consequences, and to integrate these elements into a cohesive conceptual framework. Methods: A comprehensive literature search was performed in CNKI, Wanfang, VIP, Web of Science, PubMed, CINAHL, and Cochrane Library databases from inception to April 1, 2025. Following Rodgers’ evolutionary methodology, two researchers independently screened studies and conducted a systematic thematic synthesis. Results: Twenty-nine studies met inclusion criteria. Kinesiophobia in COPD is characterized by four defining attributes: symptom hypervigilance, maladaptive cognition, complex emotional responses, and behavioral avoidance. These are influenced by sociodemographic, disease-related, and psychological antecedents, and lead to functional decline and reduced quality of life. Conclusion: This analysis synthesizes a unified conceptual framework that integrates dyspnea-related and pain-related kinesiophobia, addressing a critical gap in the literature. This framework provides the foundation for developing precise assessment tools and mechanism-based interventions tailored to specific fear subtypes, ultimately aiming to disrupt the debilitating cycle of fear and avoidance in COPD.