title: Role of fear of movement in cancer survivors participating in a rehabilitation program: a longitudinal cohort study.
abstract: OBJECTIVE
  To study the relationship between fear of movement and perceived global health status and the role of rehabilitation with graded activity in cancer survivors.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Rehabilitation centers.
  
  
  METHODS
  Cancer survivors (N=1236).
  
  
  METHODS
  Twelve-week graded activity rehabilitation program.
  
  
  METHODS
  Fear of movement (Modified Tampa Scale for Kinesiophobia-Fatigue), fatigue (Functional Assessment of Cancer Therapy-Fatigue), and perceived global health status (European Organisation Research and Treatment of Cancer Quality of Life Questionnaire C30) were measured at baseline and after rehabilitation. We performed multiple linear regression analyses to examine the association between fear of movement and perceived global health status at baseline. Differences between baseline and postintervention scores were assessed with a paired t test and effect sizes (ESs). Hierarchical multiple regression analyses were used to investigate whether changes in fear of movement were associated with perceived global health status.
  
  
  RESULTS
  Fear of movement was associated with perceived global health status prior to rehabilitation (P=.001). Only participants with high scores on baseline fear of movement showed a considerable decrease in fear of movement after rehabilitation (ES=-.69; 95% confidence interval [CI], -.80 to -.57); the reduction was largest for fears because of a somatic focus (ES=-.57; 95% CI, -.68 to -.45). Changes in fear of movement because of a somatic focus were related to perceived global health status postintervention (P=.001).
  
  
  CONCLUSIONS
  Fear of movement is associated with the perceived global health status of cancer survivors. Fear of movement decreases after rehabilitation with graded activity in high scorers on baseline fear of movement.
authors.affiliation: Comprehensive Cancer Center the Netherlands, Utrecht, the Netherlands. mvelthuis@ikmn.nl
authors.forename: Miranda J
authors.initials: MJ
authors.lastname: Velthuis
authors.forename: Petra H
authors.initials: PH
authors.lastname: Peeters
authors.forename: Brigitte C
authors.initials: BC
authors.lastname: Gijsen
authors.forename: Jan-Paul
authors.initials: JP
authors.lastname: van den Berg
authors.forename: Ria A
authors.initials: RA
authors.lastname: Koppejan-Rensenbrink
authors.forename: Johan W
authors.initials: JW
authors.lastname: Vlaeyen
authors.forename: Anne M
authors.initials: AM
authors.lastname: May
mesh_terms: D015331:Cohort Studies; D005221:Fatigue / Q000523:psychology; D005239:Fear; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009068:Movement; D009369:Neoplasms / Q000523:psychology* / Q000534:rehabilitation*; D011788:Quality of Life; D020127:Recovery of Function; D055070:Resistance Training; D017741:Survivors / Q000523:psychology*