Relationship Between Fear of Movement and Physical Activity in Patients With Cardiac, Rheumatologic, Neurologic, Pulmonary, or Pain Conditions: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
OBJECTIVE: Physical activity contributes to the primary, secondary, and tertiary prevention of multiple diseases. However, in some patients, fear of movement may induce avoidance behaviors and reduce engagement in physical activity. This study aims to examine whether this fear of movement is negatively associated with physical activity across several health conditions and what factors may influence this relationship. METHODS: Five databases were searched for studies including both a measure of fear of movement and physical activity. Two reviewers screened articles for inclusion, assessed risk of bias, and extracted data from each study. Pearson product-moment correlations were pooled from eligible studies using the generic inverse pooling and random effects method to examine the relationship between fear of movement and physical activity. RESULTS: Seventy-four studies were included in the systematic review and 63 studies (83 estimates, 12,278 participants) in the main meta-analysis. Results showed a negative correlation between fear of movement and physical activity (r = -0.19 [95% CI = -0.26 to -0.13]; I2 = 85.5%). Funnel plot analysis showed evidence of publication bias, but p-curve analysis suggested that our results could not be caused by selective reporting. A subgroup meta-analysis showed that the correlation was statistically significant in patients with cardiac, rheumatologic, neurologic, or pulmonary conditions but not in patients with chronic or acute pain. CONCLUSIONS: Our results suggest that higher levels of fear of movement are associated with lower levels of physical activity in several health conditions that are not necessarily painful. IMPACT: Fear of movement should be dissociated from pain and considered in relation to specific health conditions when implementing exercise therapy. Fear of movement may have prognostic and therapeutic implications in patients for whom physical activity contributes to prevent recurrence or worsening of their condition.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.040 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.017 | 0.041 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".