The development of kinesiophobia is common among patients with hemophilia (PWH) who live with chronic pain, according to the results of study published in the journal Haemophilia.

An irrational fear that can result in altered movement, kinesiophobia can impair the management and control of chronic pain. The aim of this study was to evaluate the effect of kinesiophobia and catastrophic thoughts on outcomes of PWH.

In the study, 71 PWH, including types A and B, aged 12 and older were evaluated for chronic pain, function, kinesiophobia, and pain-related catastrophic thinking. Pressure Pain Threshold (PPT) was measured in 6 predetermined points in the knees, ankles, and elbows.

Continue Reading

The baseline age of the cohort was 33 (range, 12-87 years) and 81.7% of patients had hemophilia B, of which, 70.4% had severe disease, and 18.3% had hemophilia B, with 12.7% with severe disease. The majority of patients were treated with prophylaxis and none of the patients had inhibitors. Chronic pain was present among 64.8% of patients and kinesiophobia among 54.9%.

The presence of chronic pain was significantly associated with older age (P =.014) and a higher number of affected joints (P <.001).

Kinesiophobia was more common among patient with chronic pain, affecting 67.4% compared with 54.9% of patients without chronic pain (P =.004). Patients with chronic pain demonstrated a higher pain-related catastrophizing thoughts scale at 4.6 compared with 3.7 among patient without chronic pain (P =.003).

The pain threshold was significantly lower among patients with chronic pain with a mean of 47.0, 35.3, and 41.5 N in the knee, elbow, and ankle, respectively, compared with 65, 44.6, and 45.3, respectively, among patients without chronic pain (P <.0001 for all).

The authors concluded that “PWH with chronic pain showed a significant presence of kinesiophobia and catastrophic thoughts.” They suggested that “education in pain is necessary to manage safer behaviors and gradually expose patients to these dreaded activities.”

Disclosures: Some of the study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of disclosures.


Feldberg G, Ricciardi JBS, Zorzi AR, et al. Chronic pain in patients with hemophilia: Influence of kinesiophobia and catastrophizing thoughts. Haemophilia. Published online November 29, 2022. doi: 10.1111/hae.14708