Kinesiophobia and Functional Outcomes in Distal Radius Fractures

Time-Dependent Changes in Kinesiophobia and Functional Outcomes in Conservatively Treated Distal Radius Fractures

Distal radius fractures are among the most common fractures in adults and are frequently treated with closed reduction and cast immobilization. Although fracture healing is generally successful, some patients may develop fear of movement (kinesiophobia) after cast removal because of pain, reinjury concerns, or reduced confidence in using the injured wrist.

The purpose of this study is to evaluate the level of kinesiophobia in adults with conservatively treated distal radius fractures and to investigate how kinesiophobia changes over time following cast removal. The study will also examine the relationship between kinesiophobia and functional recovery.

Participants will be assessed after cast removal and again at three months following injury. Kinesiophobia, pain intensity, hand and wrist function, range of motion, grip strength, and upper extremity disability will be evaluated using standardized assessment tools. The findings may help clinicians better understand the role of movement-related fear in recovery and support the development of rehabilitation strategies aimed at improving functional outcomes after distal radius fractures.

Study Overview

• Status: Not yet recruiting
• Conditions: Distal Radius Fracture
• Intervention / Treatment: Other: Conservative Treatment of Distal Radius Fracture

Detailed Description

Distal radius fractures are among the most frequently encountered upper-extremity fractures in adults and are commonly managed using conservative treatment methods, including closed reduction and cast immobilization. While successful bone healing is generally achieved, prolonged immobilization may contribute to pain, stiffness, reduced confidence in movement, and the development of kinesiophobia (fear of movement).

Kinesiophobia has been recognized as an important psychological factor that may negatively influence rehabilitation outcomes in various musculoskeletal conditions. Increased fear of movement may result in activity avoidance, delayed return to daily activities, reduced use of the affected extremity, and persistent disability. Recent studies have demonstrated associations between kinesiophobia and upper-limb functional limitations following wrist and hand injuries; however, evidence regarding the temporal evolution of kinesiophobia after conservatively treated distal radius fractures remains limited.

The primary objective of this prospective observational clinical study is to evaluate changes in kinesiophobia over time in adults with conservatively treated distal radius fractures. The secondary objective is to investigate the relationship between kinesiophobia and functional outcomes during the recovery process.

Patients aged 18-65 years with AO type A distal radius fractures treated with closed reduction and short-arm cast immobilization will be recruited from the Orthopedics and Traumatology Clinic of Marmara University Pendik Training and Research Hospital. All participants will receive standard conservative treatment. The cast will be removed at approximately five weeks after injury.

The first assessment will be performed three days after cast removal. Kinesiophobia will be evaluated using the Tampa Scale for Kinesiophobia (TSK), and pain intensity will be recorded using a Visual Analog Scale (VAS). A second assessment will be conducted at the third month following injury. At this time, kinesiophobia will be reassessed using the TSK. Functional status will be evaluated using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Hand and wrist function, grip strength, and relevant clinical parameters will also be assessed.

Inclusion criteria include adults aged 18-65 years with AO type A distal radius fractures treated conservatively with closed reduction and short-arm cast immobilization and without treatment-related complications. Exclusion criteria include previous fracture or neurological disorders affecting the same upper extremity, concomitant injuries involving the wrist, elbow, or shoulder, cognitive impairment, severe psychiatric disorders, and surgically treated distal radius fractures.

No experimental intervention, additional imaging procedure, or investigational medication will be used. All participants will provide written informed consent prior to enrollment. The study will be conducted in accordance with the ethical principles of the Declaration of Helsinki.

The results of this study are expected to improve understanding of the role of kinesiophobia in recovery after distal radius fractures and may contribute to the development of rehabilitation programs targeting psychological as well as physical aspects of recovery.

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Samir İlgaroğlu, Surgeon; Phone Number: +905536166156; Email: doktorsamir.zeynal@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age range: 18-65 years
• Non-intra-articular extension (AO type A) distal radius fracture
• Treatment with closed reduction and short arm cast
• No complications during treatment (redisplacement, fracture failure, etc.)
• Ability to cooperate and complete the questionnaire

Exclusion Criteria:

• History of previous fracture or neurological pathology in the same extremity
• Associated wrist, elbow, or shoulder injury
• Cognitive impairment or serious psychiatric illness
• Surgically treated distal radius fractures

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Female Participants; Female adults aged 18-65 years with conservatively treated distal radius fractures who undergo prospective assessment of kinesiophobia and functional outcomes following cast immobilization.	Other: Conservative Treatment of Distal Radius Fracture; Standard conservative management consisting of closed reduction followed by short-arm cast immobilization for the treatment of distal radius fractures.
Experimental: Male Participants; Male adults aged 18-65 years with conservatively treated distal radius fractures who undergo prospective assessment of kinesiophobia and functional outcomes following cast immobilization.	Other: Conservative Treatment of Distal Radius Fracture; Standard conservative management consisting of closed reduction followed by short-arm cast immobilization for the treatment of distal radius fractures.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Kinesiophobia Level	Kinesiophobia will be assessed using the Tampa Scale for Kinesiophobia (TSK). Changes in TSK scores between the assessment performed 3 days after cast removal (approximately week 5) and the assessment performed at month 3 will be evaluated.	Week 5 (3 days after cast removal) and Month 3

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Upper Extremity Disability	Upper extremity disability and symptoms will be assessed using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire.	Month 3
Pain Intensity	Pain intensity will be assessed using a Visual Analog Scale (VAS).	Week 5 and Month 3
Grip Strength	Hand grip strength will be measured using a hand dynamometer and recorded in kilograms (kg).	Month 3
Wrist Range of Motion	Wrist flexion, extension, radial deviation, and ulnar deviation will be measured using a goniometer and recorded in degrees.	Month 3

Collaborators and Investigators

• Sponsor: Ebru Aloğlu Çiftçi

Publications and helpful links

General Publications

• Roman-Veas J, Gutierrez-Monclus R, Lopez-Gil JF, Valenzuela-Fuenzalida J, Araya-Quintanilla F, Gutierrez-Espinoza H, Hagert E. Baseline predictors related to functional outcomes in patients older than sixty years with complex regional pain syndrome type 1 after distal radius fracture treated conservatively: a prospective observational study. Int Orthop. 2023 Sep;47(9):2275-2284. doi: 10.1007/s00264-023-05880-0. Epub 2023 Jul 13.

Study record dates

Study Major Dates

• Study Start (Estimated): July 19, 2026
• Primary Completion (Estimated): January 20, 2027
• Study Completion (Estimated): February 5, 2027

Study Registration Dates

• First Submitted: June 19, 2026
• First Submitted That Met QC Criteria: June 19, 2026
• First Posted (Actual): June 25, 2026

Study Record Updates

• Last Update Posted (Actual): June 25, 2026
• Last Update Submitted That Met QC Criteria: June 19, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Kinesiophobia; Functional Recovery
• Additional Relevant MeSH Terms: Mental Disorders; Wounds and Injuries; Fractures, Bone; Arm Injuries; Phobic Disorders; Anxiety Disorders; Wrist Injuries; Wrist Fractures; Kinesiophobia
• Other Study ID Numbers: MarmaraUni-02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No