Is kinesiophobia and pain catastrophising at baseline associated with chronic pain and disability in whiplash-associated disorders? A systematic review

Research output: Contribution to journalReview articlepeer-review


  • Alejandro Luque-Suarez
  • Deborah Falla
  • Jose Miguel Morales-Asencio
  • Javier Martinez-Calderon

External organisations

  • Instituto de Investigacion Biomedica de Malaga (IBIMA), Malaga, Spain.
  • Universidad de Málaga


BACKGROUND: Kinesiophobia and pain catastrophising may be associated with patients' transition from having acute to chronic pain following a whiplash injury.

OBJECTIVE: To systematically review and critically appraise the literature to determine whether kinesiophobia and pain catastrophising are associated with greater likelihood of patients developing chronic pain and disability following a whiplash injury.

DESIGN: A systematic review of the literature DATA SOURCES: Electronic searches of PubMed, AMED, CINAHL, PsycINFO, and PubPsych, and grey literature were undertaken from inception to September 2017.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Study selection was based on longitudinal studies evaluating how kinesiophobia and/or pain catastrophising at baseline are associated with pain intensity, disability or both after a whiplash injury.

RESULTS: We included 14 longitudinal studies that described 12 independent cohorts with a total sample of 2733 participants with whiplash-associated disorder. Kinesiophobia at baseline was not associated with pain intensity over time (three studies). Whether kinesiophobia at baseline was associated with disability was unclear as results were conflicting (six studies). There were also conflicting results when we examined the association between pain catastrophising and both pain intensity (five studies) and disability (eight studies).

SUMMARY/CONCLUSIONS: Kinesiophobia at baseline was not associated with pain intensity over time. There were conflicting results for the remaining analyses. The size of the associations was small. The overall quality of the evidence was very low.


Bibliographic note

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.


Original languageEnglish
JournalBritish Journal of Sports Medicine
Early online date19 Jun 2019
Publication statusE-pub ahead of print - 19 Jun 2019


  • fear, pain, psychological factors, whiplash injury