Early Physical Activity Enjoyment Lowers Fear of Movement Later

Credit: Adobe Stock/Robert Kneschke

Enjoyment of physical activity during childhood is linked to lower levels of kinesiophobia—an exaggerated and debilitating fear of movement—in adults with chronic low back pain, according to a study published in BMC Public Health. Walking, specifically, was a key factor in mediating this relationship, suggesting that fostering a love for physical activity early in life may lead to sustained activity and less fear of movement in adulthood.

Chronic low back pack is often linked to psychological factors, including kinesiophobia. People with this phobia have a “catastrophic” interpretation of pain as a sign of damage, which induces a detrimental cycle of fear and avoidance. Unfortunately, avoiding movement and activities associated with pain creates more pain and disability as well as reduces the opportunity for positive exposure.

Conversely, regular physical activity can help people with pain increase their confidence in their physical abilities, which could reduce their fear of movement and pain. It can also release endorphins and modulate the pain perception in addition to reducing stress, anxiety and depression, which are common comorbidities linked to both chronic pain and kinesiophobia.

“Childhood is a critical phase for the development of behaviors and interests,” wrote a group of international investigators. “Various studies have confirmed that lifestyle choices during childhood, particularly levels of physical activity, are strongly predictive of adult health behaviors and associated risks, including obesity, cardiovascular diseases and type 2 diabetes. Participation in physical activities during childhood not only enhances physical well-being but also shapes the psychological mindset towards physical activity in adulthood.”

To determine the relationship between childhood physical activity enjoyment and current kinesiophobia among patients with chronic low back pain, investigators recruited 648 adults using online platforms—particularly WeChat groups focused on health and chronic pain management—between June and August 2023. Most patients (73.1%) were male and 99.1% were aged between 18 and 60 years.

Physical activity enjoyment in childhood was determined using a single-item question to measure participants’ enjoyment during primary school. Kinesiophobia was evaluated using the 11-item Tampa Scale for Kinesiophobia (TSK-11) and physical activity focused on walking, moderate physical activity and vigorous physical activity. Age, sex, income and education were used as control variables by which to assess results.

The mean score for kinesiophobia according to the TSK-11 was 26.55, which was indicative of a moderate level of fear of movement. Patients reported walking an average of 3.82 times per week, performing moderate physical activity 3.24 times per week and performing vigorous physical activity 2.87 times per week.

The analysis revealed a significant negative association between childhood physical activity enjoyment and adult kinesiophobia. That is, patients who enjoyed physical activity during the time they were in primary school were less likely to develop a fear of movement in adulthood. Childhood physical activity enjoyment was linked to increases in adult physical activity across the three types of activities assessed. However, walking was the only statistically significant activity according to an adjusted model.

This pattern of childhood enjoyment of physical activity and the higher likelihood of increased adult activity levels reflects behavioral persistence, according to investigators. This could be due in part to the formation of long-lasting habits, attitudes and preferences regarding physical activity during a critical period of development in childhood.

“These findings underscore the importance of childhood physical activity and offer valuable insights for policymakers and parents,” investigators concluded. “Encouraging children’s active participation in and enjoyment of physical activity can pave the way for long-term health-promoting behaviors.”