Kinesiophobia in chronic obstructive pulmonary disease: a scoping review

Kinesiophobia, an excessive and debilitating fear of movement, represents a significant yet under-recognized psychological barrier to engagement in pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD). This scoping review aimed to map the existing evidence regarding the manifestations, assessment tools, associated factors, and management interventions for kinesiophobia in COPD, to inform clinical practice and physical activity promotion. We conducted this review following the Arksey and O’Malley methodological framework and reported it in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). Seven electronic databases (CNKI, Wanfang, VIP, Web of Science, PubMed, CINAHL, Cochrane Library) were systematically searched from inception to 29 March 2025. Study screening, data extraction, and thematic synthesis were performed independently by two reviewers. Twenty-seven studies were included. Among studies reporting prevalence, dyspnea-related kinesiophobia reached 99.2%–100% (one study: 100% in stable COPD), pain-related kinesiophobia 67%, and concurrent dyspnea- and pain-related fear 90.3%–93%, indicating dyspnea-related fear of movement is highly prevalent in COPD. Key findings: (1) Manifestations: Two primary subtypes were identified—dyspnea-related and pain-related—with three studies reporting concurrent fear of both types; (2) Assessment: TSK for pain-related fear, BBQ/BBQ-AA for dyspnea-related kinesiophobia; (3) Associated factors: sociodemographic, clinical, and psychosocial domains; (4) Interventions: preliminary support for CBT, inspiratory muscle training, and mindfulness, but evidence remains limited. Kinesiophobia is a prevalent and multifactorial issue in COPD that warrants greater clinical and research attention. A subtype-specific approach using validated tools is recommended for screening. Management should address the cognitive-emotional mechanisms underlying the fear-avoidance cycle. Future research priorities include the development of culturally adapted assessment tools and rigorous trials of multimodal interventions targeting fear extinction. Open Science Framework Registries ( https://doi.org/10.17605/OSF.IO/R65UB ).