Relationship Between Kinesiophobia and Fear of Falling in Patients Suffering from Stroke Leading to Physical Disability in Selected Rehabilitation Center of Bangladesh

Background Psychological barriers in stroke rehabilitation remain understudied in low-resource settings. This cross-sectional study examines relationships between kinesiophobia, fear of falling (FOF), and physical disability in Bangladeshi stroke patients.

Using validated Bangla versions of WHODAS 2.0 (12-item), Tampa Scale for Kinesiophobia (TSK-17), and Falls Efficacy Scale-International (FES-I), we assessed 200 patients from two rehabilitation centers. Pearson correlations and linear regression analyzed associations between psychological factors and disability.

Participants showed moderate-severe scores: WHODAS 2.0 (M = 43.65 ±6.78), TSK (M = 47.26 ±5.44), FES-I (M = 49.12 ±7.20). Strong correlations emerged between WHODAS-FES-I (r = 0.65, 95% CI: 0.58–0.71) and TSK-FES-I (r = 0.55, 95% CI: 0.47–0.62). Regression models identified age ≥56 (β = 0.34, p = 0.002) and female gender (β = 0.28, p = 0.008) as significant predictors of higher psychological scores.

Psychological factors strongly correlate with physical disability in Bangladeshi stroke survivors, with demographic predictors suggesting the need for gender- and age-specific interventions. Study limitations include recruitment from two urban centers and a cross-sectional design. Integration of psychological assessment in rehabilitation protocols is recommended. Competing Interest Statement The authors have declared no competing interest. Funding Statement The author(s) received no specific funding for this work. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study received ethical approval from the Institutional Review Board of the Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh (Reference: CRP-R&E-0401-353, dated 02 January 2022) and was conducted in accordance with the Declaration of Helsinki. Prior to participation, written informed consent was obtained from all participants or their legal guardians after fully explaining the study's purpose, procedures, potential risks/benefits, and their right to withdraw at any time without consequences to their treatment. The consent process was conducted using forms available in both Bangla and English to ensure comprehension, with a witness verifying consent for illiterate participants (2.5% of the sample). All collected data were anonymized and stored securely, with access restricted to the research team to maintain confidentiality. The study protocol emphasized that participant information would be used solely for research purposes and not disclosed to any third parties. This thesis adhered to the STROBE checklist for observational study design and reporting. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All relevant data are within the manuscript and its Supporting Information files. Abbreviation - CRP - Centre for the Rehabilitation of the Paralysed - DALY - Disability-adjusted life-years - FES - Fall Efficacy Scale - FOF - Fear of Fall - ICF - International classification of functioning, Disability and Health - NSID - Non-steroidal anti-inflammatory drug - SPSS - Statistical Package for Social Science - TSK - Tampa Scale of Kinesiophobia - WHO - World Health Organization - WHODAS - World Health Organization Disability Assessment Scale