The Effect of Mindfulness-Based Cognitive Therapy on Kinesiophobia in Older Adults with Chronic Knee Osteoarthritis: A Randomized Controlled Trial
Zahra Kheirkhah, Fatemeh Fallahi, Khadijeh Sharifi, Fatemeh Sadat Asgarian, Amir Hossein Fallahi
Clinical Interventions in Aging October 1, 2026 DOI: 10.2147/cia.s638393 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 56 |
| Population | Older adults with chronic knee osteoarthritis at health centers in Kashan, Iran |
| Intervention | Mindfulness Based Cognitive Therapy |
| Duration | Eight 90-minute sessions; assessments at baseline, week 4, and week 8 (four-week follow-up) |
| Measures | Tampa Scale for Kinesiophobia (TSK11) |
| Topics | Meditation |
| Key findings | Kinesiophobia decreased in both groups, with a significant group-by-time interaction indicating different trajectories of change, but adjusted between-group differences were not statistically significant at any time point. The adjusted difference in change from baseline to week 8 was −1.60 points (95% CI −3.25 to 0.05; p = 0.05). The authors conclude that MBCT may influence the trajectory of kinesiophobia over time. |
Abstract
Purpose: To determine the effect of mindfulness-based cognitive therapy on kinesiophobia in older adults with chronic knee osteoarthritis. Patients and
Methods: This randomized clinical trial conducted among 56 older patients with knee osteoarthritis at health centers in Kashan, Iran, in 2024. Participants were selected via consecutive sampling and randomly assigned to either an intervention (n = 28) or a control (n = 28) group using block randomization. The intervention group participated in eight 90 minute sessions of Mindfulness Based Cognitive Therapy, while the control group received routine care. Kinesiophobia was measured with the Tampa Scale for Kinesiophobia (TSK11) at baseline, week 4 (immediately post intervention), and week 8 (four week follow up). Covariate adjusted repeated measures ANCOVA was performed, adjusting for age, number of children, and baseline pain intensity. Statistical significance was set at p < 0.05. All participants completed follow up.
Results: The mean kinesiophobia score decreased from 29.46 ± 3.81 at baseline to 25.68 ± 3.22 at week 8 in the intervention group and from 28.64 ± 4.78 to 26.68 ± 5.15 in the control group. The adjusted repeated-measures analysis showed a significant group-by-time interaction (Wilks’ Λ = 0.88, F(2.50) = 3.34, p = 0.040, ηp 2 = 0.11), indicating different trajectories of change between groups. However, adjusted between-group differences were not statistically significant at baseline, week 4, or week 8 (all p > 0.05). The adjusted difference in change from baseline to week 8 was − 1.60 points (95% CI − 3.25 to 0.05; p = 0.05). Within-group Bonferroni-adjusted comparisons showed significant reductions across all time intervals in the intervention group (all p < 0.001) and from baseline to week 4 and week 8 in the control group (p = 0.0022 and p = 0.0028, respectively), but not between weeks 4 and 8 (p = 0.13).
Conclusion: Four weeks of MBCT may influence the trajectory of kinesiophobia over time in older adults with knee osteoarthritis.
Trial Registration: Registered in the Iranian Registry of Clinical Trials (IRCT20231105059961N1). Keywords: kinesiophobia, mindfulness, knee, osteoarthritis, pain, older adults
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |