## 6 Kinesiophobia in Chronic Diseases
### Cancer Diseases  
Kinesiophobia in the context of cancer has been most extensively described in relation to breast cancer. In a study conducted by [PERSON] et al. on the prevalence of kinesiophobia among 285 breast cancer patients undergoing surgical treatment, approximately 43% of participants were found to experience this condition. Notably, women who were physically active before their diagnosis exhibited similar levels of kinesiophobia as those who had not engaged in physical activity prior to their illness (fatigue \(p=0.101\); pain \(p=0.213\)). The analysis also revealed that women with less advanced stages of the disease had higher levels of kinesiophobia (\(p=0.042\)), which the authors attributed to the widespread misconception that PA can contribute to the spread of cancer cells. Additionally, a correlation between age and kinesiophobia was observed, with older age being associated with greater fear of movement (\(p=0.016\); \(r=0.142\)). However, no significant association was found between educational level (fatigue \(p=0.757\); pain \(p=0.655\)) or employment status (fatigue \(p=0.385\); pain \(p=0.320\)) and the severity of kinesiophobia [20]. The issue of kinesiophobia in breast cancer patients was also addressed in a study by [PERSON] et al., which included 212 women divided into three groups: patients undergoing treatment, post-treatment patients, and a control group. The findings indicated that fear of movement was present in all three groups, with the highest prevalence observed among patients undergoing cancer treatment (57.14%). In the control and post-treatment groups, kinesiophobia was present in 46% and 42.85% of participants, respectively. Among the factors associated with kinesiophobia in patients undergoing treatment, the study identified fear of pain, balance disorders, fear of falling, and concern about worsening well-being after exercise (\(p<0.05\)). Furthermore, the analysis of barriers to PA revealed that oncology patients were more likely to avoid exercise due to fatigue, pain, and unfavorable weather conditions, whereas the control group reported more individual and environmental barriers, such as lack of time and domestic responsibilities. These findings align with the review by [PERSON] et al., which identified pain and fatigue as key barriers to PA engagement [62; 72]. One of the few studies examining kinesiophobia in patients with cancers other than breast cancer is the work of [PERSON]. [PERSON] et al. The authors reported findings from a study involving 282 patients with gastrointestinal cancer, lung cancer, and other unspecified malignancies. The study found that a mild form of kinesiophobia was observed in 45.7% of participants, while 18.4% exhibited moderate to severe levels of fear of movement. In contrast to the findings of [PERSON] et al., no significant association was found between age and kinesiophobia severity (\(p=0.393\)). Additionally, the study did not establish a link between kinesiophobia severity and educational level (\(p=0.471\)) or gender (\(p=0.524\)), although it remained consistent with other studies regarding the impact of pain on kinesiophobia occurrence (\(p=0.014\)) [20; 25]. There has also been increasing interest in studies exploring the relationship betweenymphedema in breast cancer survivors and kinesiophobia. Recent research suggests that fear of exacerbatingymphedema may significantly limit PA among these patients [73; 74; 75; 76]. In conclusion, the findings indicate that kinesiophobia is a prevalent issue among cancer patients, particularly during treatment. Key factors influencing kinesiophobia include pain, fatigue, and concerns about worsening symptoms, whereas age and employment status do not appear to be significant predictors. Education level is a factor that requires further research. While kinesiophobia has been widely studied in the context of breast cancer, its occurrence in other types of cancer remains underexplored.