Abstract
BACKGROUND: Early postoperative kinesiophobia represents a significant psychological barrier in the rehabilitation trajectory following arthroscopic rotator cuff repair (ARCR). Existing research predominantly focuses on patients in the chronic phase, paying insufficient attention to the heterogeneity within this population. This study aimed to identify potential subtypes of kinesiophobia in patients after rotator cuff injury (RCI), analyze the causes affecting different subtypes of kinesiophobia, and provide a basis for formulating accurate early intervention plans. METHODS: This study was conducted in the Department of Sports Medicine at the Second Affiliated Hospital of Inner Mongolia Medical University, China, from November 2024 to April 2025 (a duration of 6 months) using convenience sampling. This study included 245 consecutive participants who met the inclusion and exclusion criteria and who underwent arthroscopic ARCR after general anaesthesia. Finally, 237 participants completed this study. The Tampa Scale for Kinesiophobia(TSK,17 items, score range 17–68, ) was used as the primary outcome measure. The Self-Efficacy Scale(SEE; 9 items, 0–9 points), the “Changhai pain scale” Pain Score(0-10points), and the Groningen Orthopedic Social Support Scale (GO-SSS,12 items,0-36points) were used as secondary indicators. Mplus8.0 was used for latent profiling analysis, and the Lo-Mendell-Rubin corrected likelihood ratio test (LMR-LRT, p < 0.05), Bayesian information criterion (BIC), and entropy value > 0.80 were used to ensure the reliability of classification, followed by univariate and multivariate logistic regression analyses of the classification results using SPSS 25.0. RESULTS: 237 patients were surveyed (51.10% male), with an average age of (58.08 ± 8.57) years. There were 89 (37.60%) patients with osteoporosis and 151 (63.70%) patients with full-thickness tears. These patients could be categorized into three latent profile groups: the low kinesiophobia-active group (17.70%), the moderate kinesiophobia-stable group (61.62%), and the high kinesiophobia-avoidance group (20.68%). Educational level（Junior high school and below: p=0.043, 95%CI 1.054–31.436); diabetes mellitus (p=0.033, 95%CI 1.111–12.364); exercise self-efficacy (p=0.022, 95%CI 0.720–0.975); osteoporosis (p=0.044, 95%CI 1.028–9.384); degree of tearing (p=0.015, 95%CI 1.317–13.631); pain level (p=0.002, 95%CI 1.543–7.217). CONCLUSION: Postoperative kinesiophobia in patients with rotator cuff injuries is at a medium to high level, with group heterogeneity. It is mainly influenced by biological factors (full-thickness tears, osteoporosis), clinical factors (history of revision surgery, pain level, chronic medical history), and psychosocial factors (low self-efficacy, low education). In the future, medical staff should identify patients with kinesiophobia as soon as possible, consider the multifaceted factors affecting this situation, and develop targeted interventions to reduce early postoperative kinesiophobia and enhance rehabilitation outcomes and improve quality of life. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-025-09274-8.