{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:43Z","timestamp":1787028643809,"version":"build-2736575974"},"reference-count":57,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2014Ricerca Corrente"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Chronic shoulder pain may cause significant functional disability and reduced psychosocial well-being. Detailed Case Description: In this case, we propose the use of pain neuroscience education and whole-body cryostimulation (WBC) to treat a 64-year-old woman with severe functional limitations and chronic right shoulder pain. The aim was to overcome kinesiophobia and improve her motor function, autonomy, and quality of life. Functional and clinical assessments were conducted at admission, discharge, and at a one-month follow-up via phone call. The patient\u2019s global health, shoulder function, and quality of life showed improvement during hospitalisation and were maintained after one month. Discussion: Pain education is crucial in managing chronic shoulder pain, especially in addressing kinesiophobia and promoting positive patient outcomes. In this context, WBC was used as a supplementary treatment to traditional pain relief and exercise tolerance therapies. This can help individuals to participate more actively in their rehabilitation process, ultimately promoting functional recovery and an improved quality of life. Conclusion: The combination of cryostimulation, tailored physical exercises, pain education, manual therapy, and psychological support created a synergistic effect that addressed both the physical and psychological aspects of pain and kinesiophobia.<\/jats:p>","DOI":"10.3390\/jcm13072094","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T11:01:41Z","timestamp":1712142101000},"page":"2094","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Tackling Kinesiophobia in Chronic Shoulder Pain: A Case Report on the Combined Effect of Pain Education and Whole-Body Cryostimulation"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6609-579X","authenticated-orcid":false,"given":"Angelo","family":"Alito","sequence":"first","affiliation":[{"name":"Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariachiara Elisabetta","family":"Cifalin\u00f2","sequence":"additional","affiliation":[{"name":"Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4784-4713","authenticated-orcid":false,"given":"Jacopo Maria","family":"Fontana","sequence":"additional","affiliation":[{"name":"Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2880-8493","authenticated-orcid":false,"given":"Federica","family":"Verme","sequence":"additional","affiliation":[{"name":"Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9637-0940","authenticated-orcid":false,"given":"Paolo","family":"Piter\u00e0","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3719-8789","authenticated-orcid":false,"given":"Paolo","family":"Capodaglio","sequence":"additional","affiliation":[{"name":"Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy"},{"name":"Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Torino, 10121 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"827","DOI":"10.2147\/JPR.S303186","article-title":"Chronic Pain: What Does It Mean? A Review on the Use of the Term Chronic Pain in Clinical Practice","volume":"14","author":"Raffaeli","year":"2021","journal-title":"J. Pain Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1097\/j.pain.0000000000000160","article-title":"A classification of chronic pain for ICD-11","volume":"156","author":"Treede","year":"2015","journal-title":"Pain"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s40945-018-0050-3","article-title":"Towards an integrated clinical framework for patient with shoulder pain","volume":"8","author":"Ristori","year":"2018","journal-title":"Arch. Physiother."},{"key":"ref_4","first-page":"1107","article-title":"Shoulder pain","volume":"2010","author":"Murphy","year":"2010","journal-title":"BMJ Clin. Evid."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"150","DOI":"10.3109\/03009742.2011.605390","article-title":"Incidence, prevalence, and consultation rates of shoulder complaints in general practice","volume":"41","author":"Greving","year":"2012","journal-title":"Scand. J. Rheumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e012822","DOI":"10.1136\/bmjopen-2016-012822","article-title":"Influence of psychological factors on the prognosis of chronic shoulder pain: Protocol for a prospective cohort study","volume":"7","author":"Struyf","year":"2017","journal-title":"BMJ Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.21037\/apm-20-1808","article-title":"Understanding the physical examination of the shoulder: A narrative review","volume":"10","author":"Yang","year":"2021","journal-title":"Ann. Palliat. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1080\/00913847.2016.1108883","article-title":"Rotator cuff rehabilitation: Current theories and practice","volume":"44","author":"Osborne","year":"2016","journal-title":"Phys. Sportsmed."},{"key":"ref_9","first-page":"765","article-title":"Impingement Syndrome of the Shoulder","volume":"114","author":"Garving","year":"2017","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.mcna.2014.01.016","article-title":"Evaluation and treatment of shoulder pain","volume":"98","author":"Greenberg","year":"2014","journal-title":"Med. Clin. N. Am."},{"key":"ref_11","first-page":"609","article-title":"Conservative management vs. surgical repair in degenerative rotator cuff tears: A systematic review and meta-analysis","volume":"25","author":"Garibaldi","year":"2021","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.pain.2004.02.017","article-title":"Systematic review of prognostic cohort studies on shoulder disorders","volume":"109","author":"Kuijpers","year":"2004","journal-title":"Pain"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.ejpain.2005.08.004","article-title":"Expectancy, fear and pain in the prediction of chronic pain and disability: A prospective analysis","volume":"10","author":"Boersma","year":"2006","journal-title":"Eur. J. Pain"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.jmpt.2019.12.009","article-title":"Kinesiophobia Is Associated With Pain Intensity and Disability in Chronic Shoulder Pain: A Cross-Sectional Study","volume":"43","author":"Meeus","year":"2020","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2062","DOI":"10.1097\/CORR.0000000000000389","article-title":"Are Psychologic Factors Associated With Shoulder Scores After Rotator Cuff Surgery?","volume":"476","author":"Thorpe","year":"2018","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.pain.2012.10.025","article-title":"The acquisition and generalization of cued and contextual pain-related fear: An experimental study using a voluntary movement paradigm","volume":"154","author":"Meulders","year":"2013","journal-title":"Pain"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S86","DOI":"10.1097\/j.pain.0000000000000107","article-title":"Learning to predict and control harmful events: Chronic pain and conditioning","volume":"156","author":"Vlaeyen","year":"2015","journal-title":"Pain"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"933483","DOI":"10.3389\/fnbeh.2022.933483","article-title":"Treatments for kinesiophobia in people with chronic pain: A scoping review","volume":"16","author":"Bordeleau","year":"2022","journal-title":"Front. Behav. Neurosci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.msksp.2017.10.008","article-title":"Subacromial impingement syndrome\u2014What does this mean to and for the patient? A qualitative study","volume":"33","author":"Cuff","year":"2018","journal-title":"Musculoskelet. Sci. Pract."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/PHM.0000000000000329","article-title":"Association of Strength Measurement with Rotator Cuff Tear in Patients with Shoulder Pain: The Rotator Cuff Outcomes Workgroup Study","volume":"95","author":"Miller","year":"2016","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40945-017-0032-x","article-title":"Depicting individual responses to physical therapist led chronic pain self-management support with pain science education and exercise in primary health care: Multiple case studies","volume":"7","author":"Miller","year":"2017","journal-title":"Arch. Physiother."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1177\/2049463712449961","article-title":"Evaluating the impact of pain education: How do we know we have made a difference?","volume":"6","author":"Briggs","year":"2012","journal-title":"Br. J. Pain"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lepri, B., Romani, D., Storari, L., and Barbari, V. (2023). Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20054098"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.math.2011.04.005","article-title":"How to explain central sensitization to patients with \u2018unexplained\u2019 chronic musculoskeletal pain: Practice guidelines","volume":"16","author":"Nijs","year":"2011","journal-title":"Man. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1140.e11","DOI":"10.1016\/j.jpain.2019.02.011","article-title":"Pain Neuroscience Education for Adults With Chronic Musculoskeletal Pain: A Mixed-Methods Systematic Review and Meta-Analysis","volume":"20","author":"Watson","year":"2019","journal-title":"J. Pain."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3017","DOI":"10.2147\/JPR.S370718","article-title":"Catastrophizing, Kinesiophobia, and Acceptance as Mediators of the Relationship Between Perceived Pain Severity, Self-Reported and Performance-Based Physical Function in Women with Fibromyalgia and Obesity","volume":"15","author":"Varallo","year":"2022","journal-title":"J. Pain Res."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Galan-Martin, M.A., Montero-Cuadrado, F., Lluch-Girbes, E., Coca-Lopez, M.C., Mayo-Iscar, A., and Cuesta-Vargas, A. (2020). Pain Neuroscience Education and Physical Therapeutic Exercise for Patients with Chronic Spinal Pain in Spanish Physiotherapy Primary Care: A Pragmatic Randomized Controlled Trial. J. Clin. Med., 9.","DOI":"10.3390\/jcm9041201"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1080\/09593985.2016.1194648","article-title":"Listening is therapy: Patient interviewing from a pain science perspective","volume":"32","author":"Diener","year":"2016","journal-title":"Physiother. Theory Pract."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Alito, A., Verme, F., Mercati, G.P., Piter\u00e0, P., Fontana, J.M., and Capodaglio, P. (2024). Whole Body Cryostimulation: A New Adjuvant Treatment in Central Sensitization Syndromes? An Expert Opinion. Healthcare, 12.","DOI":"10.3390\/healthcare12050546"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Fontana, J.M., Alito, A., Piter\u00e0, P., Verme, F., Cattaldo, S., Cornacchia, M., Mai, S., Brunani, A., and Capodaglio, P. (2023). Whole-Body Cryostimulation in Post-COVID Rehabilitation for Patients with Obesity: A Multidisciplinary Feasibility Study. Biomedicines, 11.","DOI":"10.3390\/biomedicines11113092"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Varallo, G., Piter\u00e0, P., Fontana, J.M., Gobbi, M., Arreghini, M., Giusti, E.M., Franceschini, C., Plazzi, G., Castelnuovo, G., and Capodaglio, P. (2022). Is Whole-Body Cryostimulation an Effective Add-On Treatment in Individuals with Fibromyalgia and Obesity? A Randomized Controlled Clinical Trial. J. Clin. Med., 11.","DOI":"10.3390\/jcm11154324"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Piter\u00e0, P., Springhetti, I., Alito, A., Verme, F., Fontana, J.M., and Capodaglio, P. (2024). Whole-Body Cryostimulation, a Complementary Treatment for Phantom Limb Syndrome: Preliminary Evidence from a Case Study. Medicina, 60.","DOI":"10.20944\/preprints202311.0172.v1"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"688828","DOI":"10.3389\/fspor.2021.688828","article-title":"Cryostimulation for Post-exercise Recovery in Athletes: A Consensus and Position Paper","volume":"3","author":"Bouzigon","year":"2021","journal-title":"Front. Sports Act. Living"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.jclinepi.2017.04.026","article-title":"CARE guidelines for case reports: Explanation and elaboration document","volume":"89","author":"Riley","year":"2017","journal-title":"J. Clin. Epidemiol."},{"key":"ref_35","first-page":"783","article-title":"The six-minute walk test","volume":"48","author":"Enright","year":"2003","journal-title":"Respir. Care"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Amaral, C.A., Amaral, T.L.M., Monteiro, G.T.R., Vasconcellos, M.T.L., and Portela, M.C. (2019). Hand grip strength: Reference values for adults and elderly people of Rio Branco, Acre, Brazil. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0211452"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Michalos, A.C. (2014). Encyclopedia of Quality of Life and Well-Being Research, Springer.","DOI":"10.1007\/978-94-007-0753-5"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Gummesson, C., Atroshi, I., and Ekdahl, C. (2003). The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: Longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet. Disord., 4.","DOI":"10.1186\/1471-2474-4-11"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/S1836-9553(11)70045-5","article-title":"Shoulder Pain and Disability Index (SPADI)","volume":"57","author":"Breckenridge","year":"2011","journal-title":"J. Physiother."},{"key":"ref_40","unstructured":"Ware, J.E. (1999). The Use of Psychological Testing for Treatment Planning and Outcomes Assessment, Lawrence Erlbaum Associates Publishers. [2nd ed.]."},{"key":"ref_41","first-page":"222","article-title":"The Tampa Scale of Kinesiophobia and neck pain, disability and range of motion: A narrative review of the literature","volume":"55","author":"Hudes","year":"2011","journal-title":"J. Can. Chiropr. Assoc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e273","DOI":"10.1016\/j.bja.2019.03.023","article-title":"Chronic pain: A review of its epidemiology and associated factors in population-based studies","volume":"123","author":"Mills","year":"2019","journal-title":"Br. J. Anaesth."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Ressler, K.J., Pine, D.S., and Rothbaum, B.O. (2015). Anxiety Disorders, Oxford University Press.","DOI":"10.1093\/med\/9780199395125.001.0001"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e35872","DOI":"10.1097\/MD.0000000000035872","article-title":"A scientometric analysis and visualization of kinesiophobia research from 2002 to 2022: A review","volume":"102","author":"Li","year":"2023","journal-title":"Medicine"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"375","DOI":"10.2340\/16501977-0186","article-title":"Kinesiophobia in patients with chronic musculoskeletal pain: Differences between men and women","volume":"40","year":"2008","journal-title":"J. Rehabil. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1136\/bjsports-2017-098673","article-title":"Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: A systematic review","volume":"53","author":"Falla","year":"2019","journal-title":"Br. J. Sports Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"100346","DOI":"10.1016\/j.apjon.2023.100346","article-title":"Relationship between kinesiophobia and quality of life among patients with breast cancer\u2013related lymphedema: Chain-mediating effect of self-care and functional exercise compliance","volume":"11","author":"Wang","year":"2024","journal-title":"Asia-Pac. J. Oncol. Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/2046-7648-2-26","article-title":"Cold-water immersion and other forms of cryotherapy: Physiological changes potentially affecting recovery from high-intensity exercise","volume":"2","author":"White","year":"2013","journal-title":"Extrem. Physiol. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jtherbio.2008.10.003","article-title":"Effects of whole-body cryotherapy on serum mediators of inflammation and serum muscle enzymes in athletes","volume":"34","author":"Banfi","year":"2009","journal-title":"J. Therm. Biol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.apmr.2012.07.013","article-title":"Effects of whole-body cryotherapy in the management of adhesive capsulitis of the shoulder","volume":"94","author":"Ma","year":"2013","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e32181","DOI":"10.1097\/MD.0000000000032181","article-title":"Brown adipose tissue human biomarkers: Which one fits best? A narrative review","volume":"101","author":"Alito","year":"2022","journal-title":"Medicine"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Douzi, W., Dupuy, O., Theurot, D., Boucard, G., and Dugu\u00e9, B. (2019). Partial-body cryostimulation after training improves sleep quality in professional soccer players. BMC Res. Notes, 12.","DOI":"10.1186\/s13104-019-4172-9"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1007\/s00421-020-04406-5","article-title":"The use of whole-body cryotherapy: Time- and dose-response investigation on circulating blood catecholamines and heart rate variability","volume":"120","author":"Louis","year":"2020","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Verme, F., Fontana, J.M., Piter\u00e0, P., Alito, A., Saffioti, S., Baccalaro, G., Zebellin, G., and Capodaglio, P. (2023). Whole-Body Cryostimulation in Functional Neurological Disorders: A Case Report. Healthcare, 12.","DOI":"10.20944\/preprints202310.0937.v1"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Larsson, C., Ekvall Hansson, E., Sundquist, K., and Jakobsson, U. (2016). Kinesiophobia and its relation to pain characteristics and cognitive affective variables in older adults with chronic pain. BMC Geriatr., 16.","DOI":"10.1186\/s12877-016-0302-6"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.pain.2004.03.035","article-title":"Pain-related fear and daily functioning in patients with osteoarthritis","volume":"110","author":"Heuts","year":"2004","journal-title":"Pain"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1093\/pm\/pnac077","article-title":"Effectiveness of Pain Neuroscience Education in Patients with Fibromyalgia: A Systematic Review and Meta-Analysis","volume":"23","year":"2022","journal-title":"Pain Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/7\/2094\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:23:05Z","timestamp":1760106185000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/7\/2094"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,3]]},"references-count":57,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["jcm13072094"],"URL":"https:\/\/doi.org\/10.3390\/jcm13072094","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,3]]}}}