Relationship of Sleep Disturbance and Kinesiophobia with Trigger Points of Gastrocnemius
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Abstract
Background: Gastrocnemius myofascial trigger points may contribute to calf pain, nocturnal discomfort, functional limitation, and altered movement behavior. Sleep disturbance and kinesiophobia are clinically relevant in musculoskeletal pain, but their relationship among individuals with gastrocnemius trigger points remains insufficiently explored. Objective: To determine the association between sleep disturbance and kinesiophobia among individuals with gastrocnemius trigger points. Methods: This cross-sectional observational study was conducted in Layyah and included 109 participants aged 20–50 years with clinically identified gastrocnemius trigger points. Participants were selected using non-probability purposive sampling. Trigger points were identified using Travell and Simons’ diagnostic criteria and a positive jump sign. Sleep disturbance was assessed using the Insomnia Severity Index, and kinesiophobia was assessed using the Tampa Scale of Kinesiophobia. Data were analyzed using SPSS version 27. Categorical variables were summarized as frequencies and percentages, age was summarized using median and interquartile range, and the association between insomnia severity and kinesiophobia was assessed using Spearman’s rank correlation. Results: The median age was 34 years (IQR: 28–42), and 57 participants (52.3%) were female. Left-sided involvement was reported by 56 participants (51.4%). Sleep-related functional interference was the most prominent insomnia-related domain, while pain-related protective beliefs were commonly endorsed across kinesiophobia items. Spearman’s correlation showed a statistically significant positive association between insomnia severity and kinesiophobia (rs = 0.977, p = 0.001). Conclusion: Higher insomnia severity was strongly associated with higher kinesiophobia among individuals with gastrocnemius trigger points. These findings support integrated assessment of sleep disturbance and fear-avoidance beliefs during rehabilitation planning, although causal direction cannot be inferred from the cross-sectional design.
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