Stroke was described as "rapidly emerging clinical signs of focal disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin [1]. The acute phase is one to seven days following stroke onset, and the subacute period is seven days to six months [2]. According to CT/MRI findings, stroke types were divided into ischemic stroke (IS), intracerebral haemorrhage (ICH), subarachnoid haemorrhage (SAH), and stroke of undetermined type (UND) [3]. According to a study conducted in 2019 by GBD, globally, stroke continued to be the third-leading cause of death and disability combined (5.7%) and the second-leading cause of death overall (11.6%), making it an enormous health issue [4], [5]. Stroke is also the leading cause of death and adult disability in China, with 3.94 million new cases reported in 2019, implying a stroke incidence of 276.7 per 100,000 people [6]. From 1990–2019, the incidence of stroke increased by 86.0%, with a 106.0% increase in prevalence and a 13.2% increase in age-standardized prevalence [7]. Eighty per cent of stroke patients have some degree of movement and linguistic dysfunction, with post-stroke hemiparesis being the most common and catastrophic outcome [8], [9].

Hemiplegia refers to motor dysfunction such as weakness and incomplete random movements of the body on the lateral side, mainly manifested by a significant decrease in electromyographic excitability of the affected limb, limitation of joint motion and the appearance of co-movement patterns [10]. Patients will present with upper motor neuron damage syndromes, such as limb paralysis, hypertonia, tendon hyperreflexia, and sensory nerve damage, seriously affecting their physical and mental health and imposing a heavy burden on survivors and society [10], [11], [12].

Stroke rehabilitation is the coordinated application of medical, social, and educational strategies to maximize socio-professional potential and physical and psychological fitness within the limitations of physiology and the environment [13]. The role of rehabilitation in the psychomotor rehabilitation of stroke patients has been stressed in the literature to reduce symptoms and increase the likelihood of better functioning [14]. However, Marque et al. found that 40% of stroke patients experience minor or moderate deficits after recovery [15]. Patients' inactivity in their movements is one of the key challenges to effective rehabilitation. The main reason might be the psychological aspects, particularly the fear of movement—kinesiophobia [16].

The term "kinesiophobia," proposed by Kori in 1990, was defined as an excessive, irrational, and crippling fear of physical movement and activity that stems from a sense of vulnerability brought on by a painful injury or reinjury [17]. Based on earlier research, Vlaeyen proposed the cognitive fear-avoidance model in 1995 [18]. According to Vlaeyen's view, kinesiophobia can lead to avoidance behaviour, which over time results in disability, inactivity, desperation, and a patient caught in a cycle of heightened fear of pain, worse incapacity, and further distress [19], [20].

Stroke is common, yet it is a devastating condition with high mortality and disability rates. Studies have reported that stroke patients exhibit higher levels of kinesiophobia [21]. It has been demonstrated that kinesiophobia affects more than 80% of stroke patients and is quite common [16]. Another study showed that stroke patients experienced mild kinesiophobia, or a fear of moving, connected to a fear of falling [22]. Compared to other nations, China's research on kinesiophobia began relatively recently. Most of it is currently cross-sectional, and short of understanding kinesiophobia's full effects [23], [24]. It must be acknowledged that understanding this occurrence will make it easier to plan strategies for successful post-stroke rehabilitation.

This study aims to: (1) describe the state of kinesiophobia of stroke patients with hemiplegia and analyze the reasons and influencing factors of kinesiophobia of stroke patients with hemiplegia; (2) examine the source and coping experience of kinesiophobia of stroke patients with hemiplegia through qualitative research.