Elif ALTUNEL KILINÇ, Gizem KIRMIZIER, Nurdan ORUÇOĞLU

Ankilozan Spondilitte Hastalık Aktivitesi ve Obezitenin Kinezyofobi Üzerindeki Etkisi

Amaç: Bu çalışmanın amacı ankilozan spondilit (AS) hastalarında kinezyofobi oranını belirlemek ve kinezyofobi ile hastalık aktivitesi, obezite, yaşam kalitesi, fonksiyonel durum, yorgunluk ve düşme korkusu arasındaki ilişkiyi saptamaktır. Gereç ve Yöntemler: Çalışma prospektif olarak dizayn edilmiştir. Çalışmaya 83 ankilozan spondilit hastası ve yaş ve cinsiyet açısından eşleştirilmiş 79 sağlıklı kontrol dahil edildi. Kinezyofobi Tampa Kinezyofobi Ölçeği (TSK) ile, hastalık aktivitesi Bath AS Hastalık Aktivite İndeksi (BASDAI) ile, fonksiyonel durum Sağlık Değerlendirme Anketi (HAQ) ve Bath AS Fonksiyonel İndeksi (BASFI) ile, düşme korkusu Uluslararası Düşme Etkinliği Ölçeği (FES-I) ve Yorgunluk Şiddeti Ölçeği (FSS) ile, Yaşam Kalitesi Anketi (ASQoL), Vücut Kitle İndeksi (VKİ) ile değerlendirildi. Sonuç ölçümlerinin kinezyofobi düzeyleri ile korelasyonu analiz edilmiş ve tüm parametreler kinezyofobisi olan (TSK>37) ve olmayan (TSK≤37) hastalarda karşılaştırılmıştır. Sonuçlar: AS hastalarında kinezyofobi oranı %78,3, ortalama TSK skoru 43,85±9,78 iken, sağlıklı kontrollerde kinezyofobi oranı %17,7, ortalama TSK skoru 27,07±8,46 idi (odds oranı (OR)=16,766, %95 güven aralığı (CI): 7,697-36,518; p<0,001). TSK; VKİ, ASQoL, BASDAI, HAQ, FES-I, FSS, BASFI ile pozitif korelasyon göstermiştir (r=0.336, r=0.457, r=0.341, r=0.447, r=0.269, r=0.371, her biri için p<0.05). VKİ>25 ve BASDAI>4 olan hastaların TSK skorları daha yüksekti (sırasıyla p=0.041 ve p<0.001).

Anahtar Kelimeler:

Ankilozan Spondilit, vücut kitle indeksi, hastalık aktivitesi, kinezyofobi

The Impact of Disease Activity and Obesity on Kinesiophobia in Ankylosing Spondylitis Kinesiophobia and Ankylosing Spondylitis

Objective: This study aims to determine the rate of kinesiophobia in ankylosing spondylitis (AS) patients and to determine the relationship between kinesiophobia and disease activity, obesity, quality of life, functional status, fatigue, and fear of falling. Methods: The study design is a prospective study. That included 83 ankylosing spondylitis patients and 79 age- and gender-matched healthy controls. Kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia (TSK), disease activity with the Bath AS Disease Activity Index (BASDAI), functional status with the Health Assessment Questionnaire (HAQ) and Bath AS Functional Index (BASFI), fear of falling with the Falls Efficacy Scale International (FES-I) and Fatigue Severity Scale (FSS), Quality of Life Questionnaire (ASQoL), Body Mass Index (BMI). The correlation of outcome measures with kinesiophobia levels was analyzed, and all parameters were compared in patients with (TSK>37) and without kinesiophobia (TSK≤37). Results: In AS patients, the rate of kinesiophobia was 78.3%, the mean TSK score was 43.85±9.78, while in healthy controls, the kinesiophobia rate was 17.7%, the mean TSK score was 27.07±8.46 (odds ratio (OR)=16.766, 95% confidence interval (CI): 7.697-36.518; p<0.001). TSK was positively correlated with BMI, ASQoL, BASDAI, HAQ, FES-I, FSS, and BASFI (r=0.336, r=0.457, r=0.341, r=0.447, r=0.269, r=0.371, p<0.05 for each). Patients with a BMI>25, and a BASDAI> 4 had higher TSK scores (p=0.041 and p<0.001, respectively). Conclusion: AS patients have a very high rate of kinesiophobia. Patients with obesity and high disease activity have higher levels of kinesiophobia. Detection of kinesiophobia in patients with AS, control of weight/obesity, and reduction of disease activity should be an important goal.

Keywords:

: Ankylosing Spondylitis, body mass index, disease activity, kinesiophobia,

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1. Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007;369(9570):1379-1390.
2. Dougados M, Dijkmans B, Khan M, Maksymowych W, van der Linden S, Brandt J. Conventional treatments for ankylosing spondylitis. Ann Rheum Dis. 2002;61(Suppl III):40–50.
3. Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability, and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019;53(9):554-559.
4. Gorczyca R, Filip R, Walczak E. Psychological aspects of pain. Ann Agric Environ Med. 2013;20(1):23–7.
5. Keefe FJ, Rumble ME, Scipio CD, Giordano LA, Perri LCM. Psychological aspects of persistent pain: current state of the science. J Pain. 2004;5:195–211.
6. Severeijns R, Vlaeyen JWS, van den Hout MA, Weber WE. Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain. 2001;17:165–72.
7. Sullivan MJL, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17:52–64.
8. Alschuler KN, Hoodin F, Murphy SL, Rice J, Geisser ME. Factors contributing to physical activity in a chronic low back pain clinical sample: a comprehensive analysis using continuous ambulatory monitoring. Pain. 2011;152(11):2521-2527.
9. Lundberg M, Frennered K, Hägg O, Styf J. The impact of fear-avoidance model variables on disability in patients with specific or nonspecific chronic low back pain. Spine (Phila Pa 1976). 2011;36(19):1547-53.
10. Lamoth CJ, Meijer OG, Daffertshofer A, Wuisman PI, Beek PJ. Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control. Eur Spine J. 2006;15(1):23-40.
11. Altuğ F, Ünal A, Kilavuz G, Kavlak E, Çitişli V, Cavlak U. Investigation of the relationship between kinesiophobia, physical activity level, and quality of life in patients with chronic low back pain. J Back Musculoskelet Rehabil. 2016;29(3):527-31.
12. Oskay D, Tuna Z, Düzgün İ, Elbasan B, Yakut Y, Tufan A. Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis. Turk J Med Sci. 2017;47(5):1340-1347.
13. Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007;369(9570):1379-1390.
14. Dougados M, Dijkmans B, Khan M, Maksymowych W, van der Linden S, Brandt J. Conventional treatments for ankylosing spondylitis. Ann Rheum Dis. 2002;61(Suppl III):40–50.
15. Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability, and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019;53(9):554-559.
16. Gorczyca R, Filip R, Walczak E. Psychological aspects of pain. Ann Agric Environ Med. 2013;20(1):23–7.
17. Keefe FJ, Rumble ME, Scipio CD, Giordano LA, Perri LCM. Psychological aspects of persistent pain: current state of the science. J Pain. 2004;5:195–211.
18. Severeijns R, Vlaeyen JWS, van den Hout MA, Weber WE. Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain. 2001;17:165–72.
19. Sullivan MJL, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17:52–64.
20. Alschuler KN, Hoodin F, Murphy SL, Rice J, Geisser ME. Factors contributing to physical activity in a chronic low back pain clinical sample: a comprehensive analysis using continuous ambulatory monitoring. Pain. 2011;152(11):2521-2527.
21. Lundberg M, Frennered K, Hägg O, Styf J. The impact of fear-avoidance model variables on disability in patients with specific or nonspecific chronic low back pain. Spine (Phila Pa 1976). 2011;36(19):1547-53.
22. Lamoth CJ, Meijer OG, Daffertshofer A, Wuisman PI, Beek PJ. Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control. Eur Spine J. 2006;15(1):23-40.
23. Altuğ F, Ünal A, Kilavuz G, Kavlak E, Çitişli V, Cavlak U. Investigation of the relationship between kinesiophobia, physical activity level, and quality of life in patients with chronic low back pain. J Back Musculoskelet Rehabil. 2016;29(3):527-31.
24. Oskay D, Tuna Z, Düzgün İ, Elbasan B, Yakut Y, Tufan A. Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis. Turk J Med Sci. 2017;47(5):1340-1347.
25. Er G, AngIn E. Determining the relationship of kinesiophobia with respiratory functions and functional capacity in ankylosing spondylitis. Medicine (Baltimore). 2017;96(29):e7486.
26. Alghamdi NH, Pohlig RT, Lundberg M, Silbernagel KG. The Impact of the Degree of Kinesiophobia on Recovery in Patients With Achilles Tendinopathy. Phys Ther. 2021;101(11):pzab178.
27. Vincent HK, Vincent KR, Seay AN, Hurley RW. Functional Impairment in Obesity: A Focus on Knee and Back Pain. Pain Med. 2011;12(5):427–439.
28. Bakirci S, Dabague J, Eder L, McGonagle D, Aydin SZ. The role of obesity on inflammation and damage in spondyloarthritis: a systematic literature review on body mass index and imaging. Clin Exp Rheumatol. 2020;38(1):144–148.
29. Vincent HK, Seay AN, Montero C, Conrad BP, Hurley RW, Vincent KR. Kinesiophobia and fear-avoidance beliefs in overweight older adults with chronic low-back pain: relationship to walking endurance--part II. Am J Phys Med Rehabil. 2013;92(5):439-445.