Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis

Relationship between kinesiophobia and pain, quality of life, functional status, disease activity, mobility, and depression in patients with ankylosing spondylitis

Background/aim: Our aim was to investigate the association of kinesiophobia with pain, quality of life, clinical measures, and depression in patients with ankylosing spondylitis (AS). Materials and methods: Patients with AS (n: 163) were enrolled in the study. Kinesiophobia was evaluated with the Tampa Scale of Kinesiophobia (TSK), pain with a visual analog scale (VAS), mobility with Bath Ankylosing Spondylitis Metrology Index (BASMI), disease activity with the Bath AS Disease Activity Index (BASDAI), functional status with the Bath AS Functional Index (BASFI), depression level with Beck s Depression Inventory (BDI), and quality of life with the AS Quality of Life Questionnaire (ASQoL). Besides correlation analysis, outcome measures were compared between patients with (TSK ≥ 37) and without (TSK < 37) kinesiophobia. Results: Kinesiophobia was found to be common with a percentage of 66.6%. TSK scores were correlated with VAS, BASFI, ASQoL, and BDI scores (r = 0.259, r = 0.294, r = 0.392, and r = 0.398, respectively; P < 0.05 for each). There were no correlations between TSK and the BASDAI and BASMI scores (r = 0.142, r = 0.198, respectively; P > 0.05). Patients with kinesiophobia had more pain and poorer BASFI, ASQoL, and BDI scores than patients without kinesiophobia (P < 0.05). Conclusion: Our study is the first study that investigated the relationship between kinesiophobia and other clinical measures in AS patients. Pain and psychological status have an impact on fear of movement and thus functional status and quality of life.

___

  • 1. Zochling J, Brandt J, Braun J. The current concept of spondyloarthritis with special emphasis on undifferentiated spondyloarthritis. Rheumatology 2005; 44: 1483-1491.
  • 2. Singh JA, Strand V. Spondyloarthritis is associated with poor function and physical health-related quality of life. J Rheumatol 2009; 36: 1012-1020.
  • 3. Heikkila S, Viitanen JV, Kautiainen H, Kauppi M. Functional long-term changes in patients with spondyloarthropathy. Clin Rheumatol 2002; 21: 119-122.
  • 4. Braun J, van den Berg R, Baraliakos X, Boehm H, BurgosVargas R, Collantes-Estevez E, Dagfinrud H, Dijkmans B, Dougados M, Emery P et al. 2010 update of the ASAS/ EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis 2011; 70: 896-904.
  • 5. Roelofs J, Goubert L, Peters ML, Vlaeyen JWS, Crombez G. The Tampa Scale for Kinesiophobia: further examination of psychometric properties in patients with chronic low back pain and fibromyalgia. Eur J Pain 2004; 8: 495-502.
  • 6. Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000; 85: 317-332.
  • 7. Buer N, Linton SJ. Fear-avoidance beliefs and catastrophizing: occurrence and risk factor in back pain and ADL in the general population. Pain 2002; 99: 485-491.
  • 8. Rudwaleit M, van der Heijde D, Landewé R, Listing J, Akkoc N, Brandt J, Braun J, Chou CT, Collantes-Estevez E, Dougados M et al. The development of assessment of SpondyloArthritis International Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis 2009; 68: 777e83.
  • 9. Jenkinson TR,  Mallorie PA,  Whitelock HC,  Kennedy LG,  Garrett SL,  Calin A. Defining spinal  mobility  in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol 1994; 21: 1694-1698.
  • 10. Ozer HT,  Sarpel T,  Gulek B,  Alparslan ZN,  Erken E. The  Turkish  version of the Bath Ankylosing Spondylitis Functional Index: reliability and validity. Clin Rheumatol 2005; 24: 123-128.
  • 11. Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc NA.  Turkish  version of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int 2005; 25: 280-284.
  • 12. Tunca Yılmaz Ö, Yakut Y, Uygur F, Uluğ N. Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability. Türk Fizyoterapi ve Rehabilitasyon Dergisi 2011; 22:44-49 (in Turkish with abstract in English).
  • 13. Duruöz MT,  Doward L,  Turan Y,  Cerrahoglu L,  Yurtkuran M,  Calis M,  Tas N,  Ozgocmen S,  Yoleri O,  Durmaz B  et al. Translation and validation of the  Turkish  version of the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. Rheumatol Int 2013; 33: 2717-2722.
  • 14. Hisli N. Beck Depresyon Envanteri’nin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi 1989; 7: 3-13 (in Turkish).
  • 15. Branstrom H, Fahlstrom M. Kinesiophobia in patients with chronic musculoskeletal pain: differences between men and women. J Rehabil Med 2008; 40: 375-380.
  • 16. Roelofs J, van Breukelen G, Sluiter J, Frings-Dresen MH, Goossens M, Thibault P, Boersma K, Vlaeyen JW. Norming of the Tampa Scale for Kinesiophobia across pain diagnoses and various countries. Pain 2011; 152: 1090-1095.
  • 17. Pells J,  Edwards CL,  McDougald CS,  Wood M,  Barksdale C,  Jonassaint J,  Leach-Beale B,  Byrd G,  Mathis M,  Harrison MO  et al. Fear of movement (kinesiophobia), pain, and psychopathology in patients with sickle cell disease. Clin J Pain 2007; 23: 707-713.
  • 18. Nederhand MJ, Ijzerman MJ, Hermens HJ, Turk DC, Zilvold G. Predictive value of fear avoidance in developing chronic neck pain disability: consequences for clinical decision making. Arch Phys Med Rehabil 2004; 85: 496-501.
  • 19. Asmundson GJ, Taylor S. Role of anxiety sensitivity in painrelated fear and avoidance. J Behav Med 1996; 19: 577-586. 20. Lööf H, Demmelmaier I, Henriksson EW, Lindblad S, Nordgren
  • B,  Opava CH,  Johansson UB. Fear avoidance beliefs about physical activity in adults with rheumatoid arthritis. Scan J Rheum 2015; 44: 93-99.
  • 21. Leeuw M, Goossens ME, Linton SJ, Crombez G, Boersma K, Vlaeyen JW. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med 2007; 30: 77-94.
  • 22. Burwinkle T, Robinson JP, Turk DC. Fear of movement: factor structure of the tampa scale of kinesiophobia in patients with fibromyalgia syndrome. J Pain 2005; 6: 384-391.
  • 23. Holmgren A, Wise MG, Boukoms AJ.  Pain management. In: Wise MG, Randell JR, editors. Textbook of Consultation Liaison Psychiatry. 2nd ed. Washington, DC, USA: American Psychiatric Press; 2002. pp. 989-1013.
  • 24. Greenen R, Newman S, Bossema E, Vriezekolk JE, Boelen PA. Psychological interventions for patients with rheumatic diseases and anxiety or depression. Best Prac Res Clin Rheum 2012; 26: 305-319.
  • 25. Martindale J,  Smith J,  Sutton CJ,  Grennan D,  Goodacre L, Goodacre JA. Disease and psychological status in ankylosing spondylitis. Rheumatology 2006; 45: 1288-1293.
  • 26. Baysal O, Durmuş B, Ersoy Y, Altay Z, Senel K, Nas K, Uğur M, Kaya A, Gür A, Erdal A et al. Relationship between psychological status and disease activity and quality of life in ankylosing spondylitis. Rheumatol Int 2011; 31: 795-800. 
  • 27. Von Korff M, Simon G. The relationship between pain and depression. Br J Psychiatry 1996; 30 (Suppl.): 101-108.
  • 28. Prkachin K, Schultz I, Hughes E. Pain behavior and the development of pain-related disability: the importance of guarding. Clin J Pain 2007; 23: 270-277.
  • 29. Crombez G, Vlaeyen JW, Heuts PH, Lysens R. Pain-related fear is more disabling than pain itself: evidence on the role of painrelated fear in chronic back pain disability. Pain 1999; 80: 329- 339.
  • 30. Bostan EE, Borman P, Bodur H, Barça N. Functional disability and quality of life in patients with ankylosing spondylitis. Rheumatol Int 2003; 23: 121-126.
  • 31. O’Dwyer T, O’Shea F, Wilson F. Exercise therapy for spondyloarthritis: a systematic review. Rheumatol Int 2014; 34:887-902.
  • 32. Buer N, Linton SJ. Fear-avoidance beliefs and catastrophizing: occurrence and risk factor in back pain and ADL in the general population. Pain 2002; 99: 485-491.
  • 33. de Jong JR, Vlaeyen JW, Onghena P, Goossens ME, Geilen M, Mulder H. Fear of movement/(re)injury in chronic low back pain: education or exposure in vivo as mediator to fear reduction? Clin J Pain 2005; 21: 9-17.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: 6
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Effects of whole blood viscosity and plasma NOx on cardiac function and cerebral blood flow in children with chronic kidney disease

Necla BUYAN, Bülent ÇELİK, Nilgün ÇAKAR, Deniz ERBAŞ, Tayfun GÖKTAŞ, Serdar KULA, Meltem AKÇABOY, Nermin UNCU, Bijen NAZLIEL

Effect of inhaled steroids on clinical and inflammatoryparameters in children with cystic fibrosis

Bülent Taner KARADAĞ, Goncagül HAKLAR, Zeynep Seda UYAN, Fazilet KARAKOÇ, Elif DAĞLI, Sedat OKTEM, Refika ERSU, Göksenin ÜNLÜGÜZEL ÜSTÜN, Erkan ÇAKIR

Meryem ÇOLAK, Gülendam BOZDAYI, Aylin ALTAY, Zahide YALAKİ, Kamruddin AHMED, Seçil ÖZKAN

Polymorphisms of cancer-related genes and risk of multipleprimary malignancies involving colorectal cancer

Anshan WU, Jingjing LI, Chunlan LIU, Jianda ZHOU, Ke CAO, Peiguo CAO, Ling LIU, Li YU, Chengxian GUO

The effect of antidiuretic hormone on urine and serum electrolyte levelsin children with primary monosymptomatic nocturnal enuresis

Yaşar KANDUR, Oğuz SÖYLEMEZOĞLU, Kibriya FİDAN, Nesrin TAŞ

Effect of treatment of iron deficiency anemia onhemoglobin A1c in type 2 diabetic patients

Rezvan RAZMANDEH, Ensieh NASLI-ESFAHANI, Peyvand AMINI, Robabeh GHODSSI-GHASSEMABADI, Bagher LARIJANI

Hasan BOSTANCI, Kürşat DİKMEN, Nalan AKYÜREK, Ahmet Çağri BÜYÜKKASAP, Aydin YAVUZ, Mehmet Muhittin YALÇIN, Murat AKIN

Analysis of recurrent urethral strictures due to iatrogenic urethral trauma

Fuat KIZILAY, Ceyhun ÖZYURT, Adnan ŞİMŞİR

Cemal ORHAN, Nurhan ŞAHİN, Zeynep TUZCU, James R. KOMOROWSKI, Kazim ŞAHİN

Mediha TÜRKTAN, Yasemin GÜNEŞ, Hafize YALINIZ, Selçuk MATYAR, Zehra HATİPOĞLU, Ersel GÜLEÇ, Uğur GÖÇEN, Atakan ATALAY