Factors Associated with Kinesiophobia in Patients with Knee Osteoarthritis

Abstract

Purpose This study aims to determine factors affecting kinesiophobia in patients with knee osteoarthritis (OA).

Materials and Methods The fear of movement was measured using the Tampa Scale of Kinesiophobia in 60 patients with knee OA. Pain intensity was assessed with the Visual Analog Scale, quality of life with the Nottingham Health Profile (NHP), disability with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), balance with the Berg Balance Scale, mobility with the Timed Up and Go Test, and the physical activity status was measured with the International Physical Activity Questionnaire.

Results Physical mobility and emotional reactions subscales of NHP, all WOMAC subscales and the HADS depression subscale were significantly related to kinesiophobia. Muscle strength, ROM, level of physical activity, balance, mobility and anxiety were not significantly related to kinesiophobia. Quality of life and disability explained 34.4% of the variation in the Tampa Scale of Kinesiophobia.

Conclusions Kinesiophobia was associated with quality of life, disability and depression. It may be useful for clinicians to pay attention to the evaluation of psychosocial characteristics instead of physical performance parameters in order to increase treatment success in OA patients.

Zusammenfassung

ZielZiel dieser Studie ist die Ermittlung der Einflussfaktoren auf Kinesiophobie bei Patienten mit Kniearthrose.

Material und Methoden  Bei 60 Patienten mit Kniearthrose wurde mithilfe der Tampa Scale of Kinesiophobia die Angst vor Bewegung gemessen. Die Schmerzintensität wurde mit der Visual Analog Scale, die Lebensqualität mit dem Nottingham Health Profile (NHP), die Behinderung mit dem Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Angst und Depression mit der Hospital Anxiety and Depression Scale (HADS), das Gleichgewicht mit der Berg Balance Scale, die Mobilität mit dem Timed Up and Go Test und der körperliche Aktivitätsstatus mit dem International Physical Activity Questionnaire bewertet.

Ergebnisse Die Subskalen für körperliche Mobilität und emotionale Reaktionen des NHP, alle WOMAC-Subskalen und die Depressions-Subskalen des HADS waren signifikant mit Kinesiophobie assoziiert. Muskelkraft, Bewegungsfreiheit, körperlicher Aktivitätsgrad, Gleichgewicht, Mobilität und Angst waren nicht signifikant mit Kinesiophobie assoziiert. Lebensqualität und Behinderung erklärten 34,4 % der Abweichungen bei den Ergebnissen der Tampa Scale of Kinesiophobia.

Schlussfolgerung  Kinesiophobie war mit Lebensqualität, Behinderung und Depression assoziiert. Um den Behandlungserfolg bei Arthrosepatienten zu steigern, kann es für Klinikärzte sinnvoll sein, das Augenmerk auf die Bewertung der psychosozialen Merkmale statt der körperlichen Leistungsparameter zu richten.

Key words

kinesiophobia - quality of life - function - disability - depression

Schlüsselwörter

Kinesiophobie - Lebensqualität - Funktion - Behinderung - Depressionpublished online 2022

• References

• 1 Mandelbaum B, Waddell D. Etiology and pathophysiology of osteoarthritis. Orthopedics 2005; 28: 207-214
• 2 Jackson BD, Wluka AE, Teichtahl AJ. et al. Reviewing knee osteoarthritis - a biomechanical perspective. J Sci Med Sport 2004; 7: 347-357
• 3 Wu CW, Kalunian KC. New developments in osteoarthritis. ClinGeriatr Med 2005; 21: 589-601
• 4 Cicuttini FM, Spector TD. Genetics of osteoarthritis. Ann Rheum Dis 1996; 55: 665-667
• 5 Felson DT, Naimark A, Anderson J. et al. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheumatol 1987; 30: 914-918
• 6 Leyland KM, Hart DJ, Javaid MK. et al. The natural history of radiographic knee osteoarthritis: A fourteen-year population-based cohort study. Arthritis Rheumatol 2012; 64: 2243-2251
• 7 Bitton R. The economic burden of osteoarthritis. Am J Manag Care 2009; 15: 230-235
• 8 Heuts PHT, Vlaeyen JW, Roelofs J. et al. Pain-related fear and daily functioning in patients with osteoarthritis. Pain 2004; 110: 228-235
• 9 Hunter DJ, Felson DT. Osteoarthritis. BMJ 2006; 332: 639-642
• 10 Slemenda C, Heilman DK, Brandt KD. et al. Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women?. Arthritis Rheumatol 1998; 41: 1951-1959
• 11 Kori SH. Kinisophobia: a new view of chronic pain behaviour. Pain Manage 1990; 3: 35-43
• 12 Vlaeyen JW, Kole-Snijders AM, Boeren RG. et al. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 1995; 62: 363-372
• 13 O’Reilly SC, Jones A, Muir KR. et al. Quadriceps weakness in knee osteoarthritis: the effect on pain and disability. Ann Rheum Dis 1998; 57: 588-594
• 14 Somers TJ, Keefe FJ, Pells JJ. et al. Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability. J Pain Symptom Manage 2009; 37: 863-872
• 15 Van der Esch M, Steultjens M, Harlaar J. et al. Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee. Arthritis Care Res 2007; 57: 787-793
• 16 Magni G, Moreschi C, Rigatti-Luchini S. et al. Prospective study on the relationship between depressive symptoms and chronic musculoskeletal pain. Pain 1994; 56: 289-297
• 17 Magni G, Caldieron C, Rigatti-Luchini S. et al. Chronic musculoskeletal pain and depressive symptoms in the general population. An analysis of the 1st National Health and Nutrition Examination Survey data. Pain 1990; 43: 299-307
• 18 Urquhart DM, Phyomaung PP, Dubowitz J. et al. Are cognitive and behavioural factors associated with knee pain? A systematic review. Semin Arthritis Rheu 2015; 44: 445-455
• 19 Helminen EE, Sinikallio SH, Valjakka AL. et al. Determinants of pain and functioning in knee osteoarthritis: a one-year prospective study. ClinRehabil 2016; 30: 890-900
• 20 Baert IAC, Meeus M, Mahmoudian A. et al. Do Psychosocial Factors Predict Muscle Strength, Pain, or Physical Performance in Patients With Knee Osteoarthritis?. Jcr-J ClinRheumatol 2017; 23: 308-316
• 21 Turk DC, Monarch ES. Biopsychosocial perspective on chronic pain. Psychological approaches to pain management: A practitioner’s handbook 1996; 3-32
• 22 Gatchel RJ. Comorbidity of chronic pain and mental health disorders: the biopsychosocial perspective. American Psychologist 2004; 59: 95
• 23 Kellgren JH, Lawrence JS. Radiologicalassessment of osteoarthrosis. Ann Rheum Dis 1957; 16: 494-501
• 24 Yilmaz OT, Yakut Y, Uygur F. et al. Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability. TJPR 2011; 22: 44-44
• 25 Miller RP, Kori SH, Todd DD. The Tampa Scale: a measure of kinesiophobia. Clin J Pain 1991; 7: 51
• 26 Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain 2000; 85: 317-32.
• 27 Dixon JS, Bird HA. Reproducibility along a 10-cm vertical visual analogue scale. Ann Rheum Dis 1981; 40: 87-89
• 28 Maffiuletti NA. Assessment of hip and knee muscle function in orthopaedic practice and research. The Journal of bone and joint surgery. JBJS 2010; 92: 220-229
• 29 Watkins MA, Riddle DL, Lamb RL. et al. Reliability of goniometric measurements and visual estimates of knee range of motion obtained in a clinical setting. PhysTher 1991; 71: 90-96
• 30 Berg KO, Wood-Dauphinee SL, Williams JI. et al. Measuring balance in the elderly: validation of an instrument. Can J Public Halth 1992; 83: 7-11
• 31 Sahin F, Yilmaz F, Ozmaden A. et al. Reliability and validity of the Turkish version of the Berg Balance Scale. J GeriatrPhysTher 2008; 31: 32-37
• 32 Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am GeriatrSoc 1991; 39: 142-148
• 33 Bohannon RW. Reference values for the timed Up and Go test: a descriptive meta-analysis. J GeriatrPhysTher 2006; 29: 64-68
• 34 Saglam M, Arikan H, Savci S. et al. International physical activity questionnaire: reliability and validity of the Turkish version. Perceptual and motor skills 2010; 111: 278-284
• 35 Craig CL, Marshall AL, Sjöström M. et al. International Physical Activity Questionnaire: 12 Country Reliability and Validity. Medicine Science and Sports Exercise 2003; 35: 1381-1395
• 36 Tüzün EH, Eker L, Aytar A. et al. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis and cartilage 2005; 13: 28-33
• 37 Bellamy N, Buchanan WW, Goldsmith CH. et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. The Journal of rheumatology 1988; 15: 1833-1840
• 38 Küçükdeveci AA, McKenna SP, Kutlay S. et al. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. International Journal of Rehabilitation Research 2000; 23: 31-38
• 39 Aydemir Ö, Bayar C. Reliability and Validity of the Turkish version of Hospital Anxiety and Depression Scale. TürkPsikiyatrDerg 1997; 8: 280-287
• 40 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Actapsychiatricascandinavica 1983; 67: 361-370
• 41 Burwinkle T, Robinson JP, Turk DC. Fear of movement: factor structure of the Tampa Scale of Kinesiophobia in patients with fibromyalgia syndrome. The Journal of Pain 2005; 6: 384-391
• 42 Crombez G, Vlaeyen JW, Heuts PH. et al. Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability. Pain. 1999; 80: 329-339
• 43 Buitenhuis J, Jaspers JP, Fidler V. Can kinesiophobia predict the duration of neck symptoms in acute whiplash? . The Clinical journal of pain 2006; 22: 272-277
• 44 Ishak NA, Zahari Z, Justine M. Kinesiophobia, Pain, Muscle Functions, and Functional Performances among Older Persons with Low Back Pain. Pain Research and Treatment 2017;
• 45 Leeuw M, Houben RM, Severeijns R. et al. Pain-related fear in low back pain: a prospective study in the general population. Eur J Pain 2007; 11: 256-266
• 46 Boersma K, Linton SJ. Psychological processes underlying the development of a chronic pain problem: a prospective study of the relationship between profiles of psychological variables in the fear-avoidance model and disability. Clin J Pain 2006; 22: 160-166
• 47 Doménech J, Sanchis-Alfonso V, Espejo B. Changes in catastrophizing and kinesiophobia are predictive of changes in disability and pain after treatment in patients with anterior knee pain. Knee Surgery, Sports Traumatology, Arthroscopy 2014; 22: 2295-2300
• 48 Filardo G, Merli G, Roffi A. et al. Kinesiophobia and depression affect total knee arthroplasty outcome in a multivariate analysis of psychological and physical factors on 200 patients. Knee Surgery, Sports Traumatology, Arthroscopy 2017; 25: 3417-23.
• 49 Sled EA, Khoja L, Deluzio KJ. et al. Effect of a home program of hip abductor exercises on knee joint loading, strength, function, and pain in people with knee osteoarthritis: a clinical trial. Physical therapy 2010; 90: 895-904
• 50 Anwer S, Alghadir A. Effect of isometric quadriceps exercise on muscle strength, pain, and function in patients with knee osteoarthritis: a randomized controlled study. Journal of physical therapy science 2014; 26: 745-748
• 51 Russek L, Gardner S, Maguire K. et al. A cross-sectional survey assessing sources of movement-related fear among people with fibromyalgia syndrome. Clinical rheumatology 2015; 34: 1109-1119
• 52 Clark BC, LePorte A, Clark S. et al. Effects of persistent Mal de debarquement syndrome on balance, psychological traits, and motor cortex exctiability. Journal of Clinical Neuroscience 2013; 20: 446-450
• 53 Acar M, Tonga E, Daskapan A et al. Comparison of Physical Activity Levels in Rheumatic Diseases. Aktuelle Rheumatologie 2017; 42: 329–335