Evaluation Of The Relationship Of Kinesiophobia With Anxiety, Upper Extremity Disability And Quality Of Life In Patients With Frozen Shoulders

Abstract

Introduction Frozen shoulder is a painful shoulder disease in which glenohumeral joint movements are actively and passively restricted in all directions. If not treated, it can cause various psychological diseases and muscle and joint diseases. Kinesiophobia; this is defined as a fear of physical activity resulting from excessive sensitivity and an uncomfortable feeling due to painful or repeated injury. In this study, it was aimed to evaluate the relationship of kinesiophobia to upper extremity disability, anxiety and quality of life in patients with frozen shoulder.

Materials and methods Fırat University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, between September 2020 and March 2021; As a result of clinical evaluation and radiological examinations, patients were enrolled between the ages of 18–75 and who agreed to participate in the study; 48 patients were diagnosed with frozen shoulder and met the inclusion and exclusion criteria of the study and were included in the patient group; Fourty healthy subjects aged between 18–75 years, who did not have shoulder disease and who met the inclusion and exclusion criteria of the study, were included in the control group. A total of 88 cases were included in the study. The following scales were used. TAMPA kinesiophobia scale to assess kinesiophobia in patients and control group, Beck Anxiety scale to assess anxiety in patient group; The Disabilities of The Arm, Shoulder and Hand (DASH) scale to assess upper extremity disability; Short Form (SF)-36 was used to assess quality of life.

Results TAMPA kinesiophobia scale was found to be significantly different in the patient group when the patient group and control group were compared. According to the correlation analysis, the TAMPA kinesiophobia scale showed a positive correlation with the Beck-Anxiety and DASH scales in the patient group, while a negative correlation was found with the SF36-Physical function, emotional role difficulty and social functionality.

Conclusion In patients with frozen shoulder, kinesiophobia seems to be associated with increased anxiety and upper extremity disability, as well as low quality of life. Structural disorders as well as psychological factors should be taken into account among the reasons for the prolonged limitation of movement and delayed recovery. When the physicians serving in the primary care are experienced with patient management with frozen shoulder, as evaluated for therapeutic purposes, planning psychological support treatments in addition to medical and physical therapy will increase the quality of health care provided to patients.

Key words

frozen shoulder - kinesiophobia - anxiety - disability - quality of life

Schlüsselwörter

Frozen shoulder - Kinesiophobie - Angst - Behinderung - Lebensqualität

Publication History

Article published online:
16 October 2023

• References

• 1 Duplay S. De la péri-arthrite scapulo-humérale et des raideurs de L’epaule qui en sont la consequénce. Arch Gen Méd 1872; 20: 513-542
• 2 Zuckerman JD, Matsen FA, Hawkins RJ. The shoulder: a balance of mobility and stability. Am Acad Orthop Surg 1993; 19-109
• 3 Neviaser RJ, Neviaser TJ. The frozen shoulder. Diagnosis and management. Clin Orthop Relat Res 1987; 223: 59-64
• 4 Hazleman BL. The painful stiff shoulder. Rheumatology 1972; 11: 413-421
• 5 Wolfensberger A, Vuistiner P, Konzelmann M. et al. Clinician and Patient-reported Outcomes Are Associated With Psychological Factors in Patients With Chronic Shoulder Pain. Clin Orthop Relat Res 2016; 474: 2030-2039
• 6 Kori SH, Miller RP, Todd D. Kinesiophobia: a new view of chronic pain behaviour. Pain Manag 1990; 3: 35-43
• 7 Tunca Yılmaz Ö, Yakut Y, Uygur F. et al. Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability. Turk J Physiother Rehabil 2011; 22: 44-49
• 8 Walankar PP, Panhale VP, Patil MM. Psychosocial factors, disability and quality of life in chronic shoulder pain patients with central sensitization. Health Psychology Research 2020; 8: 8874
• 9 Uluc S. MMPI-2 Depresyon, Kaygı ve Öfke İçerik Ölçeklerinin Ölçüt Geçerliliği Açısından Değerlendirirlmesi. Türk Psikiyatri Dergisi 2008; 19: 57-66
• 10 Cesim BO, Akel BS, Oksuz C. Investigation of the Relation Between Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) and Lawton Activities of Daily Living Questionnaire in Individuals with Upper Extremity Injury. Journal of Occupational Therapy and Rehabilitation 2017; 5: 189-196
• 11 Ware JE, Sherbourne CD. Short Form-36 (SF-36). Med Care 1992; 30: 473-483
• 12 Hakim AJ, Cherkas LF, Spector TD. et al. Genetic associations between frozen shoulder and tennis elbow: a female twin study. Rheumatology 2003; 42: 739-742
• 13 Debeer P, Franssens F, Roosen I. et al. Frozen shoulder and the Big Five personality traits. J Shoulder Elbow Surg 2014; 23: 221-226
• 14 Cho C-H, Jung S-W, Park J-Y. et al. Is shoulder pain for three months or longer correlated with depression, anxiety, and sleep disturbance?. J Shoulder Elbow Surg 2013; 22: 222-228
• 15 Ding H, Tang Y, Xue Y. et al. A report on the prevalence of depression and anxiety in patients with frozen shoulder and their relations to disease status. Psychol Health Med 2014; 19: 730-737
• 16 Bridgman JF. Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis 1972; 31: 69-71
• 17 Vastamäki H, Varjonen L, Vastamäki M. Optimal time for manipulation of frozen shoulder may be between 6 and 9 months. Scand J Surg 2015; 104: 260-266
• 18 Fernandes MR. Correlation between functional disability and quality of life in patients with adhesive capsulitis. Acta Ortop Bras 2015; 23: 81-84
• 19 Tighe CB, Oakley WS. The prevalence of a diabetic condition and adhesive capsulitis of the shoulder. South Med J 2008; 101: 591-595
• 20 Schiefer M, Teixeira PFS, Fontenelle C. et al. Prevalence of hypothyroidism in patients with frozen shoulder. J Shoulder Elbow Surg 2017; 26: 49-55
• 21 Mallows A, Debenham J, Walker T. et al. Association of psychological variables and outcome in tendinopathy: a systematic review. Br J Sports Med 2017; 51: 743-748
• 22 Martinez-Calderon J, Struyf F, Meeus M. et al. The association between pain beliefs and pain intensity and/or disability in people with shoulder pain: A systematic review. Musculoskelet Sci Pract 2018; 37: 29-57
• 23 Bränström H, Fahlström M. Kinesiophobia in patients with chronic musculoskeletal pain: differences between men and women. J Rehabil Med 2008; 40: 375-380
• 24 Bilge C. The Effect Of Pain On Functionality, Kinesiophobia, Quality Of Sleep And Quality Of Life In The Patients With Adhesive Capsulitis. Master Thesis. Istanbul: Bezmialem Vakif University Institute of Health Sciences, Department of Physiotherapy and Rehabilitation,; 2017
• 25 Alejandro LS, Javier MC, Santiago NL. et al. Kinesiophobia Is Associated With Pain Intensity and Disability in Chronic Shoulder Pain: A Cross-Sectional Study. J Manipulative Physiol Ther 2020; 8: 791-798
• 26 Harris AH, Youd J, Buchbinder R. A comparison of directly elicited and pre-scored preference-based measures of quality of life: the case of adhesive capsulitis. Quality of Life Research 2013; 22: 2963-2971
• 27 Gupta S, Raja K, Manikandan N. Impact of adhesive capsulitis on quality of life in elderly subjects with diabetes: A cross sectional study. Int J Diabetes Dev Ctries 2008; 28: 125
• 28 Altuğ F, Ünal A, Kilavuz G. et al. 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: 527-531
• 29 Guclu DG, Guclu O, Ozaner A. et al. The relationship between disability, quality of life and fear-avoidance beliefs in patients with chronic low back pain. Turkish neurosurgery 2011; 22: 724-731
• 30 Antunes RS, Macedo BGd, Amaral TdS. et al. Pain, kinesiophobia and quality of life in chronic low back pain and depression. Acta Ortop. Bras 2013; 21: 27-29