Online ISSN 2313-1519
Print    ISSN 1812-2892
Abstract - The Relationship between Kinesiophobia and Disability, Pain and Anxiety in Patients with Chronic Shoulder Pain: A Case Control Study
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Burhan Fatih Kocyigit, Ahmet Akyol

 

ABSTRACT

Objective: Physical and psychological factors affect disability in patients with chronic shoulder pain. Kinesiophobia which is described as fear of movement may induce disability. Therefore, we aimed to compare kinesiophobia levels between patients with chronic shoulder pain and healthy volunteers and to determine the correlations between kinesiophobia and disability, pain and anxiety.

Material and methods: This is a case-control study. 54 patients with shoulder pain and 56 healthy volunteers similar to case group in terms of age, sex and body mass index were enrolled in this research. Patients were evaluated with visual analogue scale, active range of motion measurements, Tampa Scale for Kinesiophobia, Shoulder Pain and Disability Index and Beck Anxiety Inventory.

Results: Tampa Scale for Kinesiophobia, Shoulder Pain and Disability Index-pain, Shoulder Pain and Disability Index-disability and Beck Anxiety Inventory scores were significantly higher in the patient group (p<0.05). Tampa Scale for Kinesiophobia scores were significantly and positively correlated with visual analogue scale, Shoulder Pain and Disability Index-pain, Shoulder Pain and Disability Index-disability and Beck Anxiety Inventory scores (r=0.334, p=0.014; r=0.585, p<0.001; r=0.540, p<0.001 and r=0.419, p<0.001). Tampa Scale for Kinesiophobia scores were significantly and negatively correlated with range of motion-flexion, range of motion-abduction and range of motion-extension (r= -0.438, p=0.001; r= -0.373, p=0.005 and r= -0.278, p=0.042). No significant correlation was detected between Tampa Scale for Kinesiophobia scores and symptom duration (p>0.05).

Conclusion: Kinesiophobia is associated with disability, pain and anxiety in patients with chronic shoulder pain. Therefore, factors associated with kinesiophobia should be clearly identified and strategies should be created to improve kinesiophobia levels.

Key words: kinesiophobia, shoulder pain, disability

Corresponding Author: Burhan Fatih Kocyigit, Department of Physical Medicine and Rehabilitation, Kahramanmaras Sutcu Imam University School of Medicine, Kahramanmaras, Turkey. E-mail: bfk2701@hotmail.com

References

1. Ostör AJK, Richards CA, Prevost AT, Speed CA, Hazleman BL. Diagnosis and relation to general health of shoulder disorders presenting to primary care. Rheumatology (Oxford). 2005; 44(6):800-805.
https://doi.org/10.1093/rheumatology/keh598

2. Luime JJ, Koes BW, Hendriksen IJM, Burdorf A, Verhagen AP, Miedema HS, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol. 2004; 3(2):73-81. https://doi.org/10.1080/03009740310004667

3. Van Der Windt DAWM, Koes BW, Boeke AJP, Devillé W, De Jong BA, Bouter LM. Shoulder disorders in general practice: prognostic indicators of outcome. Br J Gen Pract. 1996; 46(410):519-523.

4. Kietrys DM, Palombaro KM, Azzaretto E, Hubler R, Schaller B, Schlussel JM, et al. Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. J Orthop Sport Phys. 2013; 43(9):620-634. https://doi.org/10.2519/jospt.2013.4668

5. Pope DP, Croft PR, Pritchard CM, Silman AJ. Prevalence of shoulder pain in the community: the influence of case definition. Ann Rheum Dis. 1997; 56(5):308-312. https://doi.org/10.1136/ard.56.5.308

6. Parr JJ, Borsa PA, Fillingim RB, Tillman MD, Manini TM, Gregory CM, et al. Pain-related fear and catastrophizing predict pain intensity and disability independently using an induced muscle injury model. J Pain. 2012; 13(4):370-378. https://doi.org/10.1016/j.jpain.2011.12.011

7. Lentz TA, Barabas JA, Day T, Bishop MD, George SZ. The relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology. J Orthop Sports Phys Ther. 2009; 39(4):270-277. https://doi.org/10.2519/jospt.2009.2879

8. Lethem J, Slade PD, Troup JD, Bentley G. Outline of a Fear-Avoidance Model of exaggerated pain perception--I. Behav Res Ther. 1983; 21(4):401-408. https://doi.org/10.1016/0005-7967(83)90009-8

9. Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000; 85(3):317-332. https://doi.org/10.1016/S0304-3959(99)00242-0

10. Vlaeyen JWS, Crombez G. Fear of movement / (re)injury, avoidance and pain disability in chronic low back pain patients. Manual Ther. 1999; 4(4):185-195. https://doi.org/10.1054/math.1999.0199

11. Swinkels-Meewisse IEJ, Roelofs J, Oostendorp RAB, Verbeek AL, Vlaeyen JW. Acute low back pain: pain-related fear pain catastrophizing influence physical performance perceived disability. Pain. 2006; 120(1-2):36-43.https://doi.org/10.1016/j.pain.2005.10.005

12. Scopaz KA, Piva SR, Wisniewski S, Fitzgerald GK. Relationships of fear, anxiety, and depression with physical function in patients with knee osteoarthritis. Arch Phys Med Rehabil. 2009; 90(11):1866-1873. https://doi.org/10.1016/j.apmr.2009.06.012

13. George SZ, Fritz JM, Erhard RE. A comparison of fear avoidance beliefs in patients with lumbar spine pain and cervical spine pain. Spine. 2001; 26(19):2139-2145. https://doi.org/10.1097/00007632-200110010-00019

14. Fritz JM, George SZ, Delitto A. The role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work status. Pain. 2001; 94(1):7-15. https://doi.org/10.1016/S0304-3959(01)00333-5

15. Sabari JS, Maltzev I, Lubarsky D, Liszkay E, Homel P. Goniometric assessment of shoulder range of motion: comparison of testing in supine and sitting positions. Arch Phys Med Rehabil. 1998; 79(6):647-651. https://doi.org/10.1016/S0003-9993(98)90038-7

16. Palmer ML, Epler ME. Fundamentals of musculoskeletal assessment techniques. 2nd ed. Philadelphia: Lippincott Raven Publishers; 1998.

17. Hayes K, Walton JR, Szomor ZL, Murrell GA. Reliability of five methods for assessing shoulder range of motion. Aust J Physiother. 2001; 47(4):289-294. https://doi.org/10.1016/S0004-9514(14)60274-9

18. 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).

19. MacDermid JC, Solomon P, Prkachin K. The Shoulder Pain and Disability Index demonstrates factor, construct and longitudinal validity. BMC Musculoskelet Disord. 2006; 7:12. https://doi.org/10.1186/1471-2474-7-12

20. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988; 56(6):893-897. https://doi.org/10.1037/0022-006X.56.6.893

21. Jason M. Beneciuk, Michael E. Robinson, Steven Z. George. Low Back Pain Subgroups using Fear-Avoidance Model Measures: Results of a Cluster Analysis. The Clinical Journal of Pain. 2012; 28(8):658-666. https://doi.org/10.1097/AJP.0b013e31824306ed

22. Feleus A, van Dalen T, Bierma-Zeinstra SM, Bernsen RM, Verhaar JA, Koes BW, et al. Kinesiophobia in patients with non-traumatic arm, neck and shoulder complaints: a prospective cohort study in general practice. BMC Musculoskelet Disord. 2007; 8:117. https://doi.org/10.1186/1471-2474-8-117

23. Veeger HE, van der Helm FC. Shoulder function: the perfect compromise between mobility and stability. Journal of Biomechanics. 2007; 40(10):2119-2129. https://doi.org/10.1016/j.jbiomech.2006.10.016

24. Güney-Deniz H, Irem Kınıklı G, Çağlar Ö, Atilla B, Yüksel İ. Does kinesiophobia affect the early functional outcomes following total knee arthroplasty? Physiotherapy Theory and Practice. 2017; 33(6):448-453. https://doi.org/10.1080/09593985.2017.1318988

25. Brown ML, Plate JF, Von Thaer S, Fino NF, Smith BP, Seyler TM, et al. Decreased Range of Motion After Total Knee Arthroplasty Is Predicted by the Tampa Scale of Kinesiophobia. J Arthroplasty. 2016; 31(4):793-797. https://doi.org/10.1016/j.arth.2015.10.037

26. Bot SD, van der Waal JM, Terwee CB, van der Windt DA, Scholten RJ, Bouter LM, et al. Predictors of outcome in neck and shoulder symptoms: a cohort study in general practice. Spine (Phila Pa 1976). 2005; 30(16):E459-470. https://doi.org/10.1097/01.brs.0000174279.44855.02

27. Perrot S, Trouvin AP, Rondeau V, Chartier I, Arnaud R, Milon JY, et al. Kinesiophobia and physical therapy-related pain in musculoskeletal pain: A national multicenter cohort study on patients and their general physicians. Joint Bone Spine. 2018; 85(1):101-107. https://doi.org/10.1016/j.jbspin.2016.12.014

28. Damsgard E, Thrane G, Anke A, Fors T, Røe C. Activity-related pain in patients withchronic musculoskeletal disorders. Disabil Rehabil. 2010; 32(17):1428-1437. https://doi.org/10.3109/09638280903567877

29. Hanratty CE, Kerr DP, Wilson IM, McCracken M, Sim J, Basford JR, et al. Physical Therapists' Perceptions and Use of Exercise in the Management of Subacromial Shoulder Impingement Syndrome: Focus Group Study. Physical Therapy. 2016; 96(9):1354-1363. https://doi.org/10.2522/ptj.20150427

30. Meeus M, Hermans L, Ickmans K, Struyf F, Van Cauwenbergh D, Bronckaerts L, et al. Endogenous pain modulation in response to exercise in patients with rheumatoid arthritis, patients with chronic fatiguesyndrome and comorbid fibromyalgia, and healthy controls: a double-blind randomized controlled trial. Pain Pract. 2015; 15(2):98-106. https://doi.org/10.1111/papr.12181

31. Koltyn KF, Brellenthin AG, Cook DB, Sehgal N, Hillard C. Mechanisms of exercise-induced hypoalgesia. J Pain. 2014; 15:1294-1304. https://doi.org/10.1016/j.jpain.2014.09.006

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(3):485-491. https://doi.org/10.1016/S0304-3959(02)00265-8

33. Morris LD, Grimmer-Somers KA, Spottiswoode B, Louw QA. Virtual reality exposure therapy as treatment for pain catastrophizing in fibromyalgia patients: proof-of-concept study (Study Protocol). BMC Musculoskeletal Disorders. 2011; 12(1):85. https://doi.org/10.1186/1471-2474-12-85

34. Yilmaz Yelvar GD, Çırak Y, Dalkılınç M, Parlak Demir Y, Guner Z, Boydak A. Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial. Eurepan Spine Journal. 2017; 26(2):538-545. https://doi.org/10.1007/s00586-016-4892-7

 

Volume 3, Number 57 (2020)