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类风湿关节炎患者运动恐惧与健康相关生活质量的关系:一项对照横断面研究。

The relationship between kinesiophobia and health-related quality of life in patients with rheumatoid arthritis: A controlled cross-sectional study.

作者信息

Baday-Keskin Dilek, Ekinci Bilge

机构信息

Department of Physical Medicine and Rehabilitation, Erzincan Binali Yildirim University Mengucek Gazi Training and Research Hospital, Erzincan, Turkey.

Department of Physical Medicine and Rehabilitation, Erzincan Binali Yildirim University Mengucek Gazi Training and Research Hospital, Erzincan, Turkey.

出版信息

Joint Bone Spine. 2022 Mar;89(2):105275. doi: 10.1016/j.jbspin.2021.105275. Epub 2021 Sep 15.

Abstract

OBJECTIVES

To evaluate the kinesiophobia and kinesiophobia-related factors in patients with rheumatoid arthritis (RA) and provide a better perspective on the relationship between kinesiophobia and patients' health-related quality of life (HRQoL).

METHODS

A total of 88 patients (67 females, 21 males) with RA and 93 healthy volunteers (67 females, 26 males) were included in the study between March 2020 and July 2020. Kinesiophobia was evaluated using the Tampa Scale of Kinesiophobia (TSK) and HRQoL was evaluated using the 36-item Short-Form Health Survey (SF-36). The Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Health Assessment Questionnaire Disability Index (HAQ-DI), International Physical Activity Questionnaire (IPAQ) (Short Form) were completed by all participants.

RESULTS

The median age was 52.0 (IQR, 45.0-58.0) years in the RA group and 50.0 (IQR, 41.5-56.0) years in the control group. Age and sex were not significantly different between the groups. The median TSK score was 45.0 (IQR, 39.0-49.75) in the RA group, 39.0 (IQR, 37.0-43.0) in the control group (P<0.001). The median FSS, BDI, and HAQ-DI scores were higher and the median HRQoL domains were lower in the RA group than in the control group (P<0.05). Multivariate linear regression analysis including age, sex, education level, body mass index (BMI), morning stiffness duration, Disease Activity Score in 28 joints, FSS, BDI, visual analog scale and IPAQ scores variables showed that FSS scores (B=1.07, P<0.05), BDI scores (B=0.24, P<0.05), and BMI (B=0.22, P<0.05) were independent variables for kinesiophobia in patients with RA (R=0.32). TSK was a predictive variable for HAQ-DI (B=0.03, P<0.001), the physical functioning domain of the HRQoL (B=-1.18, P<0.001), the bodily pain domain of the HRQoL (B=-0.78, P<0.05), respectively.

CONCLUSION

Physicians should have awareness of kinesiophobia in patients with RA. Educating patients about kinesiophobia, developing strategies for avoiding kinesiophobia, and specific treatment strategies with a multidisciplinary approach may improve HRQoL and disability.

摘要

目的

评估类风湿关节炎(RA)患者的运动恐惧及与运动恐惧相关的因素,并更好地了解运动恐惧与患者健康相关生活质量(HRQoL)之间的关系。

方法

2020年3月至2020年7月期间,共纳入88例RA患者(67例女性,21例男性)和93名健康志愿者(67例女性,26例男性)。采用坦帕运动恐惧量表(TSK)评估运动恐惧,采用36项简短健康调查问卷(SF-36)评估HRQoL。所有参与者均完成疲劳严重程度量表(FSS)、贝克抑郁量表(BDI)、健康评估问卷残疾指数(HAQ-DI)、国际体力活动问卷(IPAQ)(简表)。

结果

RA组的中位年龄为52.0(四分位间距,45.0 - 58.0)岁,对照组为50.0(四分位间距,41.5 - 56.0)岁。两组间年龄和性别无显著差异。RA组TSK评分中位数为45.0(四分位间距,39.0 - 49.75),对照组为39.0(四分位间距,37.0 - 43.0)(P<0.001)。RA组的FSS、BDI和HAQ-DI评分中位数高于对照组,HRQoL各领域评分中位数低于对照组(P<0.05)。多因素线性回归分析纳入年龄、性别、教育水平、体重指数(BMI)、晨僵持续时间、28个关节疾病活动评分、FSS、BDI、视觉模拟量表和IPAQ评分等变量,结果显示FSS评分(B = 1.07,P<0.05)、BDI评分(B = 0.24,P<0.05)和BMI(B = 0.22,P<0.05)是RA患者运动恐惧的独立变量(R = 0.32)。TSK分别是HAQ-DI(B = 0.03,P<0.001)、HRQoL身体功能领域(B = -1.18,P<0.001)、HRQoL身体疼痛领域(B = -0.78,P<0.05)的预测变量。

结论

医生应了解RA患者的运动恐惧情况。对患者进行运动恐惧教育、制定避免运动恐惧的策略以及采用多学科方法的特定治疗策略,可能会改善HRQoL和残疾状况。

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