Baysalhan Öztürk İlkay, Garip Yeşim, Sivas Filiz, Parlak Özden Merve, Bodur Hatice
Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital Physical Therapy and Rehabilitation Hospital, Ankara, Turkey.
Pediatric Brain Injury Rehabilitation Clinic, Ankara Bilkent City Hospital Physical Therapy and Rehabilitation Hospital, Ankara, Turkey.
Arch Rheumatol. 2021 Feb 9;36(3):427-434. doi: 10.46497/ArchRheumatol.2021.8535. eCollection 2021 Sep.
This study aims to determine the frequency of kinesiophobia in rheumatoid arthritis (RA) patients and to evaluate the relation of kinesiophobia with the knee range of motion (ROM), quadriceps muscle strength, fear of falling, functional status, disease activity, depression, and quality of life.
Between September 2018 and September 2019, a total of 100 RA patients (25 males, 75 females; mean age: 56.1±9.3 years; range, 32 to 69 years) and 50 healthy controls (14 males, 36 females; mean age: 54.6±9.8 years; range, 30 to 69 years) were included. Disease activity was evaluated using the Disease Activity Score 28 (DAS28), and functional status using the Health Assessment Questionnaire (HAQ). Pain severity was measured using the Visual Analog Scale (VAS). Tampa Kinesiophobia Scale (TKS) was used to evaluate kinesiophobia. Quadriceps muscle strength and knee ROM measurements of two extremities were recorded. Depression was evaluated using the Beck Depression Inventory (BDI), fear of falling by Falls Efficacy Scale (FES) and quality of life using the Short Form-36 (SF-36).
The rate of kinesiophobia was 70% in RA patients and 12% in controls, indicating a higher rate in RA patients, compared to controls (odds ratio [OR] = 44.861, 95% confidence interval [CI]: 42.571-49.052; p<0.05). This rate was 76% in females and 52% in males. Regression analysis revealed that the number of swollen and tender joints, DAS28, VAS-pain, and HAQ scores were positively associated with the TKS scores (p<0.05). Quadriceps muscle strength and knee flexion were negatively associated with the TKS scores (p<0.05). The TKS was significantly correlated with FES and BDI (p<0.05). The TKS was negatively correlated with SF-36 subscales (p<0.05).
Kinesiophobia is common in RA patients. Our study is the first to evaluate the frequency of kinesiophobia in RA patients and to show pain level, disease activity, functional status, knee flexion ROM, and quadriceps muscle strength are effective on kinesiophobia. Kinesiophobia is also associated with fear of falling and depression, negatively affecting the quality of life in terms of physical, emotional, social and mental functions. Therefore, evaluating kinesiophobia and developing targeted treatment approaches seem to be useful in increasing the quality of life in RA.
本研究旨在确定类风湿关节炎（RA）患者运动恐惧的发生率，并评估运动恐惧与膝关节活动范围（ROM）、股四头肌力量、跌倒恐惧、功能状态、疾病活动度、抑郁及生活质量之间的关系。
2018年9月至2019年9月，共纳入100例RA患者（男性25例，女性75例；平均年龄：56.1±9.3岁；范围32至69岁）和50例健康对照者（男性14例，女性36例；平均年龄：54.6±9.8岁；范围30至69岁）。采用疾病活动度评分28（DAS28）评估疾病活动度，采用健康评估问卷（HAQ）评估功能状态。使用视觉模拟量表（VAS）测量疼痛严重程度。采用坦帕运动恐惧量表（TKS）评估运动恐惧。记录双侧下肢的股四头肌力量和膝关节ROM测量值。采用贝克抑郁量表（BDI）评估抑郁，采用跌倒效能量表（FES）评估跌倒恐惧，采用简短健康调查问卷36（SF-36）评估生活质量。
RA患者运动恐惧发生率为70%，对照组为12%，表明RA患者的发生率高于对照组（优势比[OR]=44.861，95%置信区间[CI]：42.571-49.052；p<0.05）。女性发生率为76%，男性为52%。回归分析显示，肿胀和压痛关节数、DAS28、VAS疼痛评分和HAQ评分与TKS评分呈正相关（p<0.05）。股四头肌力量和膝关节屈曲与TKS评分呈负相关（p<0.05）。TKS与FES和BDI显著相关（p<0.05）。TKS与SF-36各分量表呈负相关（p<0.05）。
运动恐惧在RA患者中很常见。我们的研究首次评估了RA患者运动恐惧的发生率，并表明疼痛程度、疾病活动度、功能状态、膝关节屈曲ROM和股四头肌力量对运动恐惧有影响。运动恐惧还与跌倒恐惧和抑郁相关，在身体、情感、社会和心理功能方面对生活质量产生负面影响。因此，评估运动恐惧并制定针对性的治疗方法似乎有助于提高RA患者的生活质量。
