Medrado Larissa Nakahata, Oliveira-Junior Silvio Assis de, Martinez Paula Felippe
Striated Muscle Study Laboratory, Integrated Health Institute, Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Brazil.
Int J Rehabil Res. 2024 Dec 1;47(4):252-259. doi: 10.1097/MRR.0000000000000650. Epub 2024 Oct 22.
Pain is the main symptom of inflammatory arthritis and it can impair physical functional performance and physical activity level. Some individuals can develop kinesiophobia and experience a vicious circle of worsening health. This study aimed to investigate the association between pain and physical functional performance/physical activity and determine whether kinesiophobia mediates this association. This was a cross-sectional study with individuals diagnosed with inflammatory arthritis (rheumatoid arthritis or spondyloarthritis) treated at a Rheumatology Outpatient Clinic. We assessed pain (Visual Analogue Scale), physical activity (International Physical Activity Questionnaire - long form), kinesiophobia (Tampa Scale for Kinesiophobia), and physical functional performance (Handgrip Strength Dynamometry, 30-second Sit-to-Stand test, Static Muscular Endurance test, and Timed Up and Go test). The mediating effect of kinesiophobia on the relationship between pain intensity and physical functional performance/physical activity was analyzed, and the significance of the mediating effect (kinesiophobia) was tested through a bootstrap approach. Thirty-three individuals with inflammatory arthritis (mean age: 48 ± 12 years) participated in the study. Kinesiophobia mediates the relationship between pain intensity and physical functional performance analyzed by the 30-second Sit-to-Stand test [indirect effect (IE)overall = -0.343, bootstrap 95% confidence interval (CI): -0.698 to -0.002] and by knee flexion at 90º of the dominant limb (IEoverall = -1.55, bootstrap 95% CI: -3.43 to -0.237). In conclusion, pain intensity can affect physical functional performance through kinesiophobia in individuals with inflammatory arthritis.
疼痛是炎症性关节炎的主要症状，它会损害身体功能表现和身体活动水平。一些人会产生运动恐惧，并经历健康状况恶化的恶性循环。本研究旨在调查疼痛与身体功能表现/身体活动之间的关联，并确定运动恐惧是否介导这种关联。这是一项横断面研究，研究对象为在风湿病门诊接受治疗的被诊断为炎症性关节炎（类风湿关节炎或脊柱关节炎）的个体。我们评估了疼痛（视觉模拟量表）、身体活动（国际身体活动问卷 - 长表）、运动恐惧（坦帕运动恐惧量表）和身体功能表现（握力测力计、30秒坐立试验、静态肌肉耐力试验和定时起立行走试验）。分析了运动恐惧对疼痛强度与身体功能表现/身体活动之间关系的中介作用，并通过自抽样法检验了中介作用（运动恐惧）的显著性。33名患有炎症性关节炎的个体（平均年龄：48±12岁）参与了本研究。运动恐惧介导了通过30秒坐立试验分析的疼痛强度与身体功能表现之间的关系[总体间接效应（IE）=-0.343，自抽样95%置信区间（CI）：-0.698至-0.002]以及优势肢体90º膝关节屈曲时的关系（总体间接效应（IE）=-1.55，自抽样95%置信区间：-3.43至-0.237）。总之，在患有炎症性关节炎的个体中，疼痛强度可通过运动恐惧影响身体功能表现。
