Yılmaz Güleser Güney, Tanrıverdi Müberra, Önal Gözde, Yiğit Ayşenur Baysal, Şahin Sedef, Çakır Fatma Betül
Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Türkiye.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakıf University, Istanbul, Türkiye.
Eur J Pediatr. 2025 Feb 13;184(3):195. doi: 10.1007/s00431-025-06032-9.
Primary malignant bone tumors are significant health concerns in children. These tumors, often accompanied by pain, fatigue, and reduced physical function, can lead to the development of kinesiophobia, a fear of movement that can further complicate rehabilitation. Although factors associated with kinesiophobia have been examined in various adult cancer populations, there is limited research on kinesiophobia and its predictors in children with bone tumors. This study aims to investigate the factors contributing to kinesiophobia in pediatric bone tumor patients. This prospective cross-sectional study was conducted in children with primary malignant bone tumors aged 8-17 years who actively on treatment. The Tampa Scale for Kinesiophobia (TSK) was used to assess fear of movement. Other assessments included the numerical rating scale (NRS) for pain, the PedsQL™ Multidimensional Fatigue Scale for fatigue, the Children Depression Rating Scale-Revised (CDRS-R) for depression, manual muscle testing, and the TUG Test for functionality. Logistic regression was performed to identify predictors of kinesiophobia, while chi-square tests examined the relationship between muscle strength and kinesiophobia levels. One hundred children with bone tumors an average age of 11.83 years participated in the study. The logistic regression model indicated that surgery status, pain levels, and fatigue were significant predictors of kinesiophobia, with an R value of 0.870, explaining 87% of the variance in kinesiophobia levels. Children who had surgery and were in more pain and had higher levels of depression were more likely to exhibit kinesiophobia.
This study highlights the multifactorial nature of kinesiophobia in children with malignant bone tumors, emphasizing the roles of surgical status, pain, and psychological factors. Integrating biopsychosocial assessments and approaches into routine care may be important to reduce kinesiophobia, improve rehabilitation outcomes, and increase overall well-being.
• Kinesiophobia has been studied in adult cancer populations and has been associated with decreased physical activity and poorer rehabilitation outcomes.
• This study demonstrates that surgery status, pain levels, and fatigue are significant predictors of kinesiophobia in children with malignant bone tumors and highlights that, in addition to various cancer-related symptoms, kinesiophobia can also be present in this population.
原发性恶性骨肿瘤是儿童重要的健康问题。这些肿瘤常伴有疼痛、疲劳和身体功能下降,可导致运动恐惧的产生,而这种对运动的恐惧会使康复过程更加复杂。尽管在各类成年癌症患者群体中已对与运动恐惧相关的因素进行了研究,但关于骨肿瘤患儿的运动恐惧及其预测因素的研究却很有限。本研究旨在调查导致小儿骨肿瘤患者运动恐惧的因素。这项前瞻性横断面研究是在8至17岁正在接受积极治疗的原发性恶性骨肿瘤患儿中进行的。采用坦帕运动恐惧量表(TSK)来评估运动恐惧。其他评估包括疼痛数字评定量表(NRS)、用于评估疲劳的儿童多维疲劳量表(PedsQL™)、用于评估抑郁的儿童抑郁评定量表修订版(CDRS-R)、徒手肌力测试以及用于评估功能的定时起立行走测试(TUG测试)。进行逻辑回归以确定运动恐惧的预测因素,同时采用卡方检验来研究肌肉力量与运动恐惧水平之间的关系。100名平均年龄为11.83岁的骨肿瘤患儿参与了该研究。逻辑回归模型表明,手术状态、疼痛程度和疲劳是运动恐惧的显著预测因素,R值为0.870,解释了运动恐惧水平变异的87%。接受过手术、疼痛更严重且抑郁程度更高的儿童更有可能表现出运动恐惧。
本研究突出了恶性骨肿瘤患儿运动恐惧的多因素性质,强调了手术状态、疼痛和心理因素的作用。将生物心理社会评估和方法纳入常规护理对于减少运动恐惧、改善康复效果和提高整体幸福感可能很重要。
• 运动恐惧已在成年癌症患者群体中得到研究,且与身体活动减少和康复效果较差相关。
• 本研究表明,手术状态、疼痛程度和疲劳是恶性骨肿瘤患儿运动恐惧的显著预测因素,并强调除了各种与癌症相关的症状外,该群体中也可能存在运动恐惧。