Kiefer David, Braun Juergen, Kiltz Uta, Kolle Niklas, Schneider Lucia, Andreica Ioana, Buehring Bjoern, Sewerin Philipp, Redeker Imke, Tsiami Styliani, Herbold Susanne, Baraliakos Xenofon
Ruhr-Universität, Bochum, Germany; Rheumazentrum Ruhrgebiet, Herne, Germany.
Ruhr-Universität, Bochum, Germany; Rheumatologisches Versorgungszentrum RVZ Steglitz, Berlin, Germany.
Joint Bone Spine. 2025 Feb 25;92(4):105873. doi: 10.1016/j.jbspin.2025.105873.
To investigate prevalence and associations of kinesiophobia on patients with axSpA, and its relation to global functioning and health, disease activity, function, spinal mobility and physical activity in comparison to healthy controls (HC).
Cross-sectional, observational study in which consecutive axSpA patients with axSpA (n=100) and 20 healthy controls (HC) were examined by the Tampa scale of kinesiophobia (TSK), and the Fear avoidance belief questionnaire (FABQ). Patient reported outcomes and objective assessments of disease activity physical function, global health and functioning as well as the BASMI, the AS physical performance index (ASPI), the Short Physical Performance Battery (SPPB) and Epionics SPINE (ES) measurements, including range of motion (RoM) and kinematics (RoK) were collected.
AxSpA patients showed higher TSK (25.5±6.8 vs. 14.0±5.1) and FABQ scores (40.1±22 vs. 3.1±6.9) compared to HC, all P≤0.001. Categorical analyses of kinesiophobia levels revealed that patients with higher levels performed significantly worse in ASPI and SPPB tasks, and they also showed impairments in BASMI and ES measures. TSK and FABQ scores correlated with ASAS HI (r=0.45 and r=0.52) and BASFI (r=0.38 and r=0.44), but not with ASPI, SPPB and RoK. Weak correlations were found for BASMI (r=0.24 and r=0.38) and BASDAI (both r=0.35).
Kinesiophobia seems to be a clinically relevant problem of axSpA patients, since the mobility of patients with moderate to high TSK and FABQ scores was much more impaired in this study. Of interest, the level of kinesiophobia showed stronger correlations with physical function, global functioning and health than with mobility and PA.
调查运动恐惧在轴向脊柱关节炎（axSpA）患者中的患病率及相关性，以及与健康对照（HC）相比，其与整体功能和健康、疾病活动度、功能、脊柱活动度及身体活动的关系。
采用横断面观察性研究，对连续纳入的100例axSpA患者和20例健康对照进行坦帕运动恐惧量表（TSK）及恐惧回避信念问卷（FABQ）评估。收集患者报告的结局以及疾病活动度、身体功能、整体健康和功能的客观评估指标，以及简明脊柱活动度测量指数（BASMI）、强直性脊柱炎身体表现指数（ASPI）、简短身体表现量表（SPPB）和Epionics SPINE（ES）测量值，包括活动范围（RoM）和运动学（RoK）。
与健康对照相比，axSpA患者的TSK评分（25.5±6.8 vs. 14.0±5.1）和FABQ评分（40.1±22 vs. 3.1±6.9）更高，所有P≤0.001。运动恐惧水平的分类分析显示，运动恐惧水平较高的患者在ASPI和SPPB任务中的表现明显更差，并且在BASMI和ES测量中也存在损伤。TSK和FABQ评分与ASAS健康指数（r=0.45和r=0.52）以及BASFI（r=0.38和r=0.44）相关，但与ASPI、SPPB和RoK无关。发现与BASMI（r=0.24和r=0.38）以及BASDAI（两者r=0.35）存在弱相关性。
运动恐惧似乎是axSpA患者的一个临床相关问题，因为在本研究中，TSK和FABQ评分中至高度的患者活动能力受损更严重。有趣的是，运动恐惧水平与身体功能、整体功能和健康的相关性强于与活动度和身体活动的相关性。
