Research Article
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Relationships of Pain Intensity, Kinesiophobia and Quality of Life in Chronic Subacromial Pain Syndrome

Year 2019, Volume: 19 Issue: 2, 396 - 406, 28.06.2019
https://doi.org/10.17098/amj.581993

Abstract

Objectives: Shoulder pain is an important and frequently
reported biopsychosocial problem. In addition to physical problems,
understanding of psychological problems that contribute to shoulder pain is
important for the treatment process. Therefore, the purpose was to investigate
the relationship between kinesiophobia, demographic characteristics, pain
intensity and quality of life in patients seeking conservative treatment for
chronic subacromial pain syndrome



Materials and Methods: Patients with chronic shoulder pain who applied to
İzmir Atatürk Training and Research Hospital were included in the study.
Demographic data of the patients were recorded. The pain severity with Visual
Analogue Scale, kinesiophobia with the Tampa Scale of Kinesiophobia (TSK), and
quality of life with SF-36 quality of life index were assessed. In statistical
analysis, Spearman and Kendall Correlation Analysis were used. Statistical
significance level was set at p <0.05.



Results: Ninety-five patients, 32 male and 63 female, were included in the
study. The median age was 51 (40-61) years, TSK score was 43(38-47), pain at
rest was 3(0-5), pain during activity was 7 (5-8), SF-36 physical component
(PC) and mental component (MC) scores were 36.50(29.3-42.1) and 42(34.9-49.6),
respectively. While there was no difference between the pain (rest pain
female/male= 3/2, p=0.054; activity pain female/male= 7/6, p=0.187) and
kinesophobia scores (female/male=43/41, p=0,185) between genders, physical
(female/male= 34.40 /41.40, p=0.001) and mental components
(female/male=37.70/48.45, p=0.000) of quality of life was lower in women.
Kinesiophobia score showed correlations with educational level, physical and
mental components of quality of life (r= -0.163, p= 0.039; r= -0.499, p= 0.000;
r= -0.279, p= 0.006).



Conclusion: Patients with subacromial pain syndrome had high
kinesiophobia scores. Female and male participants showed similar pain and
kinesiophobia, however, quality of life scores were better in male
participants. Kinesiophobia showed negative correlations with the level of
education, SF-36 scores. It is important to consider kinesiophobia, education
level and quality of life integrations in chronic shoulder rehabilitation.

References

  • George SZ, Staud R, Borsa PA, et al. Biopsychosocial influence on shoulder pain: Rationale and protocol for a pre-clinical trial. Contemp Clin Trials 2017;56:9-17.
  • Diercks RL. Practice guideline 'Diagnosis and treatment of the subacromial pain syndrome. Ned Tijdschr Geneeskd 2014;158:A6985.
  • Luime JJ, Koes BW, Hendriksen IJ, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol 2004;33(2):73-81.
  • Pribicevic M. The epidemiology of shoulder pain: A narrative review of the literature. In Pain in perspective. InTech. 2012.
  • Steuri R, Sattelmayer M, Elsig S, et al. Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs. Br J Sports Med 2017 Jun 19. pii: bjsports-2016-096515. doi: 10.1136/bjsports-2016-096515. [Epub ahead of print] Review.
  • Lentz TA, Barabas JA, Day T, Bishop MD, George SZ. The relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology. J Orthop Sports Phys Ther 2009;39(4):270-7
  • Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the ‘Scapular Summit’. Br J Sports Med 2013; 47(14):877-885.
  • Burwinkle T, Robinson JP, Turk DC. Fear of movement: factor structure of the tampa scale of kinesiophobia in patients with fibromyalgia syndrome. J Pain 2005;6(6):384- 391.
  • Westman AE, Boersma K, Leppert J, Linton SJ. Fear-avoidance beliefs, catastrophizing, and distress: a longitudinal subgroup analysis on patients with musculoskeletal pain. Clin J Pain 2011;27(7):567–577.
  • Sindhu SB, Lehman LA, Tarima S, Bishop MD, Hart DL, Klein MR, et al. Influence of fear-avoidance beliefs on functional status outcomes for people with musculoskeletal conditions of the shoulder. Phys Ther 2012; 92(8): 992-1005.
  • Erol Ö, Özçakar L, Çeliker R. Shoulder rotator strength in patients with stage I-II subacromial impingement: relationship to pain, disability, and quality of life. J Shoulder Elbow Surg 2008;17(6), 893-7.
  • Bailey KM, Carleton RN, Vlaeyen JW, Asmundson GJ. Treatments addressing pain-related fear and anxiety in patients with chronic musculoskeletal pain: a preliminary review. Cogn Behav Ther 2010;39(1), 46-63
  • George SZ, Dover GC, Fillingim RB. Fear of pain influences outcomes after exercise-induced delayed onset muscle soreness at the shoulder. Clin J Pain 2007;23(1):76-84.
  • Boersma K, Linton SJ. Expectancy, fear and pain in the prediction of chronic pain and disability: a prospective analysis. Eur J Pain. 2006;10(6):551-7.
  • Hart DL, Werneke MW, George SZ, et al. Screening for elevated levels of fear-avoidance beliefs regarding work or physical activities in people receiving outpatient therapy. Phys Ther 2009;89(8):770-85.
  • Clark P, Pilar L, Homero M. Learning from pain scales: patient perspective. J Rheumatology (2003);30(7): 1584-1588.
  • Miller RP, Kori SH, Todd DD. The Tampa Scale: a Measure of Kinisophobia. Clin J Pain 1991; 7(1):51.
  • Vlaeyen JW, Kole-Snijders AM, Rotteveel AM, Ruesink R, Heuts PH. The role of fear of movement/(re) injury in pain disability. J Occup Rehabil 1995;5(4):235-52.
  • Tunca Yılmaz Ö, Yakut Y, Uygur F, Ulug N. Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. Fizyoterapi Rehabilitasyon 2011;22(1):44-9.
  • McHorney CA, Ware Jr JE, Lu JR, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994;32(1):40-66.
  • Koçyiğit H, Aydemir Ö, Fişek G. Kısa Form-36’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi Dergisi 1999;12(2):102-6.
  • Thompson DP, Oldham JA, Urmston M, Woby SR. Cognitive determinants of pain and disability in patients with chronic whiplash-associated disorder: a cross-sectional observational study. Physiotherapy 2010;96(2):151-9
  • Brӓnström H, Fahlström M. Kinesiophobia in patients with chronic musculoskeletal pain: Differences between men and women. J Rehabil Med 2008;40:375–80.
  • Lundberg M, Grimby-Ekman A, Verbunt J, Simmonds MJ. Pain-related fear: A critical review of the related measures. Pain Res Treat 2011; 494196.
  • Barke A, Baudewig J, Schmidt-Samoa C, Dechent P, Kröner-Herwing B. Neural correlates of fear of movement in high and low fear-avoidant chronic low back pain patients: An event-related fMRI study. Pain 2012;153,540–52.
  • Martinez-Calderon J, Struyf F, Meeus M, Morales-Ascencio JM, Luque-Suarez A. Influence of psychological factors on the prognosis of chronic shoulder pain: protocol for a prospective cohort study. BMJ open 2017; 7(3), e012822.
  • Dunn WR, Kuhn JE, Sanders R, et al. Symptoms of pain do not correlate with rotator cuff tear severity: a cross-sectional study of 393 patients with a symptomatic atraumatic full-thickness rotator cuff tear. J Bone Joint Surg Am 2014;96:793–800.
  • Feleus A, van Dalen T, Bierma-Zeinstra SM, et al. Kinesiophobia in patients with non-traumatic arm, neck and shoulder complaints:a prospective cohort study in general practice. BMC Musculoskelet Disord 2007; 28;8:117
  • Wideman TH, Sullivan MJ. Differential predictors of the long-term levels of pain intensity, work disability, healthcare use, and medication use in a sample of workers’ compensation claimants. Pain 2011;152(2):376–83.
  • Das de S, Vranceanu AM, Ring DC. Contribution of kinesophobia and catastrophic thinking to upper-extremity-specific disability. J Bone Joint Surg Am 2013;95(1):76–81.
  • Potter MQ, Wylie JD, Greis PE, Burks RT, Tashjian RZ. Psychological distress negatively affects self-assessment of shoulder function in patients with rotator cuff tears. Clin Orthop Relat Res 2014;472:3926–32.
  • Altuğ F, Ünal A, Kilavuz G, Kavlak E, Veli C, Ugur C. Investigation of the relationship between kinesiophobia, physical activity level and quality of life in patients with chronic low back pain. J Back Musculoskelet Rehabil 2016; 29(3): 527-31.

Kronik Subakromiyal Ağrı Sendromunda Ağrı Şiddeti, Kinezyofobi ve Yaşam Kalitesi Arasındaki Ilişki

Year 2019, Volume: 19 Issue: 2, 396 - 406, 28.06.2019
https://doi.org/10.17098/amj.581993

Abstract

Amaç:
Omuz ağrısı sıkça karşılaşılan biyopsikososyal bir problemdir. Fiziksel
problemlerin yanı sıra, omuz ağrısına katkıda bulunan psikolojik sorunların
anlaşılması, tedavi süreci açısından önemlidir. Bu nedenle çalışmanın amacı
kronik subakromiyal ağrı sendromunda demografik özellikler, ağrı şiddeti,
kinezyofobi ve yaşam kalitesi arasındaki ilişkiyi araştırmaktı.



Materyal
ve Metot
: Çalışmaya İzmir Atatürk Eğitim Araştırma
Hastanesine başvuran kronik omuz ağrılı hastalar dâhil edildi. Hastaların
demografik bilgileri kaydedildi. Ağrı şiddeti Görsel Analog Skala ile,
kinezyofobi Tampa Kinezyofobi anketi (TSK) ile ve yaşam kalitesi SF-36 yaşam
kalitesi indeksi ile değerlendirildi. İstatistiksel analizde spearman ve kendal
korolesyan analizi kullanıldı. İstatistiksel anlamlılık düzeyi p< 0,05
olarak kabul edildi.



Bulgular:
Çalışmaya 32’ si erkek, 63’ü kadın olan 95 hasta alındı. Olguların yaş
ortancaları 51 (40-61) yıl, TSK skoru 43 (38-47), istirahat ağrısı(3 (0-5),
aktivite sırasındaki ağrı 7 (5-8), SF-36 fiziksel bileşen (PC) ve mental
bileşen (MC) skorları sırasıyla 36,50 (29,3-42,1) ve 42 (34,9-49,6) du.
Cinsiyetler arasında ağrı (istirahat ağrısı kadın/erkek= 3/2, p=0,054; aktivite
ağrısı kadın/erkek= 7/6, p= 0,187) ve kinezyofobi skorları (kadın/erkek= 43/41,
p= 0,185) arasında fark yokken, yaşam kalitesinin fiziksel (kadın/erkek= 34,40
/41,40, p= 0,001) ve mental komponentlerinin ( kadın/erkek= 37,70/48,45, p=
0,000) kadınlarda daha düşük olduğu bulundu. Kinezyofobi skorunun eğitim
düzeyi, yaşam kalitesinin fiziksel ve mental komponenti ile ilişkili olduğu
bulundu (r= -0,163, p= 0,039; r= -0,499, p= 0,000; r= -0,279, p= 0,006).



Sonuç:
Subakromiyal ağrı sendromu olan hastalarda kinezyofobi skorları yüksek bulundu.
Ağrı ve kinezyofobi değerleri kadın ve erkeklerde benzer bulunurken, erkek
katılımcılarda yaşam kalitesi puanları daha iyi bulunmuştur. Kinezyofobi ile
eğitim düzeyi ve yaşam kalitesi arasında negatif ilişki bulunmuştur. Kronik
omuz ağrı rehabilitasyonunda kinezyofobi, eğitim düzeyi ve yaşam kalitesi
entegrasyonlarının dikkate alınmasının önemli olduğunu düşünmekteyiz.

References

  • George SZ, Staud R, Borsa PA, et al. Biopsychosocial influence on shoulder pain: Rationale and protocol for a pre-clinical trial. Contemp Clin Trials 2017;56:9-17.
  • Diercks RL. Practice guideline 'Diagnosis and treatment of the subacromial pain syndrome. Ned Tijdschr Geneeskd 2014;158:A6985.
  • Luime JJ, Koes BW, Hendriksen IJ, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol 2004;33(2):73-81.
  • Pribicevic M. The epidemiology of shoulder pain: A narrative review of the literature. In Pain in perspective. InTech. 2012.
  • Steuri R, Sattelmayer M, Elsig S, et al. Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs. Br J Sports Med 2017 Jun 19. pii: bjsports-2016-096515. doi: 10.1136/bjsports-2016-096515. [Epub ahead of print] Review.
  • Lentz TA, Barabas JA, Day T, Bishop MD, George SZ. The relationship of pain intensity, physical impairment, and pain-related fear to function in patients with shoulder pathology. J Orthop Sports Phys Ther 2009;39(4):270-7
  • Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the ‘Scapular Summit’. Br J Sports Med 2013; 47(14):877-885.
  • Burwinkle T, Robinson JP, Turk DC. Fear of movement: factor structure of the tampa scale of kinesiophobia in patients with fibromyalgia syndrome. J Pain 2005;6(6):384- 391.
  • Westman AE, Boersma K, Leppert J, Linton SJ. Fear-avoidance beliefs, catastrophizing, and distress: a longitudinal subgroup analysis on patients with musculoskeletal pain. Clin J Pain 2011;27(7):567–577.
  • Sindhu SB, Lehman LA, Tarima S, Bishop MD, Hart DL, Klein MR, et al. Influence of fear-avoidance beliefs on functional status outcomes for people with musculoskeletal conditions of the shoulder. Phys Ther 2012; 92(8): 992-1005.
  • Erol Ö, Özçakar L, Çeliker R. Shoulder rotator strength in patients with stage I-II subacromial impingement: relationship to pain, disability, and quality of life. J Shoulder Elbow Surg 2008;17(6), 893-7.
  • Bailey KM, Carleton RN, Vlaeyen JW, Asmundson GJ. Treatments addressing pain-related fear and anxiety in patients with chronic musculoskeletal pain: a preliminary review. Cogn Behav Ther 2010;39(1), 46-63
  • George SZ, Dover GC, Fillingim RB. Fear of pain influences outcomes after exercise-induced delayed onset muscle soreness at the shoulder. Clin J Pain 2007;23(1):76-84.
  • Boersma K, Linton SJ. Expectancy, fear and pain in the prediction of chronic pain and disability: a prospective analysis. Eur J Pain. 2006;10(6):551-7.
  • Hart DL, Werneke MW, George SZ, et al. Screening for elevated levels of fear-avoidance beliefs regarding work or physical activities in people receiving outpatient therapy. Phys Ther 2009;89(8):770-85.
  • Clark P, Pilar L, Homero M. Learning from pain scales: patient perspective. J Rheumatology (2003);30(7): 1584-1588.
  • Miller RP, Kori SH, Todd DD. The Tampa Scale: a Measure of Kinisophobia. Clin J Pain 1991; 7(1):51.
  • Vlaeyen JW, Kole-Snijders AM, Rotteveel AM, Ruesink R, Heuts PH. The role of fear of movement/(re) injury in pain disability. J Occup Rehabil 1995;5(4):235-52.
  • Tunca Yılmaz Ö, Yakut Y, Uygur F, Ulug N. Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. Fizyoterapi Rehabilitasyon 2011;22(1):44-9.
  • McHorney CA, Ware Jr JE, Lu JR, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994;32(1):40-66.
  • Koçyiğit H, Aydemir Ö, Fişek G. Kısa Form-36’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve Tedavi Dergisi 1999;12(2):102-6.
  • Thompson DP, Oldham JA, Urmston M, Woby SR. Cognitive determinants of pain and disability in patients with chronic whiplash-associated disorder: a cross-sectional observational study. Physiotherapy 2010;96(2):151-9
  • Brӓnström H, Fahlström M. Kinesiophobia in patients with chronic musculoskeletal pain: Differences between men and women. J Rehabil Med 2008;40:375–80.
  • Lundberg M, Grimby-Ekman A, Verbunt J, Simmonds MJ. Pain-related fear: A critical review of the related measures. Pain Res Treat 2011; 494196.
  • Barke A, Baudewig J, Schmidt-Samoa C, Dechent P, Kröner-Herwing B. Neural correlates of fear of movement in high and low fear-avoidant chronic low back pain patients: An event-related fMRI study. Pain 2012;153,540–52.
  • Martinez-Calderon J, Struyf F, Meeus M, Morales-Ascencio JM, Luque-Suarez A. Influence of psychological factors on the prognosis of chronic shoulder pain: protocol for a prospective cohort study. BMJ open 2017; 7(3), e012822.
  • Dunn WR, Kuhn JE, Sanders R, et al. Symptoms of pain do not correlate with rotator cuff tear severity: a cross-sectional study of 393 patients with a symptomatic atraumatic full-thickness rotator cuff tear. J Bone Joint Surg Am 2014;96:793–800.
  • Feleus A, van Dalen T, Bierma-Zeinstra SM, et al. Kinesiophobia in patients with non-traumatic arm, neck and shoulder complaints:a prospective cohort study in general practice. BMC Musculoskelet Disord 2007; 28;8:117
  • Wideman TH, Sullivan MJ. Differential predictors of the long-term levels of pain intensity, work disability, healthcare use, and medication use in a sample of workers’ compensation claimants. Pain 2011;152(2):376–83.
  • Das de S, Vranceanu AM, Ring DC. Contribution of kinesophobia and catastrophic thinking to upper-extremity-specific disability. J Bone Joint Surg Am 2013;95(1):76–81.
  • Potter MQ, Wylie JD, Greis PE, Burks RT, Tashjian RZ. Psychological distress negatively affects self-assessment of shoulder function in patients with rotator cuff tears. Clin Orthop Relat Res 2014;472:3926–32.
  • Altuğ F, Ünal A, Kilavuz G, Kavlak E, Veli C, Ugur C. Investigation of the relationship between kinesiophobia, physical activity level and quality of life in patients with chronic low back pain. J Back Musculoskelet Rehabil 2016; 29(3): 527-31.
There are 32 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

Sevtap Günay Uçurum

Publication Date June 28, 2019
Published in Issue Year 2019 Volume: 19 Issue: 2

Cite

APA Günay Uçurum, S. (2019). Relationships of Pain Intensity, Kinesiophobia and Quality of Life in Chronic Subacromial Pain Syndrome. Ankara Medical Journal, 19(2), 396-406. https://doi.org/10.17098/amj.581993
AMA Günay Uçurum S. Relationships of Pain Intensity, Kinesiophobia and Quality of Life in Chronic Subacromial Pain Syndrome. Ankara Med J. June 2019;19(2):396-406. doi:10.17098/amj.581993
Chicago Günay Uçurum, Sevtap. “Relationships of Pain Intensity, Kinesiophobia and Quality of Life in Chronic Subacromial Pain Syndrome”. Ankara Medical Journal 19, no. 2 (June 2019): 396-406. https://doi.org/10.17098/amj.581993.
EndNote Günay Uçurum S (June 1, 2019) Relationships of Pain Intensity, Kinesiophobia and Quality of Life in Chronic Subacromial Pain Syndrome. Ankara Medical Journal 19 2 396–406.
IEEE S. Günay Uçurum, “Relationships of Pain Intensity, Kinesiophobia and Quality of Life in Chronic Subacromial Pain Syndrome”, Ankara Med J, vol. 19, no. 2, pp. 396–406, 2019, doi: 10.17098/amj.581993.
ISNAD Günay Uçurum, Sevtap. “Relationships of Pain Intensity, Kinesiophobia and Quality of Life in Chronic Subacromial Pain Syndrome”. Ankara Medical Journal 19/2 (June 2019), 396-406. https://doi.org/10.17098/amj.581993.
JAMA Günay Uçurum S. Relationships of Pain Intensity, Kinesiophobia and Quality of Life in Chronic Subacromial Pain Syndrome. Ankara Med J. 2019;19:396–406.
MLA Günay Uçurum, Sevtap. “Relationships of Pain Intensity, Kinesiophobia and Quality of Life in Chronic Subacromial Pain Syndrome”. Ankara Medical Journal, vol. 19, no. 2, 2019, pp. 396-0, doi:10.17098/amj.581993.
Vancouver Günay Uçurum S. Relationships of Pain Intensity, Kinesiophobia and Quality of Life in Chronic Subacromial Pain Syndrome. Ankara Med J. 2019;19(2):396-40.