Investigation of The Relationship Between Pain, Fear of Movement and Anxiety Level in Lower Extremity Chronic Orthopedic Problems
Year 2023,
Volume: 10 Issue: 2, 413 - 425, 31.08.2023
Esra Ateş Numanoğlu
,
Asude Arık
,
Ayşenur Gökşen
,
Kübra Canlı
,
Nazım Tolgahan Yıldız
,
Gürsoy Coşkun
,
Zafer Erden
,
Filiz Can
Abstract
Objectives:Pain in orthopedic injuries is an important problem that prevents active movement. This study was planned to examine the relationship between pain, fear of movement and anxiety level in chronic orthopedic problems of the lower extremity.
Materials and Methods: Patients with chronic orthopedic problems in the hip, knee and ankle joints were included in the study. In the patients who were included in the study pain level was evaluated with ‘’Visual Analog Scale’’; fear of movement was evaluated with ‘’Tampa Kinesiophobia Scale’’ and anxiety level was evaluated with ‘’State and Trait Anxiety Inventory (STAI-I and STAI-II)”.
Results: It was found that fear of movement was associated with activity pain in patients with lower extremity orthopedic injuries. It was observed that fear of movement was higher in the patients with hip joint orthopedic injury than in patients with knee or ankle involvement.
Conclusion: It was concluded that pain effects fear of movement in injuries associated with the hip joint more than in other joints of lower extremity. Pain and psychosocial factors should be evaluated in patients with chronic term lower extremity orthopedic problems and their possible effects on each other should be considered.
References
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- Alaca, N. (2019). The relationships between pain beliefs and kinesiophobia and clinical parameters in Turkish patients with chronic knee osteoarthritis: a cross-sectional study. J Pak Med Assoc, 69(6), 823-827.
- Alshahrani, M. S., Reddy, R. S., Tedla, J. S., Asiri, F., & Alshahrani, A. (2022). Association between Kinesiophobia and knee pain intensity, joint position sense, and functional performance in individuals with bilateral knee osteoarthritis. Healthcare, 10(1), 120.
- Altuğ, F., Ünal, A., Kilavuz, G., Kavlak, E., Çitişli, V., & Cavlak, U. (2016). Investigation of the relationship between kinesiophobia, physical activity level and quality of life in patients with chronic low back pain 1. Journal of back and musculoskeletal rehabilitation, 29(3), 527-531.
- Archer, K. R., Abraham, C. M., & Obremskey, W. T. (2015). Psychosocial factors predict pain and physical health after lower extremity trauma. Clinical Orthopaedics and Related Research®, 473(11), 3519-3526.
- Bijur, P. E., Silver, W., & Gallagher, E. J. (2001). Reliability of the visual analog scale for measurement of acute pain. Academic emergency medicine, 8(12), 1153-1157.
- Bombardier, C., Hawker, G., & Mosher, D. (2011). The Impact of Arthritis in Canada: Today and Over the Next 30 Years. Toronto (ON): Arthritis Alliance of Canada; 2011. In.
- Castillo, R. C., Wegener, S. T., Heins, S. E., Haythornthwaite, J. A., MacKenzie, E. J., Bosse, M. J., & Group, L. S. (2013). Longitudinal relationships between anxiety, depression, and pain: results from a two-year cohort study of lower extremity trauma patients. PAIN®, 154(12), 2860-2866.
- Coggon, D., Reading, I., Croft, P., McLaren, M., Barrett, D., & Cooper, C. (2001). Knee osteoarthritis and obesity. International journal of obesity, 25(5), 622-627.
- Cotchett, M., Munteanu, S. E., & Landorf, K. B. (2016). Depression, anxiety, and stress in people with and without plantar heel pain. Foot & ankle international, 37(8), 816-821.
- De Baets, L., Matheve, T., & Timmermans, A. (2020). The association between fear of movement, pain catastrophizing, pain anxiety, and protective motor behavior in persons with peripheral joint conditions of a musculoskeletal origin: a systematic review. American journal of physical medicine & rehabilitation, 99(10), 941-949.
- Domenech, J., Sanchis-Alfonso, V., López, L., & Espejo, B. (2013). Influence of kinesiophobia and catastrophizing on pain and disability in anterior knee pain patients. Knee Surgery, Sports Traumatology, Arthroscopy, 21(7), 1562-1568.
- Drake, C., Mallows, A., & Littlewood, C. (2018). Psychosocial variables and presence, severity and prognosis of plantar heel pain: A systematic review of cross‐sectional and prognostic associations. Musculoskeletal care, 16(3), 329-338.
- Edwards, R. R., Haythornthwaite, J. A., Smith, M. T., Klick, B., & Katz, J. N. (2009). Catastrophizing and depressive symptoms as prospective predictors of outcomes following total knee replacement. Pain Research and Management, 14(4), 307-311.
- Eitzen, I., Fernandes, L., Nordsletten, L., Snyder-Mackler, L., & Risberg, M. A. (2014). Weight-bearing asymmetries during Sit-To-Stand in patients with mild-to-moderate hip osteoarthritis. Gait & posture, 39(2), 683-688.
- Gallagher, E. J., Liebman, M., & Bijur, P. E. (2001). Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Annals of emergency medicine, 38(6), 633-638.
- Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short‐form mcgill pain questionnaire (sf‐mpq), chronic pain grade scale (cpgs), short form‐36 bodily pain scale (sf‐36 bps), and measure of intermittent and constant osteoarthritis pain (icoap). Arthritis care & research, 63(S11), S240-S252.
- Johnson, C. (2005). Measuring pain. Visual analog scale versus numeric pain scale: what is the difference? Journal of chiropractic medicine, 4(1), 43.
- Kent, P., Mirkhil, S., Keating, J., Buchbinder, R., Manniche, C., & Albert, H. B. (2014). The concurrent validity of brief screening questions for anxiety, depression, social isolation, catastrophization, and fear of movement in people with low back pain. The Clinical journal of pain, 30(6), 479-489.
- Kocic, M., Stankovic, A., Lazovic, M., Dimitrijevic, L., Stankovic, I., Spalevic, M., . . . Nikolic, D. (2015). Influence of fear of movement on total knee arthroplasty outcome. Ann Ital Chir, 86(2), 148-155.
- Leeuw, M., Goossens, M. E., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. (2007). The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. Journal of behavioral medicine, 30(1), 77-94.
- Lundberg, M., Larsson, M., Ostlund, H., & Styf, J. (2006). Kinesiophobia among patients with musculoskeletal pain in primary healthcare. Journal of rehabilitation medicine, 38(1), 37-43.
- Luque-Suarez, A., Martinez-Calderon, J., & Falla, D. (2019). Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculskeletal pain: a systematic review. British journal of sports medicine, 53(9), 554-559.
- Martinez-Calderon, J., Flores-Cortes, M., Morales-Asencio, J. M., & Luque-Suarez, A. (2019). Pain-related fear, pain intensity and function in individuals with chronic musculoskeletal pain: a systematic review and meta-analysis. The journal of pain, 20(12), 1394-1415.
- Mc Auliffe, S., Synott, A., Casey, H., Mc Creesh, K., Purtill, H., & O'Sullivan, K. (2017). Beyond the tendon: experiences and perceptions of people with persistent Achilles tendinopathy. Musculoskeletal Science and Practice, 29, 108-114.
- Melzack, R., Coderre, T. J., Katz, J., & Vaccarino, A. L. (2001). Central neuroplasticity and pathological pain. Annals of the New York Academy of Sciences, 933(1), 157-174.
- Moalem, G., & Tracey, D. J. (2006). Immune and inflammatory mechanisms in neuropathic pain. Brain research reviews, 51(2), 240-264.
- Niraj, G., & Rowbotham, D. (2011). Persistent postoperative pain: where are we now? British journal of anaesthesia, 107(1), 25-29.
- O'Connell, M., Farrokhi, S., & Fitzgerald, G. K. (2016). The role of knee joint moments and knee impairments on self-reported knee pain during gait in patients with knee osteoarthritis. Clinical Biomechanics, 31, 40-46.
- Öztürk, Z., Karakuş, G., & Tamam, L. (2011). Yaşlı bireylerde ölüm kaygısı. Anadolu Psikiyatri Dergisi, 12(1), 37-43.
- Pamuk, Y., Hamurcu, Hülya, & Armağan, B. (2014). Sınıf öğretmeni adaylarının durumluk ve sürekli kaygı düzeylerinin incelenmesi (İzmir-Buca Örneği). Bartın University Journal of Faculty of Education, 3(2), 293-316.
- Perrot, S., Trouvin, A.-P., Rondeau, V., Chartier, I., Arnaud, R., Milon, J.-Y., & Pouchain, D. (2018). Kinesiophobia and physical therapy-related pain in musculoskeletal pain: A national multicenter cohort study on patients and their general physicians. Joint Bone Spine, 85(1), 101-107.
- Pinto, D., Song, J., Lee, J., Chang, R. W., Semanik, P. A., Ehrlich-Jones, L. S., . . . Dunlop, D. D. (2017). Association between sedentary time and quality of life from the osteoarthritis initiative: who might benefit most from treatment? Archives of physical medicine and rehabilitation, 98(12), 2485-2490.
- Rodriguez, R. M., Marroquin, A., & Cosby, N. (2019). Reducing fear of reinjury and pain perception in athletes with first-time anterior cruciate ligament reconstructions by implementing imagery training. Journal of sport rehabilitation, 28(4), 385-389.
- Scopaz, K. A., Piva, S. R., Wisniewski, S., & Fitzgerald, G. K. (2009). Relationships of fear, anxiety, and depression with physical function in patients with knee osteoarthritis. Archives of physical medicine and rehabilitation, 90(11), 1866-1873.
- Shelby, R. A., Somers, T. J., Keefe, F. J., DeVellis, B. M., Patterson, C., Renner, J. B., & Jordan, J. M. (2012). Brief fear of movement scale for osteoarthritis. Arthritis care & research, 64(6), 862-871.
- Spielberger, C. D., & Reheiser, E. C. (2003). Measuring anxiety, anger, depression, and curiosity as emotional states and personality traits with the STAI. Comprehensive Handbook of Psychological Assessment, Volume 2: Personality Assessment, 2, 70.
- Sullivan, M., Tanzer, M., Stanish, W., Fallaha, M., Keefe, F. J., Simmonds, M., & Dunbar, M. (2009). Psychological determinants of problematic outcomes following total knee arthroplasty. Pain, 143(1-2), 123-129.
- Van Wilgen, C. P., Konopka, K., Keizer, D., Zwerver, J., & Dekker, R. (2013). Do patients with chronic patellar tendinopathy have an altered somatosensory profile?–AQ uantitative S ensory T esting (QST) study. Scandinavian journal of medicine & science in sports, 23(2), 149-155.
- Vlaeyen, J. W., Kole-Snijders, A. M., Boeren, R. G., & Van Eek, H. (1995). Fear of movement/(re) injury in chronic low back pain and its relation to behavioral performance. Pain, 62(3), 363-372.
- Volders, S., Boddez, Y., De Peuter, S., Meulders, A., & Vlaeyen, J. W. (2015). Avoidance behavior in chronic pain research: a cold case revisited. Behaviour Research and Therapy, 64, 31-37.
- Woolf, C. J., & Salter, M. W. (2000). Neuronal plasticity: increasing the gain in pain. science, 288(5472), 1765-1768.
Alt Ekstremitenin Kronik Ortopedik Problemlerinde Ağrı, Hareket Korkusu ve Kaygı Düzeyi Arasındaki İlişkinin Araştırılması
Year 2023,
Volume: 10 Issue: 2, 413 - 425, 31.08.2023
Esra Ateş Numanoğlu
,
Asude Arık
,
Ayşenur Gökşen
,
Kübra Canlı
,
Nazım Tolgahan Yıldız
,
Gürsoy Coşkun
,
Zafer Erden
,
Filiz Can
Abstract
Amaç: Ortopedik yaralanmalarda ağrı aktif harekete engel olan önemli bir problemdir. Bu çalışma alt ekstremitenin kronik ortopedik problemlerinde ağrı, hareket korkusu ve kaygı düzeyi arasındaki ilişkiyi incelemek amacı ile planlandı.
Gereç ve Yöntem: Çalışmaya kalça, diz ve ayak bileği eklemlerine ait kronik ortopedik problemleri olan hastalar dahil edildi. Çalışmaya dahil edilen hastaların ağrı seviyesi ‘‘Görsel Analog Skalası’’ ile; hareket korkusu ‘‘Tampa Kinezyofobi Ölçeği’’ ile; kaygı düzeyi ise “Durumluk ve Sürekli Kaygı Ölçeği (STAI-I ve STAI-II)” ile değerlendirildi.
Bulgular: Alt ekstremite ortopedik yaralanması olan hastalarda hareket korkusu aktivite ağrısı ile ilişkili bulundu. Kalça eklemine ait ortopedik yaralanması olan hastalarda hareket korkusunun diz veya ayak bileği etkilenimi olan hastalardan daha yüksek olduğu gözlemlendi.
Sonuç: Kalça eklemi ile ilişkili yaralanmalarda ağrının hareket korkusunu diğer alt ekstremite eklemlerine oranla daha fazla etkilediği sonucuna varıldı. Kronik dönem alt ekstremite ortopedik problemi olan hastalarda ağrı ve psikososyal faktörler değerlendirilmeli ve birbirlerine olan olası etkileri göz önünde bulundurulmalıdır.
References
- Aksoy, D. (2019). Spor yaralanmalarinda tedavi sonrasi durumluk ve sürekli kaygi düzeylerinin incelenmesi. Beden Eğitimi ve Spor Bilimleri Dergisi, 21(2), 89-96.
- Alaca, N. (2019). The relationships between pain beliefs and kinesiophobia and clinical parameters in Turkish patients with chronic knee osteoarthritis: a cross-sectional study. J Pak Med Assoc, 69(6), 823-827.
- Alshahrani, M. S., Reddy, R. S., Tedla, J. S., Asiri, F., & Alshahrani, A. (2022). Association between Kinesiophobia and knee pain intensity, joint position sense, and functional performance in individuals with bilateral knee osteoarthritis. Healthcare, 10(1), 120.
- Altuğ, F., Ünal, A., Kilavuz, G., Kavlak, E., Çitişli, V., & Cavlak, U. (2016). Investigation of the relationship between kinesiophobia, physical activity level and quality of life in patients with chronic low back pain 1. Journal of back and musculoskeletal rehabilitation, 29(3), 527-531.
- Archer, K. R., Abraham, C. M., & Obremskey, W. T. (2015). Psychosocial factors predict pain and physical health after lower extremity trauma. Clinical Orthopaedics and Related Research®, 473(11), 3519-3526.
- Bijur, P. E., Silver, W., & Gallagher, E. J. (2001). Reliability of the visual analog scale for measurement of acute pain. Academic emergency medicine, 8(12), 1153-1157.
- Bombardier, C., Hawker, G., & Mosher, D. (2011). The Impact of Arthritis in Canada: Today and Over the Next 30 Years. Toronto (ON): Arthritis Alliance of Canada; 2011. In.
- Castillo, R. C., Wegener, S. T., Heins, S. E., Haythornthwaite, J. A., MacKenzie, E. J., Bosse, M. J., & Group, L. S. (2013). Longitudinal relationships between anxiety, depression, and pain: results from a two-year cohort study of lower extremity trauma patients. PAIN®, 154(12), 2860-2866.
- Coggon, D., Reading, I., Croft, P., McLaren, M., Barrett, D., & Cooper, C. (2001). Knee osteoarthritis and obesity. International journal of obesity, 25(5), 622-627.
- Cotchett, M., Munteanu, S. E., & Landorf, K. B. (2016). Depression, anxiety, and stress in people with and without plantar heel pain. Foot & ankle international, 37(8), 816-821.
- De Baets, L., Matheve, T., & Timmermans, A. (2020). The association between fear of movement, pain catastrophizing, pain anxiety, and protective motor behavior in persons with peripheral joint conditions of a musculoskeletal origin: a systematic review. American journal of physical medicine & rehabilitation, 99(10), 941-949.
- Domenech, J., Sanchis-Alfonso, V., López, L., & Espejo, B. (2013). Influence of kinesiophobia and catastrophizing on pain and disability in anterior knee pain patients. Knee Surgery, Sports Traumatology, Arthroscopy, 21(7), 1562-1568.
- Drake, C., Mallows, A., & Littlewood, C. (2018). Psychosocial variables and presence, severity and prognosis of plantar heel pain: A systematic review of cross‐sectional and prognostic associations. Musculoskeletal care, 16(3), 329-338.
- Edwards, R. R., Haythornthwaite, J. A., Smith, M. T., Klick, B., & Katz, J. N. (2009). Catastrophizing and depressive symptoms as prospective predictors of outcomes following total knee replacement. Pain Research and Management, 14(4), 307-311.
- Eitzen, I., Fernandes, L., Nordsletten, L., Snyder-Mackler, L., & Risberg, M. A. (2014). Weight-bearing asymmetries during Sit-To-Stand in patients with mild-to-moderate hip osteoarthritis. Gait & posture, 39(2), 683-688.
- Gallagher, E. J., Liebman, M., & Bijur, P. E. (2001). Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Annals of emergency medicine, 38(6), 633-638.
- Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short‐form mcgill pain questionnaire (sf‐mpq), chronic pain grade scale (cpgs), short form‐36 bodily pain scale (sf‐36 bps), and measure of intermittent and constant osteoarthritis pain (icoap). Arthritis care & research, 63(S11), S240-S252.
- Johnson, C. (2005). Measuring pain. Visual analog scale versus numeric pain scale: what is the difference? Journal of chiropractic medicine, 4(1), 43.
- Kent, P., Mirkhil, S., Keating, J., Buchbinder, R., Manniche, C., & Albert, H. B. (2014). The concurrent validity of brief screening questions for anxiety, depression, social isolation, catastrophization, and fear of movement in people with low back pain. The Clinical journal of pain, 30(6), 479-489.
- Kocic, M., Stankovic, A., Lazovic, M., Dimitrijevic, L., Stankovic, I., Spalevic, M., . . . Nikolic, D. (2015). Influence of fear of movement on total knee arthroplasty outcome. Ann Ital Chir, 86(2), 148-155.
- Leeuw, M., Goossens, M. E., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. (2007). The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. Journal of behavioral medicine, 30(1), 77-94.
- Lundberg, M., Larsson, M., Ostlund, H., & Styf, J. (2006). Kinesiophobia among patients with musculoskeletal pain in primary healthcare. Journal of rehabilitation medicine, 38(1), 37-43.
- Luque-Suarez, A., Martinez-Calderon, J., & Falla, D. (2019). Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculskeletal pain: a systematic review. British journal of sports medicine, 53(9), 554-559.
- Martinez-Calderon, J., Flores-Cortes, M., Morales-Asencio, J. M., & Luque-Suarez, A. (2019). Pain-related fear, pain intensity and function in individuals with chronic musculoskeletal pain: a systematic review and meta-analysis. The journal of pain, 20(12), 1394-1415.
- Mc Auliffe, S., Synott, A., Casey, H., Mc Creesh, K., Purtill, H., & O'Sullivan, K. (2017). Beyond the tendon: experiences and perceptions of people with persistent Achilles tendinopathy. Musculoskeletal Science and Practice, 29, 108-114.
- Melzack, R., Coderre, T. J., Katz, J., & Vaccarino, A. L. (2001). Central neuroplasticity and pathological pain. Annals of the New York Academy of Sciences, 933(1), 157-174.
- Moalem, G., & Tracey, D. J. (2006). Immune and inflammatory mechanisms in neuropathic pain. Brain research reviews, 51(2), 240-264.
- Niraj, G., & Rowbotham, D. (2011). Persistent postoperative pain: where are we now? British journal of anaesthesia, 107(1), 25-29.
- O'Connell, M., Farrokhi, S., & Fitzgerald, G. K. (2016). The role of knee joint moments and knee impairments on self-reported knee pain during gait in patients with knee osteoarthritis. Clinical Biomechanics, 31, 40-46.
- Öztürk, Z., Karakuş, G., & Tamam, L. (2011). Yaşlı bireylerde ölüm kaygısı. Anadolu Psikiyatri Dergisi, 12(1), 37-43.
- Pamuk, Y., Hamurcu, Hülya, & Armağan, B. (2014). Sınıf öğretmeni adaylarının durumluk ve sürekli kaygı düzeylerinin incelenmesi (İzmir-Buca Örneği). Bartın University Journal of Faculty of Education, 3(2), 293-316.
- Perrot, S., Trouvin, A.-P., Rondeau, V., Chartier, I., Arnaud, R., Milon, J.-Y., & Pouchain, D. (2018). Kinesiophobia and physical therapy-related pain in musculoskeletal pain: A national multicenter cohort study on patients and their general physicians. Joint Bone Spine, 85(1), 101-107.
- Pinto, D., Song, J., Lee, J., Chang, R. W., Semanik, P. A., Ehrlich-Jones, L. S., . . . Dunlop, D. D. (2017). Association between sedentary time and quality of life from the osteoarthritis initiative: who might benefit most from treatment? Archives of physical medicine and rehabilitation, 98(12), 2485-2490.
- Rodriguez, R. M., Marroquin, A., & Cosby, N. (2019). Reducing fear of reinjury and pain perception in athletes with first-time anterior cruciate ligament reconstructions by implementing imagery training. Journal of sport rehabilitation, 28(4), 385-389.
- Scopaz, K. A., Piva, S. R., Wisniewski, S., & Fitzgerald, G. K. (2009). Relationships of fear, anxiety, and depression with physical function in patients with knee osteoarthritis. Archives of physical medicine and rehabilitation, 90(11), 1866-1873.
- Shelby, R. A., Somers, T. J., Keefe, F. J., DeVellis, B. M., Patterson, C., Renner, J. B., & Jordan, J. M. (2012). Brief fear of movement scale for osteoarthritis. Arthritis care & research, 64(6), 862-871.
- Spielberger, C. D., & Reheiser, E. C. (2003). Measuring anxiety, anger, depression, and curiosity as emotional states and personality traits with the STAI. Comprehensive Handbook of Psychological Assessment, Volume 2: Personality Assessment, 2, 70.
- Sullivan, M., Tanzer, M., Stanish, W., Fallaha, M., Keefe, F. J., Simmonds, M., & Dunbar, M. (2009). Psychological determinants of problematic outcomes following total knee arthroplasty. Pain, 143(1-2), 123-129.
- Van Wilgen, C. P., Konopka, K., Keizer, D., Zwerver, J., & Dekker, R. (2013). Do patients with chronic patellar tendinopathy have an altered somatosensory profile?–AQ uantitative S ensory T esting (QST) study. Scandinavian journal of medicine & science in sports, 23(2), 149-155.
- Vlaeyen, J. W., Kole-Snijders, A. M., Boeren, R. G., & Van Eek, H. (1995). Fear of movement/(re) injury in chronic low back pain and its relation to behavioral performance. Pain, 62(3), 363-372.
- Volders, S., Boddez, Y., De Peuter, S., Meulders, A., & Vlaeyen, J. W. (2015). Avoidance behavior in chronic pain research: a cold case revisited. Behaviour Research and Therapy, 64, 31-37.
- Woolf, C. J., & Salter, M. W. (2000). Neuronal plasticity: increasing the gain in pain. science, 288(5472), 1765-1768.