PULMONER HİPERTANSİYONLU BİREYLERDE KİNEZYOFOBİ

Yıl 2019, Cilt: 30 Sayı: 3, 168 - 175, 20.12.2019

Özge Ertan Gökşen Kuran Aslan , Buket Akıncı , Nigar Gülfer Okumuş

https://doi.org/10.21653/tjpr.665154

Cited By: 4

Öz

Amaç: Bu çalışmanın amacı pulmoner hipertansiyonlu (PH) bireylerde kinezyofobinin egzersiz
kapasitesi, günlük yaşam aktiviteleri (GYA) ve yaşam kalitesi ile ilişkisini araştırmak ve demografik
ve klinik özelliklere göre karşılaştırmaktı.
Yöntem: Çalışmaya 37 PH’li hasta dahil edildi. Kinezyofobi değerlendirmesi, Kalp İçin Tampa
Kinezyofobi Derecelendirmesi (KTKD) ile yapıldı. Yaşam kalitesi, Nottingham Sağlık Profili (NSP)
ile belirlendi. Günlük yaşam aktiviteleri, London Chest Günlük Yaşam Aktiviteleri Ölçeği (LCGYAÖ)
ile değerlendirildi. Egzersiz kapasitesi, altı dakika yürüme testi (6DYT) ile ölçüldü ve 6DYT mesafesi
hesaplandı.
Sonuçlar: KTKD toplam skor, 6DYT sonrası dispne algılaması (p=0,016), NSP toplam skoru
(p=0,024), NSP alt gruplarından emosyonel reaksiyonlar (p<0,001) ve ağrı (p=0,018) ile pozitif yönlü
ilişkili bulundu. KTKD toplam skor ve KTKD alt grup skorları ile yaş, pulmoner arter basıncı, 6DYT
mesafesi ve LCGYAÖ arasında anlamlı ilişki yoktu (p>0,05). Çoklu doğrusal regresyon analizinde;
dispne algılaması (p=0,006) ve emosyonel reaksiyonların (p<0,001) KTKD toplam skorunu etkilediği
bulundu (R2=0,439, F(2,34)=13,309, p<0,001). Düşük eğitim seviyesi (p=0,023) ve dispne sebebi ile
GYA etkilenimi (p=0,029) olan olgularda KTKD toplam skoru daha yüksek saptandı.
Tartışma: Çalışmanın sonuçları PH’li bireylerde, kinezyofobinin eforla algılanan nefes darlığındaki
artış ve emosyonel reaksiyonlardan etkilendiğini ve azalmış yaşam kalitesi ile ilişkili olduğunu
gösterdi. Ayrıca düşük eğitim seviyesine sahip PH’li bireylerde kinezyofobi düzeyinin arttığı görüldü.

Anahtar Kelimeler

Egzersiz, Günlük Yaşam Aktivitesi

Kaynakça

• 1. Hoeper MM, Bogaard HJ, Condliffe R, Frantz R, Khanna D, Kurzyna M, et al. Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol. 2013;62(25 Suppl):D42-50.
• 2. Galie N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J. 2016;37(1):67-119.
• 3. Fowler RM, Gain KR, Gabbay E. Exercise intolerance in pulmonary arterial hypertension. Pulm Med. 2012;2012:359204.
• 4. Halank M, Einsle F, Lehman S, Bremer H, Ewert R, Wilkens H, et al. Exercise capacity affects quality of life in patients with pulmonary hypertension. Lung. 2013;191(4):337-43.
• 5. Mainguy V, Provencher S, Maltais F, Malenfant S, Saey D. Assessment of daily life physical activities in pulmonary arterial hypertension. PLoS One. 2011;6(11):e27993.
• 6. Pugh ME, Buchowski MS, Robbins IM, Newman JH, Hemnes AR. Physical activity limitation as measured by accelerometry in pulmonary arterial hypertension. Chest. 2012;142(6):1391-8.
• 7. Philips HC. Avoidance behaviour and it’s role in sustaining chronic pain. Behav Res Ther. 1987;25(4):273-9.
• 8. Korri S, Miller R, Todd D. Kinesiophobia: a new view of chronic pain behaviour. Pain Manag. 1990;3:35-43.
• 9. Vlaeyen JW, Kole-Snijders AM, Boeren RG, Van Eek H. Fear of movement/(re) injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62(3):363-72.
• 10. Picavet HSJ, Vlaeyen JW, Schouten JS. Pain catastrophizing and kinesiophobia: predictors of chronic low back pain. Am J Epidemiol. 2002;156(11):1028-34.
• 11. Vardar-Yagli N, Calik-Kutukcu E, Saglam M, Inal-Ince D, Arikan H, Coplu L. The relationship between fear of movement, pain and fatigue severity, dyspnea level and comorbidities in patients with chronic obstructive pulmonary disease. Disabil Rehabil. 2019;41(18):2159-63.
• 12. Brunetti ND, Guerra A, Ieva R, Correale M, Santoro F, Tarantino N, et al. Scared for the scar: fearsome impact of acute cardiovascular disease on perceived kinesiophobia (fear of movement). Clin Cardiol. 2017;40(7):480-4.
• 13. Back M, Cider A, Herlitz J, Lundberg M, Jansson B. The impact on kinesiophobia (fear of movement) by clinical variables for patients with coronary artery disease. Int J Cardiol. 2013;167(2):391-7.
• 14. Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the joint task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J. 2015;37(1):67-119. TURKISH JOURNAL OF PHYSIOTHERAPY AND REHABILITATION 2019; 30(3) 175 Ertan Ö, Kuran Aslan G, Akıncı B, Okumuş NG.
• 15. Hardinge M, Annandale J, Bourne S, Cooper B, Evans A, Freeman D, et al. British Thoracic Society guidelines for home oxygen use in adults: accredited by NICE. Thorax. 2015;70(Suppl 1):1-43.
• 16. Back M, Jansson B, Cider A, Herlitz J, Lundberg M. Validation of a questionnaire to detect kinesiophobia (fear of movement) in patients with coronary artery disease. J Rehabil Med. 2012;44(4):363-9.
• 17. Acar S, Savci S, Keskinoglu P, Akdeniz B, Ozpelit E, Ozcan Kahraman B, et al. Tampa Scale of Kinesiophobia for Heart Turkish Version Study: cross-cultural adaptation, exploratory factor analysis, and reliability. J Pain Res. 2016;9:445-51.
• 18. Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1428-46.
• 19. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.
• 20. Saka S, Savcı S, Çalık Kütükçü E, Sağlam M, Vardar Yagli N, İnal İnce D, et al. Validity and reliability of the Turkish version of the London Chest Activity of Daily Living Scale in Obstructive Lung Diseases. Turk Thorac J. 2019;doi.10,5152/ TurkThoracJ.2019.18155.
• 21. Garrod R, Bestall J, Paul E, Wedzicha J, Jones P. Development and validation of a standardized measure of activity of daily living in patients with severe COPD: the London Chest Activity of Daily Living scale (LCADL). Respir Med. 2000;94(6):589-96.
• 22. Kücükdeveci A, McKenna S, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000;23(1):31-8.
• 23. Hunt SM, McEwen J, McKenna SP. Measuring health status: a new tool for clinicians and epidemiologists. JR Coll Gen Pract. 1985;35(273):185-8.
• 24. Fernandes CJ, Martins BC, Jardim CV, Ciconelli RM, Morinaga LK, Breda AP, et al. Quality of life as a prognostic marker in pulmonary arterial hypertension. Health Qual Life Outcomes. 2014;12(1):130.
• 25. Back M, Cider A, Herlitz J, Lundberg M, Jansson B. Kinesiophobia mediates the influences on attendance at exercise-based cardiac rehabilitation in patients with coronary artery disease. Physiother Theory Pract. 2016;32(8):571-80.
• 26. van Ittersum M, de Greef M, van Gelder I, Coster J, Brügemann J, van der Schans C. Fear of exercise and health-related quality of life in patients with an implantable cardioverter defibrillator. Int J Rehabil Res. 2003;26(2):117-22.
• 27. Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of art. Pain. 2000;85(3):317- 32.
• 28. Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2018:bjsports-2017-098673.
• 29. Kinikli GI, Deniz HG, Karahan S, Aşkın A, Turgay M, Kinikli G. Predictors of fear of movement in patients with rheumatoid arthritis. Turk J Physiother Rehabil. 2018;29(2):11-7.
• 30. Demir R, Küçükoğlu MS. Pulmoner arter hipertansiyonunda egzersiz kapasitesinin değerlendirilmesi. Türk Kardiyol Dern Arş. 2010;38(8):580-8.