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ORIJINAL ARAŞTIRMA

Ankilozan Spondilitte Kinezyofobi Bozulmuş Yaşam Kalitesi ile İlişkili midir?
Is Kinesiophobia Associated with Impaired Quality of Life in Patients with Ankylosing Spondylitis?
Received Date : 22 Oct 2019
Accepted Date : 08 Feb 2020
Available Online : 17 Feb 2020
Doi: 10.31609/jpmrs.2019-71981 - Makale Dili: EN
J PMR Sci. 2020;23(3):137-43
ÖZET
Amaç: Bu çalışmanın amacı ankilozan spondilit (AS)’li hastalarda gelişen kinezyofobinin yaşam kalitesi üzerine olan etkisini değerlendirmektir. Gereç ve Yöntemler: Çalışmaya 38 AS ve 38 sağlıklı kontrol dahil edildi. Hastalar kendi içinde radyografik sakroileit evrelerine göre ve kinezyofobi skoruna göre (yüksek (≥37) ve düşük (<37)) olarak değerlendirildi. Katılımcıların yaşam kalitesi Short form-36 (SF-36) ile kinezyofobi ise Tampa Kinezyofobi Skalası (TKS) ile değerlendirilerek korelasyon analizleri yapıldı. Hastaların hastalık aktivitesi Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAI) ile ağrı durumları ise Vizüel Analog Skala (VAS) ile değerlendirildi. Bulgular: Hasta grupta kinezyofobi skoru (40.92±6.65) sağlıklı kontrollerden (36.66±8.05) daha yüksek bulundu. Hastalarda başta genel sağlık ve fiziksel fonksiyon olmak üzere tüm SF-36 alt parametreleri sağlıklı kontrollere göre anlamlı olarak daha düşük bulundu (p<0,05). Hasta grubunda kinezyofobi skoru yüksek olanlarla, düşük olanlar kıyaslandığında kinezyofobi skoru yüksek olanların, ağrı skorlarının daha yüksek (4.83±3.09, 2.89±1.27, sırasıyla) ve genel sağlık skorlarının daha düşük olduğu (35.26±20.90, 57.22±20.02, sırasıyla) gözlendi (p<0,05). Emosyonel rol güçlüğü skorunun radyografik sakroileti olan hastalarda (33.30 (0-67.10)) nonradyografik olanlara (83.50 (66.70-100)) göre daha düşük olduğu gözlendi. Bunun dışında diğer SF-36 alt parametreleri ile BASDAI ve VAS skorları açısından hasta grupları arasında farklılık saptanmadı (p>0,05). Sonuç: Ankilozan spondilitli hastalarda kinezyofobi sağlıklı kontrollerle karşılaştırıldığında daha fazla görülürken yaşam kalitesi azalmıştır. Kinezyofobi varlığı artmış ağrı ve genel sağlıkta bozulma gibi yaşam kalitesi değişkenleri ile ilişkilidir. Bu nedenle her hasta tedavi başlangıcında kinezyofobi ve yaşam kalitesi yönünden de değerlendirilmelidir.
ABSTRACT
Objective: To evaluate the effect of kinesiophobia on quality of life in patients with ankylosing spondylitis (AS). Material and Methods: This study included 38 patients with AS and 38 controls. Patients were assessed according to the grades of radiographic sacroiliitis and kinesiophobia scores (high (≥37) and low (<37)). Short form-36 (SF-36) was used to evaluate the quality of life and the Tampa kinesiophobia scale (TKS) was used to evaluate the presence of kinesiophobia. The correlations were analyzed. The ‘Bath Ankylosing Spondylitis Disease Activity Index’ (BASDAI) was used to assess the disease activity and, the visual analogue scale (VAS) was used to evaluate the pain objectively. Results: In patient group, kinesiophobia score was significantly higher (40.92±6.65) than in healthy controls (36.66±8.05) (p<0,05). All SF-36 sub-parameters, especially general health and physical function, were significantly lower in patients compared to healthy controls (p<0,05). Patients with high kinesiophobia score had a higher pain score and lower general health score compared to the patients with low kinesiophobia score (for pain score 4.83±3.09, 2.89±1.27, respectively, and for general health score (35.26±20.90, 57.22±20.02, respectively) (p<0.05). Emotional role limitation score was lower in patients with radiographic sacroiliitis (33.30 (0-67.10)) compared to the patients with non-radiographic sacroiliitis (83.50 (66.70-100)). Other SF-36 sub-parameters, BASDAI and VAS scores did not exhibit a significant difference between the groups (p>0.05). Conclusion: Kinesiophobia is more common in patients with ankylosing spondylitis compared to healthy controls, and quality of life is impaired. The presence of kinesiophobia is associated with quality of life variables, such as increased pain and impaired general health. Therefore, each patient should be evaluated for kinesiophobia and quaility of life at the beginning of treatment.
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