ORIJINAL ARAŞTIRMA
Kinezyofobi, İnme Sonrası Nöropatik Ağrı ve İnme Şiddeti ile İlişkili midir?
Does Kinesiophobia Associated with Poststroke Neuropathic Pain and Stroke Severity?
Received Date : 10 May 2019
Accepted Date : 08 Jul 2019
Tuba Tülay KOCAa, Arif GÜLKESENb, Vedat NACİTARHANa, Özlem KOCAa
aDepartment of Physical Medicine and Rehabilitation, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, TURKEY
bDepartment of Physical Medicine and Rehabilitation, Fırat University Faculty of Medicine, Elazığ, TURKEY
Doi: 10.31609/jpmrs.2019-66862 - Makale Dili: EN
J PMR Sci. 2019;22(2):60-5
ÖZET
Amaç: Kinezyofobi, yaralanmaya yatkınlık inanışı nedeniyle hareket etmekten korkmak olarak
tanımlanmaktadır. Fiziksel aktivite sınırlamasına neden olur. Yaşlı nüfusta inme sonrası kötü
iyileşmeyi etkileyen birçok faktör vardır. İnme sonrası santral ağrı, patogenezi bilinmeyen bir nöropatik
ağrı bozukluğudur. Burada, rehabilitasyon programındaki inme hastalarında kinezyofobinin
poststroke santral ağrı ve inme şiddeti ile ilişkisini değerlendirmeyi amaçladık. Gereç ve
Yöntemler: Çalışmaya yaş ortalaması 55,5±13,1 yıl olan yetmiş beş (n=75) inme hastası dâhil edildi.
Kontrol grubu (n=78) benzer yaş ve cinsiyette sağlıklı gönüllülerden oluşturuldu. Tüm hastalarda
yaş, cinsiyet, inme süresi, tutulan taraf, inme tipi (iskemik, hemorajik, subaraknoid vb.) kaydedildi.
İnme şiddeti, Ulusal Sağlık Enstitüsü İnme Skalası ile değerlendirildi. İnme sonrası ağrı, Self-Leeds
Nöropatik Semptom ve Bulgu ağrı skalası ile değerlendirildi. Kinezyofobi, Tampa Kinezyofobi Skalası
ile değerlendirildi. Bulgular: Hastaların %53,3’ü akut, %20'si subakut ve %20'si kronik dönemde
idi. İnme süresi ortalama 13,6±22,2 yıldı. Sağ tarafın tutulma oranı %48 idi ve %58’i iskemik tipti.
Ortalama Tampa skoru 44±7,7 idi ve kontrol grubundan istatistiksel olarak daha yüksekti. Ortalama
Ulusal Sağlık Enstitüsü İnme Skalası skoru 4,5±3,9 idi; Self-Leeds Nöropatik Semptom ve Bulgu
ağrı skalası skoru 7,2±6,7 idi; nöropatik ağrı prevalansı kontrol grubu ile benzerdi ve %21,3 (n=16)
idi. Sonuç: Kinezyofobi inme hastalarında daha yüksek bulundu ve ileri yaş, hastalık süresi ve inme
şiddeti ile pozitif korele idi. İnme rehabilitasyon programlarında kinezyofobiyi dikkate almalıyız.
Anahtar Kelimeler: İnme; nörorehabilitasyon; yaşlanma; kronik ağrı; nöropatik ağrı; kinezyofobi
ABSTRACT
Objective: Kinesiophobia is defined as fear of acting due to belief of predisposition to
injury. It causes physical activity limitation. There are many factors in the older age population
that affect poor recovery after stroke. Central pain after stroke is a neuropathic pain disorder with
unknown pathogenesis. Here, we aimed to evaluate association of kinesiophobia with poststroke
central pain and the stroke severity in stroke patients at rehabilitation program. Material and Methods:
Seventy-five (n=75) stroke patients with the mean age range of 55.5±13.1 year were included
in the study. The control group (n=78) consisted of healthy volunteers of similar age and gender.
Age, gender, stroke duration, involved side, stroke type (ischemic, hemorrhagic, subarachnoid etc.)
were recorded in all patients. The severity of stroke was assessed by the National Institute of Health
Stroke Scale. Poststroke pain was assessed by the Self-Leeds Assessment of Neuropathic Symptoms
and Sign pain scale. Kinesiophobia was assessed by the Tampa Scale for Kinesiophobia. Results: Of
the patients, 53.3% were in acute, 20% were in subacute and 20% were in chronic period. The
mean duration of the stroke was 13.6±22.2 years. The rate of right side involvement was 48% and
58% was ischemic type. The mean Tampa score was 44±7.7 and was statistically higher than control
group. The mean National Institute of Health Stroke Scale score was 4.5±3.9; Self-Leeds Assessment
of Neuropathic Symptoms and Sign pain score was 7.2±6.7; the prevelance of neuropathic
pain was 21.3% (n=16) and was similar with control group. Conclusion: Kinesiophobia was found
to be higher in stroke patients and was positively correlated with advanced age, disease duration and
stroke severity. We should consider kinesiophobia in stroke rehabilitation programs.
Keywords: Stroke; neurorehabilitation; aging; chronic pain; neuropathic pain; kinesiophobia
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