INVESTIGATION OF THE EFFECT OF MENTAL HEALTH BURDEN ON PAIN, KINESIOPHOBIA, SLEEP AND QUALITY OF LIFE IN PATIENTS WITH ROTATOR CUFF INJURY

Abstract

Background: Rotator cuff injury is the most common pathology in the shoulder. Depression and anxiety have been associated with rotator cuff symptoms, sleep, and quality of life in patients with rotator cuff injuries. Aim: This study investigated the effects of mental health burden on pain, kinesiophobia, sleep, and quality of life in patients with rotator cuff injuries. Methods: A total of 70 patients ages 25-65 years including the study group (n=32) and the control group (n=38), were included in the study. The patients administered the Hospital Anxiety and Depression Scale (HADS); those with a score ≥8 on HADS-Depression and a score ≥11 on HADS-Anxiety were considered at risk of depression or anxiety respectively and accepted as high mental health burden. Patients with high mental health burdens were defined as the study group. The pain intensity was evaluated with the Visual Analogue Scale (VAS), kinesiophobia with the Tampa Scale of Kinesiophobia (TSK), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and quality of life with the SF-36. Results: In the comparisons, there were no differences in pain among groups (p>0,05). The TSK and PSQI scores were significantly higher in the study group than in the control group (p<0,05). SF-36 scores were significantly lower in the study group (p<0,05). Conclusion: These results show that increased mental health burden increases kinesiophobia and decreases sleep and quality of life in patients with rotator cuff injuries. This indicates the necessity of considering the mental health burden during the assessment and rehabilitation programs.

Keywords

• Rotator cuff
• anxiety
• depression
• kinesiophobia
• quality of life

ROTATOR MANŞET LEZYONU OLAN HASTALARDA ZİHİNSEL SAĞLIK YÜKÜNÜN AĞRI, KİNEZYOFOBİ, UYKU VE YAŞAM KALİTESİ ÜZERİNE ETKİSİNİN İNCELENMESİ

Öz

Giriş: Omuzda en sık karşılaşılan patolojilerden biri rotator manşet lezyonlarıdır. Rotator manşet yaralanması olan hastalarda depresyon ve anksiyete, rotator manşet semptomları, uyku ve yaşam kalitesi ile ilişkilendirilmiştir. Amaç: Bu çalışma, rotator manşet lezyonu olan hastalarda zihinsel sağlık yükünün ağrı, kinezyofobi, uyku ve yaşam kalitesi üzerine etkisinin incelenmesi amacıyla gerçekleştirildi. Yöntem: Çalışmaya, çalışma grubu (n=32) ve kontrol grubu (n=38) olmak üzere 25-65 yaş arası toplam 70 hasta dahil edildi. Hastane Anksiyete ve Depresyon Ölçeği (HADÖ) uygulanan hastalardan; HADÖ-Depresyon skoru ≥8 ve HADÖ-Anksiyete skoru ≥11 olanlar sırasıyla depresyon veya anksiyete riski altında ve zihisel yükü fazla olarak kabul edildi. Zihinsel sağlık yükü fazla olan kişiler çalışma grubu olarak tanımlandı. Ağrı şiddeti Görsel Analog Skala (GAS), kinezyofobi Tampa Kinezofobi Ölçeği (TKÖ) ile, uyku kalitesi Pittsburgh Uyku Kalite İndeksi (PUKİ) ile ve yaşam kalitesi SF-36 ile değerlendirildi. Bulgular: Gruplar arası karşılaştırmalarda ağrı açısından fark yoktu (p>0,05). TKÖ ve PUKİ puanları, çalışma grubunda kontrol grubuna göre anlamlı derecede yüksekti (p<0,05). SF-36 puanları çalışma grubunda anlamlı olarak daha düşüktü (p<0,05). Sonuç: Bu sonuçlar rotator manşet lezyonuna sahip hastalarda artan zihinsel sağlık yükünün kinezyofobiyi arttırdığı, uyku ve yaşam kalitesini azalttığını göstermektedir. Bu durum, değerlendirme ve rehabilitasyon programları sırasında ruh sağlığı yükünün dikkate alınması gerekliliğini göstermektedir

Anahtar Kelimeler

• Rotator manşet
• anksiyete
• depresyon
• kinezyofobi
• yaşam kalitesi

Kaynakça

1. Mahiroğulları M, İşyar M, Çakmak S. Rotator manşet yırtıkları. TOTBID Derg. 2013;12(4):353-9.
2. Karartı C, Özüdoğru A, Basat HÇ, Özsoy İs. Orta Büyüklükte Rotator Manşet Kas Yırtığı Olan Bireylerde Ağrı ve Yaşam Kalitesi Arasındaki İlişki. Selçuk Sağlık Dergisi.1(2):61-70.
3. Cho C-H, Jung S-W, Park J-Y, Song K-S, Yu K-I. Is shoulder pain for three months or longer correlated with depression, anxiety, and sleep disturbance? JSES. 2013;22(2):222-8.
4. Wolfensberger A, Vuistiner P, Konzelmann M, Plomb-Holmes C, Leger B, Luthi F. Clinician and patient-reported outcomes are associated with psychological factors in patients with chronic shoulder pain. CORR ®. 2016;474(9):2030-9.
5. Linton SJ. An overview of psychosocial and behavioral factors in neck-and-shoulder pain. SJRM, Supplement. 1995;32:67-77.
6. Hanley MA, Jensen MP, Ehde DM, Hoffman AJ, Patterson DR, Robinson LR. Psychosocial predictors of long-term adjustment to lower-limb amputation and phantom limb pain. Disabil. 2004;26(14-15):882-93.
7. Turk DC, Okifuji A. Psychological factors in chronic pain: evolution and revolution. J. Consult. Clin. Psychol. 2002;70(3):678.
8. Sayar K, Bilen A, Arıkan M. Kronik ağrı hastalarında öfke, benlik saygısı ve aleksitimi. Turkiye Klinikleri J Psychiatry. 2001;2(1):36-42.

9. Wong WK, Li MY, Yung PS-H, Leong HT. The effect of psychological factors on pain, function and quality of life in patients with rotator cuff tendinopathy: A systematic review. Musculoskelet. Sci. 2020;47:102173.
10. Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res.. 2020;288:112954.
11. Wolfe F, Hawley DJ. Psychosocial factors and the fibromyalgia syndrome. Z Rheumatol. 1998;57(2):S88-S91.
12. Von Korff M, Simon G. The relationship between pain and depression. BJPsych. 1996;168(S30):101-8.
13. Bal U, Çakmak S, Uğuz Ş. Anksiyete bozukluklarında cinsiyete göre semptom farklılıkları. Arch. Med. Res. 2013;22(4):441-59. Akkaya S, Büker N, Kitiş A, Akkaya N, Yörükoğlu AÇ. Rotator manşet lezyonu olan hastalarda ağrı, fonksiyonel durum ve depresyon arasındaki ilişkinin incelenmesi. Pam Tıp Derg. 2010(2):84-9.
14. Akyol Y, Yasemin U, Durmuş D, Tander B, Cantürk F, Bilgici A, et al. Shoulder Muscle Strength in Patients With Subacromial Impingement Syndrome: Its Relationship With Duration of Quality of Life and Emotional Status. Turk J Physiother Rehabil. 2013;16(3).
15. George SZ, Hirsh AT. Psychologic influence on experimental pain sensitivity and clinical pain intensity for patients with shoulder pain. J. Pain. 2009;10(3):293-9.
16. George SZ, Wallace MR, Wu SS, Moser MW, Wright TW, Farmer KW, et al. Biopsychosocial influence on shoulder pain: risk subgroups translated across preclinical and clinical prospective cohorts. Pain. 2015;156(1):148.
17. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr. Scand. 1983;67(6):361-70.
18. Aydemir Ö, Guvenir T, Kuey L, Kultur S. Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk Psikiyatri Derg. 1997;8(4):280-7.
19. Huskisson E, Jones J, Scott PJ. Application of visual-analogue scales to the measurement of functional capacity. Rheumatology. 1976;15(3):185-7.
20. Miller RP, Kori SH, Todd DD. The Tampa Scale: a measure of kinisophobia. The Clinical journal of pain. 1991;7(1):51.
21. Yilmaz O, Yakut Y, Uygur F, Ulug N. Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability. Fiz. Rehabil. 2011;22(1):44-9.
22. Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
23. Buysse DJ, Reynolds III CF, Monk TH, Hoch CC, Yeager AL, Kupfer DJ. Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep. 1991;14(4):331-8.
24. Ağargün MY, Kara H, Anlar Ö. The validity and reliability of the Pittsburgh Sleep Quality Index. Turkish journal of psychiatry. 1996;7(2):107-15.
25. Curcio G, Tempesta D, Scarlata S, Marzano C, Moroni F, Rossini PM, et al. Validity of the Italian version of the Pittsburgh sleep quality index (PSQI). Neurol. Sci. 2013;34(4):511-9.
26. Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med. 1992:473-83.
27. Kocyigit H, Aydemir O, Fisek G, Olmez N, Memis A. Validity and reliability of Turkish version of Short form 36: A study of a patients with romatoid disorder. J Drug Ther. 1999;12:102-6.
28. Vranceanu A-M, Barsky A, Ring D. Psychosocial aspects of disabling musculoskeletal pain. JBJS. 2009;91(8):2014-8.
29. 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.
30. Park JH, Rhee S-M, Kim HS, Oh JH. Effects of Anxiety and Depression Measured via the Hospital Anxiety and Depression Scale on Early Pain and Range of Motion After Rotator Cuff Repair. Am. J. Sports Med.. 2021;49(2):314-20.
31. Abraham AC, Shah SA, Thomopoulos S. Targeting inflammation in rotator cuff tendon degeneration and repair. Tech. Shoulder Elb. Surg. 2017;18(3):84.
32. Leonard BE. Pain, depression and inflammation: are interconnected causative factors involved? Mod Trends Pharmacopsychiatry.2015;30:22-35.
33. Goldberg P, Zeppieri G, Bialosky J, Bocchino C, van den Boogaard J, Tillman S, et al. Kinesiophobia and its association with health-related quality of life across injury locations. Arch. Phys. Med. Rehabil. 2018;99(1):43-8.
34. Kunze KN, Movasagghi K, Rossi DM, Polce EM, Cohn MR, Karhade AV, et al. Systematic Review of Sleep Quality Before and After Arthroscopic Rotator Cuff Repair: Are Improvements Experienced and Maintained? Orthop. J. Sports Med. 2020;8(12):2325967120969224.
35. Khazzam MS, Mulligan E, Shirley Z, Brunette M. Sleep quality in patients with rotator cuff disease. Orthop. J. Sports Med.2015;3(3_suppl):2325967115S00001.
36. Ansok CB, Khalil LS, Muh S. Objective assessment of sleep quality in patients with rotator cuff tears. OTSR. 2020;106(1):61-6.
37. Austin L, Pepe M, Tucker B, Ong A, Nugent R, Eck B, et al. Sleep disturbance associated with rotator cuff tear: correction with arthroscopic rotator cuff repair. Am. J. Sports Med. 2015;43(6):1455-9.
38. Rincón-Hurtado ÁM, Rocha-Buelvas A, López-Cardona A, Martínez JW. Health-related quality of life of patients with rotator cuff injuries, Cofee Triangle, Colombia, 2013. Rev. Bras. Ortop. 2018;53:364-72.
39. Yamamoto A, Takagishi K, Osawa T, Yanagawa T, Nakajima D, Shitara H, et al. Prevalence and risk factors of a rotator cuff tear in the general population. JSES. 2010;19(1):116-20.