Ruminasyonun Tanınması ve Ağrı Deneyimi ve Fiziksel Aktivite ile İlişkisinin İncelenmesi: Geleneksel Derleme

Abstract

Kas iskelet sistemi ağrılarının, egzersiz müdahalelerini merkeze alan biyopsikososyal bir yaklaşımla ele alınması gerektiği son yıllarda sıklıkla vurgulanmaktadır. Ağrı felaketleştirme gibi olumsuz ağrı inançları kinezyofobi ve fiziksel inaktiviteye yol açabilir. Fiziksel inaktivite ise ağrının kronikleşmesi ve korkunun artmasına yol açarak bir kısır döngüye neden olabilir. Ruminasyon, abartılı algılama ve çaresizlik ile birlikte ağrı felaketleştirmenin üç alt boyutu arasında yer alır. Sözlükte “geviş getirmek” ve “zihinde tekrar tekrar gözden geçirmek” olarak tanımlanan ruminasyonun fiziksel sağlığı olumsuz etkilediği ve kronik ağrı, kardiyovasküler hastalık ve obezite gibi kronik durumlara sahip bireylerde yüksek bulunduğu bilinmektedir. Araştırmalar ruminasyonun ağrı ile pozitif ve fiziksel aktivite ile negatif yönde ilişkili olduğunu ortaya koymaktadır. Ruminasyon düzeyindeki artış daha fazla ağrı şiddeti, duygusal sıkıntı ve ağrıya karşı olumsuz tutum oluşturabilmekte ve aynı zamanda fiziksel aktivite seviyesinde azalma ile sonuçlanabilmektedir. Yapılandırılmış egzersiz programları, kas iskelet sistemi ağrısının yanı sıra ruminasyonun olumsuz etkileri için de faydalı sonuçlar oluşturabilir. Ancak depresyon artmış ruminasyona sıklıkla eşlik eder ve fiziksel aktiviteden alınan keyfi azaltarak egzersize bağlılık açısından risk oluşturabilir. Bu derleme ile ruminasyonun ağrı ve fiziksel aktivite ile ilişkisi hakkındaki bilgilerin gözden geçirilmesi amaçlanmıştır. Sonuç olarak, ruminasyonun azaltılmasını amaçlayan fiziksel aktivite programları aerobik aktiviteler, farkındalık egzersizleri, germe ve kuvvetlendirme egzersizlerini içerebilir. Egzersizlerin haftada 3 kez ve 30-60 dakika olarak yapılması fayda sağlayabilir.

Keywords

• ağrı
• egzersiz
• fiziksel aktivite
• kinezyofobi
• ruminasyon

Recognizing Rumination and Examining the Relationship with Pain Experience and Physical Activity: A Traditional Review

Abstract

In recent years, it has been frequently emphasized that musculoskeletal pain should be addressed with a biopsychosocial approach centered on exercise interventions. Negative pain beliefs such as pain catastrophizing can lead to kinesiophobia and thus to physical inactivity. Physical inactivity can lead to chronic pain and increased fear, leading to a vicious circle. Along with magnification and helplessness, rumination is among the three sub-dimensions of pain catastrophizing. Rumination, defined as "ruminating" and "repeatedly reviewing" in the dictionary, and it is well-known that rumination negatively affects physical health, and rumination levels are high in individuals with chronic conditions such as chronic pain, cardiovascular disease, and obesity. Research showed that rumination is positively associated with pain and negatively associated with physical activity. An increase in the rumination level may cause increases in pain intensity, emotional distress, and negative attitude towards pain and may also result in reduced physical activity levels. Structured exercise programs may have beneficial consequences for musculoskeletal pain as well as the negative effects of rumination. However, depression often accompanies increased rumination and may pose a risk for exercise adherence by reducing the physical activity pleasure. This review aimed to overwiev the relationship of rumination with pain and physical activity. In conclusion, physical activity programs aimed to reduce rumination may include aerobic activities, mindfulness exercises, stretching, and strengthening exercises. It can be beneficial to perform the exercises three times a week for 30-60 minutes.

Keywords

• exercise
• kinesiophobia
• pain
• physical activity
• rumination

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