Fibromiyalji Hastalarında Merkezi Duyarlılık ve Vücut Farkındalığının Belirleyicisi Olarak Hastalık Aktivitesinin Rolü: Kesitsel Bir Çalışma

Abstract

Amaç: Bu çalışmanın amacı fibromiyalji sendromu (FMS) hastalarında hastalık aktivitesinin santral sensitizasyon ve vücut farkındalığı üzerine etkisini belirlemektir. Araçlar ve Yöntem: Bu kesitsel çalışmaya FMS'li 45 hasta (ortalama yaş: 45.9 (6.9) yıl, ortanca hastalık süresi: 3 (2-6) yıl) katıldı. Hastalık aktivitesi, Fibromiyalji Etki Anketi (FEA) kullanılarak değerlendirildi ve daha yüksek puan yüksek hastalık aktivitesi olarak kabul edildi. Santral sensitizasyonu değerlendirmek için Santral Sensitizasyon Ölçeği (SSÖ) uygulandı. Vücut farkındalığı seviyeleri Vücut Farkındalığı Anketi (VFA) ile değerlendirildi. Ağrı şiddetini belirlemek için Görsel Analog Skala (GAS) kullanıldı. Hastalık aktivitesini hangi bağımsız değişkenin açıklayabileceğini araştırmak için basit doğrusal regresyon analizleri kullanıldı. Bulgular: Ortalama FEA ve VFA puanları sırasıyla 53.4 ve 90 dı. Ortanca GAS ve SSÖ puanları sırasıyla 8 ve 52 idi. Tüm hastaların %82.2'sinde santral sensitizasyon pozitifti. FEA, GAS skoruyla orta düzeyde ilişkiliydi (r=0.445, R2=0.198, p=0.002) ve SSÖ ile yüksek düzeyde ilişkiliydi (r=0.539, R2=0.291, p<0.001). FEA ve VFA arasında ise anlamlı bir korelasyon saptanmadı (p=0.791). Basit doğrusal regresyon analizinin sonuçları, GAS'ın hastalık aktivitesinin %19.8'ini açıkladığını gösterdi. FEA (r=0.445, p=0.002) ağrı şiddetini anlamlı şekilde tahmin etti. Ayrıca SSÖ hastalık aktivitesinin %29.1'ini açıklarken, FEA (r=0.539, p<0.001) santral sensitizasyonu anlamlı şekilde öngörüldü. Sonuç: Yüksek hastalık aktivitesi FMS'li hastalarda santral sensitizasyon ve vücut farkındalığını olumsuz bir şekilde etkilemektedir. Klinisyenler yüksek hastalık aktivitesi olan hastaların yönetiminde rutin tedavilere ek olarak multimodal biyopsikososyal bakış açısını da göz önünde bulundurmalıdır.

Keywords

• beden farkındalığı
• fibromiyalji sendromu
• hastalık aktivitesi
• santral sensitizasyon

The Role of Disease Activity as a Determinant of Central Sensitivity and Body Awareness in Fibromyalgia Patients: A Cross-Sectional Study

Abstract

Purpose: The present study aimed to identify the influence of disease activity on central sensitization (CS) and body awareness in fibromyalgia syndrome (FMS) patients. Materials and Methods: Forty-five patients with FMS (mean age: 45.9 (6.9) years, median disease duration: 3 (2-6) years) were participated this cross-sectional study. Disease activity was assessed using the Fibromyalgia Impact Questionnaire (FIQ) and higher score was considered high disease activity. The Central Sensitization Inventory (CSI) was performed for central sensitivity. Body awareness levels were evaluated with the Body Awareness Questionnaire (BAQ). Visual Analogue Scale (VAS) was used to identify pain severity. Simple linear regression analyses were used to determine which independent variables could explain disease activity. Results: The mean FIQ and BAQ were 53.4 and 90 points, respectively. The median VAS and CSI were 8 cm and 52 point, respectively. The CS is positive in 82.2% of all patients. FIQ was moderately correlated with the VAS score (r=0.445, R2=0.198, p=0.002) and is highly correlated with CSI (r=0.539, R2=0.291, p<0.001). There was no significant correlation between FIQ and BAQ (p=0.791). The results of the simple linear regression analysis presented that VAS explained 19.8% of the the disease activity. FIQ (r=0.445, p=0.002) significantly predicted pain severity. Additionally, The CSI explained 29.1% of the disease activity and FIQ (r=0.539, p<0.001) significantly predicted CS. Conclusion: High disease activity negatively impacts CS and body awareness in FMS patients. Clinicians should consider a multimodal biopsychosocial perspective in addition to routine treatments in the management of patients with high disease activity.

Keywords

• body awareness
• central sensitization
• fibromyalgia syndrome
• disease activity

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