Farklı Şiddetteki Diz Osteoartritli Hastalarda Kinezyofobi, Ağrı, Fonksiyonel Durum ve Öz-Etkililik Arasındaki İlişkinin İncelenmesi

Öz

Amaç: Bu çalışmamızın amacı farklı şiddetteki diz osteoartritli hastalarda kinezyofobi, ağrı, fonksiyonel durum ve öz-etkililik arasındaki ilişkiyi incelemektir.
Gereç ve Yöntem: Çalışmaya Kellgren Lawrence sınıflamasına göre evre 2 ve evre 3 diz osteoartritli 72 birey dahil edildi. Kinezyofobi için Tampa Kinezyofobi Ölçeği (TKÖ), ağrı için Vizüel Analog Skalası (VAS) kullanıldı. Bireylerin fonksiyonel durumu The Western Ontario and McMaster Universities Arthritis Indeks (WOMAC) ile değerlendirildi. Öz-etkililik Artritlerde Öz Etkililik Ölçeği (AÖÖ) kullanılarak değerlendirildi.
Bulgular: Evre 2 ve evre 3 hastalarının WOMAC ile TKÖ sonuçları arasında pozitif yönde orta düzeyde ilişkili bulundu (p=0,048; r=0,332, p=0,024; r=0,376). Her iki evrede AÖÖ ile TKÖ sonuçları (p=0,002; r=0,449, p=0,016; r=0,390) ve AÖÖ ile WOMAC sonuçları negatif yönde orta düzeyde ilişkiliydi (p=0,000; r=0,580, p=0,010; r=0,426). Evre 3 hastalarının evre 2’ye göre düşük öz-etkililik (p=0,011), yüksek kinezyofobiye sahip oldukları görüldü (p=0,009). Evre 2 hastalarının VAS ile WOMAC sonuçları arasında anlamlı ilişki saptanmazken (p=0,281; r=0,184) evre 3 hastaları arasında pozitif yönde orta düzeyde ilişki görüldü (p=0,017; r=0,397).
Tartışma: Diz osteoartritli hastalarda kinezyofobi ve kişinin aktiviteye yapabileceğine dair kendine olan inancının fonksiyonel durumu etkileyen belirteçlerden biri olduğu ve bu parametrelerin radyolojik şiddetle ilişkili olduğu saptandı. Dolayısıyla bu bireylerin değerlendirme ve tedavi programlarında bu parametrelere de dikkat edilmesi gerektiği düşünülmektedir.

Anahtar Kelimeler

• Diz
• Osteoartrit
• Ağrı
• Fonksiyonel durum
• Öz etkililik

Investigation of the relationship Between Kinesiophobia, Pain, Functional Status and Self - Efficacy in Patients with Knee Osteoarthritis of Different Severity

Öz

Purpose: The aim of this study is to examine the relationship between kinesophobia, pain, functional status and self-efficacy in patients with knee osteoarthritis of different severity.
Material and Methods: The study included 72 individuals with stage 2 and 3 knee osteoarthritis according to the Kellgren Lawrence classification. Tampa Kinesiophobia Scale (TSK) for kinesiophobia; Visual Analogue Scale (VAS) for pain, Western Ontario and McMaster Universities Arthritis Index (WOMAC) for functional status, Self-Efficacy Scale for Arthritis (ASES) for self-efficacy were used, respectively.
Results: Positive correlations were found between WOMAC and TSK of stage 2 and 3(p=0.048; r=0.332, p=0.024; r=0.376). In both phases, ASES and TSK (p=0.002; r=0.449, p=0.016; r=0.390) and ASES and WOMAC were moderately negatively correlated (p=0.000; r=0.580, p=0.010; r=0.426). It was observed that stage 3 had lower self-efficacy (p=0.011) and higher kinesiophobia compared to stage 2 (p=0.009) patients. While there was no correlation between VAS and WOMAC of stage 2 (p=0.281; r=0.184), moderate positive correlation was found in stage 3 (p=0.017; r=0.397).
Discussion: In patients with knee osteoarthritis, it was determined that kinesiophobia and self-belief that one can do the activity were the markers affecting the functional status and these parameters were related to radiological severity. Therefore, it is thought that attention should be paid to these parameters in the evaluation and treatment programs of these individuals.

Anahtar Kelimeler

• Knee
• Osteoarthritis
• Pain
• Functional Status
• Self Efficacy

Kaynakça

1. Areeudomwong, P., & Buttagat, V. (2017). Reliability and validity of the cross-culturally adapted thai version of the tampa scale for kinesiophobia in knee osteoarthritis patients. Malays J Med Sci, 24(2), 61-67.
2. Araujo, I. L. A., Castro, M. C., Daltro, C., & Matos, M. A. (2016). Quality of life and functional independence in patients with osteoarthritis of the knee. Knee Surg Relat Res, 28(3), 219.
3. Bakırhan, S., Bozan, O., Ünver, B., & Karatosun, V. (2017). Evaluation of functional characteristics in patients wıth knee osteoarthrit,s. Acta Ortop Bras, 25(6), 248-252.
4. Benyon, K., Hill, S., Zadurian, N., & Mallen, C. (2010). Coping strategies and self-efficacy as predictors of outcome in osteoarthritis: a systematic review. Musculoskeletal Care, 8(4), 224-36.
5. Brady, T. J. (2011). Measures of self-efficacy: arthritis self-efficacy scale (ases), arthritis self-efficacy scale-8 ıtem (ases-8), children's arthritis self-efficacy scale (case), chronic disease self-efficacy scale (cdses), parent's arthritis self-efficacy scale (pase), and rheumatoid arthritis self-efficacy scale (RASE). Arthritis Care Res (Hoboken) 63 Suppl, 11, S473-485.
6. Brand, E., Nyland, J., Henzman, C., & McGinnis, M. (2013). Arthritis self-efficacy scale scores in knee osteoarthritis: A systematic review and meta-analysis comparing arthritis self-management education with or without exercise. J Orthop Sports Phys Ther, 43(12), 895-910.
7. Brisson, N. M., Gatti, A. A., Stratford, P. W., & Maly, M. R. (2018). Self-efficacy, pain, and quadriceps capacity at baseline predict changes in mobility performance over 2 years in women with knee osteoarthritis. J Clin Rheumatol, 37(2), 495-504.
8. Cruz Almeida, Y., King, C. D., Goodin, B. R., Sibille, K. T., Glover, T. L., Riley, J. L., et al. (2013). Psychological profiles and pain characteristics of older adults with knee osteoarthritis. Arthritis Care Res, 65(11), 1786-1794.

9. Doğan, N., Göriş, S., & Demir, H. (2016). Levels of pain and self-efficacy of individuals with osteoarthritis. Agri, 28(1), 25-31.
10. Erden, A., Altuğ, F., Malkoç, A., & Kocabal, A. (2016). Di̇z osteoartri̇tli̇ bi̇reylerde ki̇nezyofobi̇, ağrı şi̇ddeti̇, anksi̇yete-depresyon durumu ve yaşam kali̇tesi̇ni̇n i̇ncelenmesi̇. Uluslararası Hakemli Ortopedi Travmatoloji ve Spor Hekimliği Dergisi, 7, 1-15
11. Harrison, A. L. (2004). The influence of pathology, pain, balance, and self-efficacy on function in women with osteoarthritis of the knee. Phys Ther, 84(9), 822-831.
12. Hatfield, G.L., Morrison, A., Wenman, M., Hammond, C.A, & Hunt, M.A. (2016). Clinical tests of standing balance in the knee osteoarthritis population: systematic review and meta-analysis. Phys Ther, 96(3), 324-37.
13. Kittelson, A. J., George, S. Z., Maluf, K. S., & Stevens-Lapsley, J. E. (2014). Future directions in painful knee osteoarthritis: harnessing complexity in a heterogeneous population. Phys Ther, 94(3), 422-432.
14. Lawson, T., Morrison, A., Blaxland, S., Wenman, M., Schmidt, C. G., & Hunt, M. A.(2015). Laboratory-based measurement of standing balance in individuals with knee osteoarthritis: a systematic review. Clin Biomech, 30(4), 330-342.
15. Loeser, R. F. (2013). Aging processes and the development of osteoarthritis. Curr Opin Rheumatol, 25(1), 108-113.
16. López-Bravo, M.D., Zamarrón-Cassinello, M.D., Touche, R.L., Muñoz-Plata, R., Cuenca-Martínez, F., & Ramos-Toro, M. (2020). Psychological factors associated with functional disability in patients with hip and knee osteoarthritis, Behav Med, 10, 1-11.
17. Marks, R. (2001). Efficacy theory and its utility in arthritis rehabilitation: review and recommendations. Disabil Rehabil, 23(7), 271-280.
18. Neogi, T., Guermazi, A., Roemer, F., Nevitt, M. C., Scholz, J., Arendt-Nielsen, L., et al. (2016). Association of joint ınflammation with pain sensitization in knee osteoarthritis: The multicenter osteoarthritis study. Arthritis Rheumatol, 68(3), 654-661.
19. Odole, A., Ekediegwu, E., Ekechukwu, E. N. D., & Uchenwoke, C. (2019). Correlates and predictors of pain intensity and physical function among individuals with chronic knee osteoarthritis in Nigeria. Musculoskelet Sci Pract, 39, 150-156.
20. Oiestad, B. E., White, D. K., Booton, R., Niu, J., Zhang, Y., Torner, J., et al. (2016). Longitudinal course of physical function in people with symptomatic knee osteoarthritis: Data from the multicenter osteoarthritis study and the osteoarthritis ınitiative. Arthritis Care Res (Hoboken), 68(3), 325-331.
21. Pouli, N., Das Nair, R., Lincoln, N. B., & Walsh, D. (2014). The experience of living with knee osteoarthritis: Exploring illness and treatment beliefs through thematic analysis. Disabil Rehabil, 36(7), 600-607.
22. Rayahin, J. E., Chmiel, J. S., Hayes, K. W., Almagor, O., Belisle, L., Chang, A. H., et al. (2014). Factors associated with pain experience outcome in knee osteoarthritis. Arthritis Care Res (Hoboken), 66(12), 1828-1835.
23. Sanchez-Heran, A., Agudo-Carmona, D., Ferrer-Pena, R., Lopez-de-Uralde-Villanueva, I., Gil-Martinez, A., Paris-Alemany, A., et al. (2016). Postural stability in osteoarthritis of the knee and hip: analysis of association with pain catastrophizing and fear-avoidance beliefs. PM R, 8(7), 618-628.
24. Sanghi, D., Srivastava, R. N., Singh, A., Kumari, R., Mishra R., & Mishra A. (2011). The association of anthropometric measures and osteoarthritis knee in non-obese subjects: a cross sectional study. Clinics (Sao Paulo), 66(2), 275-279.
25. Scopaz, K. A., Piva, S. R., Wisniewski, S., & Fitzgerald, G. K. (2009). Relationships of fear, anxiety, and depression with physical function in patients with knee osteoarthritis. Arch Phys Med Rehabil, 90(11), 1866-1873.
26. Serban, O., Porojan, M., Deac, M., Cozma, F., Solomon, C., Lehghel, M., et al. (2016). Pain in bilateral knee osteoarthritis–correlations between clinical examination, radiological, and ultrasonographical findings. Med Ultrason, 18(3), 318-325.
27. Shelby, R. A., Somers, T. J., Keefe, F. J., DeVellis, B. M., Patterson, C., Renner, J. B., et al. (2012). Brief fear of movement scale for osteoarthritis. Arthritis Care Res (Hoboken), 64(6), 862-871.
28. Talic-Tanovic, A., Hadziahmetovic, Z., Madjar-Simic, I., & Papovic, A. (2017). Comparison of clinical and radiological parameters at knee osteoarthritis. Med Arch, 71(1), 48.
29. Thompson, D. P., Moula, K., & Woby, S. R. (2017). Are fear of movement, self-efficacy beliefs and fear of falling associated with levels of disability in people with osteoarthritis of the knee? A cross sectional study. Musculoskeletal Care, 15(3), 257-262.
30. Tüzün, E., Eker, L., Aytar, A., Daşkapan, A., & Bayramoğlu, M. (2005). Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC Osteoarthritis Index. Osteoarthritis Cartilage, 13(1), 28-33.
31. Ünsal, A., & Kaşıkçı, M. (2008). Artritli bireylerde öz-etkililik ölçeği’nin geçerlik ve güvenirliliği. Journal of Anatolia Nursing and Health Sciences, 11(1), 40-50.
32. Wright, L. J., Zautra, A. J., & Going, S. (2008). Adaptation to early knee osteoarthritis: the role of risk, resilience, and disease severity on pain and physical functioning. Ann of Behav Med, 36(1), 70-80.
33. Yılmaz, Ö. T., Yakut, Y., Uygur, F., & Uluğ, N. (2011). Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. Turk J Physiother Rehabil, 22(1), 44-49.