Investigation of the effect of low back pain severity on functional level, quality of life and fear-avoidance behavior in women with hip osteoarthritis

Öz

Purpose: The objective of the this study was to investigate the effect of low back pain (LBP) severity on functional level, quality of life (QoL), and fear-avoidance behavior in patients with hip osteoarthritis (HOA). Material and methods: A cross-sectional study conducted on a total of 43 female patients diagnosed with HOA. The patients were divided into two groups according to pain intensity; Group 1 consisted of patients with moderate-to-high intensity low back pain (VAS:3.5-10 cm; n=21), Group 2 consisted of patients with mild back pain (VAS:0.5-3.49 cm; n=22) occurred. Functional level (Lumbar Spine Mobility, Harris Hip Score, Timed Up and Go Test), quality of life (Nottingham Health Profile) and kinesiophobia (Tampa Scale of Kinesiophobia) were evaluated. Results: When the groups were compared, it was found that the QoL, QoL-pain and emotional reactions sub-parameters scores of Group 1 were significantly higher than Group 2 (p=0.001, p=0.002, p=0.002). However, there was no statistically significant difference between the two groups in terms of functional level and kinesiophobia (p>0.05). Conclusion: The results of the study showed that the QoL-pain and emotional reaction sub-parameters and QoL were negatively affected in patients with moderate-high severity of LBP in HOA in comparison with mild severity of LBP.

Anahtar Kelimeler

• Hip osteoarthritis
• low back pain
• quality of life
• pain
• assessment

Kalça osteoartritli kadınlarda bel ağrısı şiddetinin fonksiyonel düzey, yaşam kalitesi ve korku kaçınma davranışına etkisinin incelenmesi

Öz

Amaç: Bu çalışmanın amacı kalça osteoartritli (KOA) hastalarda bel ağrısı şiddetinin fonksiyonel düzey, yaşam kalitesi ve korku kaçınma davranışı üzerine etkisini incelemektir. Gereç ve yöntem: Yapılan kesitsel çalışmaya KOA tanısı konmuş toplam 43 kadın hasta dahil edilmiştir. Hastalar ağrı şiddetine göre iki gruba ayrılmış; Grup 1 orta-yüksek şiddette bel ağrısı olan hastalardan (VAS:3,5-10 cm; n=21), Grup 2 ise hafif bel ağrısı olan hastalardan (VAS:0,5-3,49 cm; n=22) oluşturulmuştur. Fonksiyonel düzey (Lumbar Bölge Hareketliliği, Harris Kalça Skoru, Zamanlı Kalk ve Yürü Testi), yaşam kalitesi (Nottingham Sağlık Profili) ve kinezyofobi (Tampa Kinezyofobi Ölçeği) değerlendirilmiştir. Bulgular: Gruplar karşılaştırıldığında Grup 1'in yaşam kalitesi, yaşam kalitesi-ağrı ve emosyonel reaksiyonlar alt parametre skorlarının Grup 2'ye göre anlamlı derecede yüksek olduğu görüldü (p=0,001, p=0,002, p=0,002). Ancak fonksiyonel düzey ve kinezyofobi açısından iki grup arasında istatistiksel olarak anlamlı fark yoktu (p>0,05). Sonuç: Çalışmanın sonuçları, KOA'da orta-yüksek şiddette bel ağrısı olan hastalarda, hafif şiddette bel ağrısına kıyasla yaşam kalitesi-ağrı ve emosyonel reaksiyonlar alt parametrelerinin ve yaşam kalitesinin olumsuz etkilendiğini göstermiştir.

Anahtar Kelimeler

• Kalça osteoartriti
• bel ağrısı
• yaşam kalitesi
• ağrı
• değerlendirme

Kaynakça

1. Kim C, Nevitt MC, Niu J, et al. Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study. BMJ. 2015;351:h5983. doi:10.1136/bmj.h5983
2. MacDonald KV, Sanmartin C, Langlois K, Marshall DA. Symptom onset, diagnosis and management of osteoarthritis. Health Rep. 2014;25:10-17.
3. Jordan JM, Helmick CG, Renner JB, et al. Prevalence of hip symptoms and radiographic and symptomatic hip osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. J Rheumatol. 2009;36(4):809-815. doi:10.3899/jrheum.080677
4. Faber BG, Frysz M, Boer CG, et al. The identification of distinct protective and susceptibility mechanisms for hip osteoarthritis: findings from a genome-wide association study meta-analysis of minimum joint space width and Mendelian randomisation cluster analyses. EBioMedicine. 2023;95:104759. doi:10.1016/j.ebiom.2023.104759
5. Felson DT. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev. 1988;10:1-28. doi:10.1093/oxfordjournals.epirev.a036019
6. Wang W, Sun M, Xu Z, Qiu Y, Weng W. The low back pain in patients with hip osteoarthritis: current knowledge on the diagnosis, mechanism and treatment outcome. Ann Joint. 2016;1:9. doi:10.21037/aoj.2016.0
7. Panahi R, Mohammadi B, Kazemi SS, Shamsi Nejad Geshti MR. Low back pain, disability and quality of life among university students. IJMPP. 2016;1:173-177.
8. Gatchel RJ, Neblett R, Kishino N, Ray CT. Fear-avoidance beliefs and chronic pain. J Orthop Sports Phys Ther. 2016;46(2):38-43. doi:10.2519/jospt.2016.0601

9. Sánchez Herán Á, Agudo Carmona D, Ferrer Peña R, et al. Postural stability in osteoarthritis of the knee and hip: analysis of association with pain catastrophizing and fear-avoidance beliefs. PM R. 2016;8(7):618-628. doi:10.1016/j.pmrj.2015.11.002
10. Olsson LE, Hansson E, Ekman I. Evaluation of person-centred care after hip replacement—a controlled before and after study on the effects of fear of movement and self-efficacy compared to standard care. BMC Nurs. 2016;15(1):53. doi:10.1186/s12912-016-0173-3
11. Rivière C, Lazic S, Dagneaux L, Van Der Straeten C, Cobb J, Muirhead Allwood S. Spine-hip relations in patients with hip osteoarthritis. EFORT Open Rev. 2018;3(2):39-44. doi:10.1302/2058-5241.3.170020
12. Offierski CM, MacNab I. Hip-spine syndrome. Spine (Phila Pa 1976). 1983;8(3):316-321. doi:10.1097/00007632-198304000-00014
13. Ben Galim P, Ben Galim T, Rand N, et al. Hip-spine syndrome: the effect of total hip replacement surgery on low back pain in severe osteoarthritis of the hip. Spine (Phila Pa 1976). 2007;32(19):2099-2102. doi:10.1097/BRS.0b013e318145a3c5
14. Dixon JS, Bird HA. Reproducibility along a 10 cm vertical visual analogue scale. Ann Rheum Dis. 1981;40(1):87-89. doi:10.1136/ard.40.1.87
15. Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain. 2014;155(12):2545-2550. doi:10.1136/ard.40.1.87
16. French HP, O'Donnell B, Cuddy V, O'Connell P. Clinical features of low back pain in people with hip osteoarthritis: a cross sectional study. Physiother Pract Res. 2015;36(1):15-22. doi:10.3233/PPR-140048
17. Robinson HS, Mengshoel AM. Assessments of lumbar flexion range of motion: intertester reliability and concurrent validity of 2 commonly used clinical tests. Spine (Phila Pa 1976). 2014;39(4):270-275. doi:10.1097/BRS.0000000000000131
18. Poulsen E, Christensen HW, Penny JØ, Overgaard S, Vach W, Hartvigsen J. Reproducibility of range of motion and muscle strength measurements in patients with hip osteoarthritis - an inter-rater study. BMC Musculoskelet Disord. 2012;13:242. doi:10.1186/1471-2474-13-242
19. Çelik D, Can C, Aslan Y, Ceylan HH, Bilsel K, Ozdincler AR. Translation, cross-cultural adaptation, and validation of the Turkish version of the Harris Hip Score. Hip Int. 2014;24(5):473-479. doi:10.5301/hipint.5000146
20. Çifçili S, Ünalan PC. Yaşlılarda fonksiyonel kayıplara yaklaşım. Türk Aile Hek Derg. 2004;8(4):166-173.
21. Lin MR, Hwang HF, Hu MH, Wu HDI, Wang YW, Huang FC. Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. J Am Geriatr Soc. 2004;52(8):1343-1348. doi: 10.1111/j.1532-5415.2004.52366.x
22. Tousignant M, Poulin L, Marchand S, Viau A, Place C. The Modified-Modified Schober Test for range of motion assessment of lumbar flexion in patients with low back pain: a study of criterion validity, intra- and inter-rater reliability and minimum metrically detectable change. Disabil Rehabil. 2005;27(10):553-559. doi:10.1080/09638280400018411
23. Otman AS, Köse N. Tedavi hareketlerinde temel değerlendirme prensipleri. 5. Baskı. Ankara: Meteksan Matbaacılık ve Teknik Sanayi Ticaret A.Ş.; 2013:74-76.
24. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737-755.
25. Küçükdeveci AA. Functional assessment measures in osteoarthritis. Turkish J Geriatrics. 2011;14:37-44.
26. Elibol N. Türk toplumunda total kalça protezi uygulanan hastaların beklentilerinin incelenmesi. Yüksek lisans Tezi. Dokuz Eylül Üniversitesi Sağlık Bilimleri Enstitüsü, Fizik Tedavi ve Rehabilitasyon, İzmir; 2011.
27. Küçükdeveci AA, McKenna SP, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000;23(1):31-38. doi:10.1097/00004356-200023010-00004
28. Uutela T, Kautiainen H, Hakala M. Nottingham health profile questionnaire incorporates important aspects of the patient perspective into outcome assessment in rheumatoid arthritis. Clin Exp Rheumatol 2008;26(1):39-44.
29. Madenci E, Gürsoy S, Arıca E, Keven S. Primer fibromiyalji sendromlu hastalarda yaşam kalitesinin Nottingham sağlık profili ile değerlendirilmesi. Türkiye Klinikleri. 2003;3(1):11-14.
30. Tunca Yilmaz Ö, Yakut Y, Uygur F, Ulug N. Turkish version of the Tampa scale for kinesiophobia and its test-retest reliability. Fizyoter Rehabil. 2011;22(1):44-49.
31. Bränström H, Fahlström M. Kinesiophobia in patients with chronic musculoskeletal pain: differences between men and women. J Rehabil Med. 2008;40(5):375-380. doi:10.2340/16501977-0186
32. De Araújo LM, Dell’Antonio E, Hubert M, Ruschel C, Roesler H, Pereira SM. Trunk muscular endurance, lumbar spine mobility and hip flexibility in sailors with and without low back pain. Fisioter Mov Curitiba 2020;33(1):e003334. doi:10.1590/1980-5918.033.AO34
33. Moll JM, Wright V. Normal range of spinal mobility. An objective clinical study. Ann Rheum Dis. 1971;30(4):381-386. doi:10.1136/ard.30.4.381
34. Tateuchi H, Akiyama H, Goto K, So K, Kuroda Y, Ichihashi N. Sagittal alignment and mobility of the thoracolumbar spine are associated with radiographic progression of secondary hip osteoarthritis. Osteoarthritis Cartilage. 2018;26(3):397-404. doi:10.1016/j.joca.2017.12.005
35. Latimer J, Lee M, Adams R, Moran CM. An investigation of the relationship between low back pain and lumbar posteroanterior stiffness. J Manipulative Physiol Ther. 1996;19(9):587-591.
36. Shirley D. Muscle activity and lumbar PA stiffness. PhD thesis. University of Sydney, School of Physiotherapy, Sydney, 2002.
37. Yalgın S, Karacan İ, Çelikdelen A. Mekanik bel ağrısı şiddeti ve süresi ile kas kuvveti ilişkisinin değerlendirmesi. Dirim Tıp Gazetesi 2008;83(3):117-123.
38. Parvizi J, Pour AE, Hillibrand A, Goldberg G, Sharkey PF, Rothman RH. Back pain and total hip arthroplasty: a prospective natural history study. Clin Orthop Relat Res. 2010;468(5):1325-1330. doi:10.1007/s11999-010-1236-5
39. Staibano P, Winemaker M, Petruccelli D, de Beer J. Total joint arthroplasty and preoperative low back pain. J Arthroplasty. 2014;29(5):867-871. doi:10.1016/j.arth.2013.10.001
40. Ran TF, Ke S, Li J, et al. Relieved low back pain after total hip arthroplasty in patients with both hip osteoarthritis and lumbar degenerative disease. Orthop Surg. 2021;13(6):1882-1889. doi:10.1111/os.13135
41. Arnold CM, Faulkner RA. The history of falls and the association of the timed up and go test to falls and near-falls in older adults with hip osteoarthritis. BMC Geriatr. 2007;7:17. doi:10.1186/1471-2318-7-17
42. Ceballos Laita L, Jiménez Del Barrio S, Marín Zurdo J, et al. Effectiveness of dry needling therapy on pain, hip muscle strength, and physical function in patients with hip osteoarthritis: a randomized controlled trial. Arch Phys Med Rehabil. 2021;102(5):959-966. doi:10.1016/j.apmr.2021.01.077
43. Zeni Jr J, Abujaber S, Pozzi F, Raisis L. Relationship between strength, pain, and different measures of functional ability in patients with end-stage hip osteoarthritis. Arthritis Care Res (Hoboken). 2014;66(10):1506-1512. doi:10.1002/acr.22329
44. Mutubuki EN, Beljon Y, Maas ET, et al. The longitudinal relationships between pain severity and disability versus health-related quality of life and costs among chronic low back pain patients. Qual Life Res. 2020;29(1):275-287. doi:10.1007/s11136-019-02302-w
45. Stupar M, Côté P, French MR, Hawker GA. The association between low back pain and osteoarthritis of the hip and knee: a population-based cohort study. J Manipulative Physiol Ther. 2010;33(5):349-354. doi:10.1016/j.jmpt.2010.05.008
46. Kopp B, Furlough K, Goldberg T, Ring D, Koenig K. Factors associated with pain intensity and magnitude of limitations among people with hip and knee arthritis. J Orthop. 2021;25:295-300. doi:10.1016/j.jor.2021.05.026