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INTRODUCTION: Headaches are the cause of disability worldwide, and among them, migraine stands out as one of the most prevalent. Psychosocial aspects have a relevant role in the prognosis of migraine, but their relationship with these variables is not completely clear. OBJECTIVE: To investigate the relationship between kinesiophobia and catastrophizing level, self-efficacy, hypervigilance, physical activity level, and disability in individuals with migraine. METHOD: Eighty-eight participants answered an online form containing validated questionnaires to evaluate kinesiophobia, catastrophizing, self-efficacy, hypervigilance, and disability. Based on the cutoff point of the Tampa scale, participants were categorized into two groups: migraine with kinesiophobia (KM, n = 45), and migraine without kinesiophobia (NKM, n = 43). RESULTS: The prevalence of kinesiophobia was 51.1%. The KM group presented higher catastrophizing and disability scores and lower self-efficacy scores, vigorous physical activity time, and physical activity level compared to the NKM group (p < .05). Kinesiophobia was associated with higher catastrophizing levels (r = 0.546, p < .001), hypervigilance (r = 0.302, p = .004) and disability (r = 0.517, p < .001) and lower self-efficacy levels (r = - 0.499, p < .001). In addition, kinesiophobia is associated with the risk of being physically inactive (OR = 0.186, 95% CI: 0.068-0.505). CONCLUSION: Kinesiophobia is prevalent in individuals with migraine and should be carefully considered in clinical practice, as it harms participation in physical activities and is associated with worse cognitive and behavioral outcomes.
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BACKGROUND: The Tampa Scale for Kinesiophobia (TSK) is one of the most frequently employed instruments for assessing maladaptive beliefs about pain, injury, and movement in patients with chronic musculoskeletal pain. However, the measurement properties of this tool have so far not been tested for individuals with migraine. OBJECTIVE: To evaluate the structural, construct, and criterion validity, and the internal consistency for three versions (TSK-11, TSK-13, and TSK-17) of the TSK for patients with migraine. METHODS: A total of 113 individuals aged between 18 and 55 years old with migraine diagnosis were included. All participants completed the TSK with 17 items, the Fear-Avoidance Beliefs Questionnaire, the Headache Impact Test, and the Pain Catastrophizing Scale questionnaires. Confirmatory factor analysis was used to assess the structural validity of the TSK, and Cronbach's α was used to assess internal consistency. For construct and criterion validity, the Spearman's correlation was calculated. RESULTS: The TSK structure with one factor and the 17, 13, or 11 items versions were suitable, with suitable values in all fit indices related to structural validity. The three versions showed acceptable internal consistency (α = 0.75). All TSK versions showed moderate positive correlation with the other questionnaires (rho range= 0.31-0.63), confirming most of the predefined hypothesis for the construct validity. Also, the criterion validity of the 13-item and 11-item versions was confirmed (rho=0.95 and rho=0.94, respectively). CONCLUSION: All versions of the TSK demonstrated good measurement properties in the assessment of maladaptive beliefs about pain, injury, and movement in individuals with migraine.
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Transtornos de Enxaqueca , Humanos , Inquéritos e Questionários , Pessoa de Meia-Idade , Psicometria , Adulto , Catastrofização , Transtornos Fóbicos , Reprodutibilidade dos Testes , Adolescente , CinesiofobiaRESUMO
INTRODUCTION: Chronic non-specific low back pain (CNSLBP) is a major worldwide condition that has severe emotional, social, and economic consequences. Management is difficult, requiring the development of new, effective, and safe approaches. OBJECTIVES: This study was conducted to examine the effects of Pulsed Electromagnetic Fields (PEMF) and retrowalking on pain, disability, spinal mobility, hamstring tightness, balance, and kinesiophobia in patients with chronic non-specific low back pain. MATERIALS AND METHODS: Participants (n = 48) with CNSLBP were randomised into four groups; Group A: Conventional group, Group B: PEMF group, Group C: retrowalking group, and Group D: PEMF and retrowalking group. The interventions were given three times per week for six weeks. The outcomes were pain, disability, hamstring tightness, balance, spinal mobility and kinesiophobia, measured at baseline and after 6 weeks. RESULTS: The result suggested a significant improvement in pain, disability, hamstring tightness, kinesiophobia and balance. However, no significant improvement in spinal mobility (flexion and extension ROM) was observed during the sixth week between-group comparison. The maximum improvement was seen in group D followed by group C and group B in comparison to group A. CONCLUSION: It can be concluded that PEMF and retrowalking when given in combination significantly decrease pain, disability, hamstring tightness, kinesiophobia and improve balance patients with chronic non-specific low back pain.
INTRODUÇÃO: A dor lombar crônica inespecífica (DLCI) é uma condição importante em todo o mundo que tem graves consequências emocionais, sociais e econômicas. O gerenciamento é difícil, exigindo o desenvolvimento de abordagens novas, eficazes e seguras. OBJETIVOS: Este estudo foi realizado para examinar os efeitos dos Campos Eletromagnéticos Pulsados (CEMP) e do retrowalking sobre a dor, a incapacidade, a mobilidade da coluna vertebral, a rigidez dos isquiotibiais, o equilíbrio e a cinesiofobia em pacientes com dor lombar crônica não específica. MATERIAIS E MÉTODOS: Os participantes (n = 48) com DLCI crônica foram divididos aleatoriamente em quatro grupos: Grupo A: Grupo convencional, Grupo B: Grupo CEMP, Grupo C: Grupo retrowalking e Grupo D: Grupo CEMP e retrowalking. As intervenções foram realizadas três vezes por semana durante seis semanas. Os resultados foram dor, incapacidade, tensão nos isquiotibiais, equilíbrio, mobilidade da coluna vertebral e cinesiofobia, medidos na linha de base e após seis semanas. RESULTADOS: O resultado sugeriu uma melhora significativa na dor, na incapacidade, na tensão dos isquiotibiais, na cinesiofobia e no equilíbrio. Entretanto, não foi observada melhora significativa na mobilidade da coluna vertebral (flexão e extensão da ADM) quando a comparação entre os grupos foi feita na sexta semana. A melhora máxima foi observada no grupo D, seguida pelo grupo C e pelo grupo B, em comparação com o grupo A. CONCLUSÃO: Pode-se concluir que a CEMP e o retrowalking, quando administrados em combinação, diminuem significativamente a dor, a incapacidade, a rigidez dos isquiotibiais, a cinesiofobia e melhoram o equilíbrio dos pacientes com dor crônica não espinhal.
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Dor Lombar , Campos Eletromagnéticos , CinesiofobiaRESUMO
BACKGROUND: Fear-avoidance variables are present in patients with musculoskeletal pain conditions, such as chronic low back pain (CLBP) and Achilles tendinopathy (AT) and can lead to reduced function and recovery. It is unknown how these variables relate in populations with different etiologies but similar pain provocation mechanisms. OBJECTIVE: To compare kinesiophobia, pain catastrophizing, and disability between these two groups. METHODS: Patients with CLBP and those with AT were included. Tampa Scale of Kinesiophobia (TSK-17) and Pain Catastrophizing Scale (PCS-13) were evaluated in both groups. The CLBP group completed the Oswestry Disability Index (ODI) and the AT group completed the PROMIS-29 questionnaire. Gait speed was calculated for each group. Disability outcomes were normalized between groups. RESULTS: 119 patients in the CLBP group (64 female, 46 ± 8 years) and 83 patients in the AT group (42 female, 48 ± 12 years) were included. Both groups (CLBP, AT) presented with high prevalence of kinesiophobia (67%, 55%) but the CLBP group presented with higher prevalence of pain catastrophizing (22%, 2%). The CLBP group demonstrated higher levels of disability via normalized ODI (MD= 12.4, 95% CI: 9.2, 15.5) but the AT group demonstrated slower gait speed (MD= 0.1 m/s, 95% CI: 0.0, 0.2). CONCLUSION: Similarly high prevalence of kinesiophobia was found in patients with CLBP and patients with AT. While the CLBP group reported greater prevalence of catastrophizing thoughts and greater disability, the AT group had slower gait speed. Overall, these findings demonstrate that CLBP and AT have similarities that may allow clinicians to learn from one to inform treatment of the other. CLINICAL TRIAL REGISTRATION NUMBERS: NCT03523325, ISRCTN17115599.
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Tendão do Calcâneo , Dor Crônica , Dor Lombar , Doenças Musculoesqueléticas , Tendinopatia , Humanos , Feminino , Avaliação da Deficiência , Medo , Dor Crônica/terapiaRESUMO
The aim of this study is to investigate if telerehabilitation is just as effective as the same face-to-face exercise program in patients with chronic neck pain (NP). 140 participants will participate in this non-inferiority randomized controlled trial. Primary outcomes will be pain intensity and disability, and secondary outcomes will be kinesiophobia, catastrophizing, fear avoidance beliefs, anxiety and depression symptoms, self-efficacy for pain and global perceived effect. It will be collected at baseline, 6 weeks and 6 months after intervention. The analysis of non-inferiority will be calculated by mixed linear models considering the non-inferiority margin. The results of this clinical trial will be able to overcome the barriers that physiotherapists face for the success of their therapies. In addition, it may reduce the high demands and public health costs with NP. Brazilian Clinical Trials Registry (RBR-6VBSMB). Clinical Trial Registration: REBEC (Brazilian Registry of Clinical Trials) RBR-6VBSMB (ClinicalTrials.gov).
What is this article about? This study aims to compare the effect of face-to-face and telerehabilitation treatment for chronic neck pain, since it is the third condition that causes most disability in the world among musculoskeletal conditions. In addition, because its prevalence occurs at an economically active age, it generates a drop in productivity and absenteeism at work. Due to the high public health expenses with chronic neck pain, telerehabilitation is a tool with great potential for reducing waiting lists and barriers to therapy success (transport, time, money). What do the results of the study mean? This is the first clinical trial to investigate the efficacy of telerehabilitation exercise in patients with chronic neck pain and the results will be able to overcome the barriers that physiotherapists face for the success of their therapies. In addition, it may reduce the high demands and public health costs with neck pain and may help patients experience less pain and disability and become more self-sufficient in managing their chronic condition.
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Dor Crônica , Telerreabilitação , Humanos , Catastrofização , Dor Crônica/terapia , Terapia por Exercício/métodos , Cervicalgia/terapia , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
INTRODUÇÃO: Atletas de contato estão sujeitos a lesões musculoesqueléticas devido às técnicas repetitivas aplicadas durante treinos e campeonatos. Isso pode levá-los a apresentar dores agudas e crônicas, e, a depender da técnica aplicada, diferentes regiões do corpo podem ser acometidas. Estudos nesta área focam na descrição da lesão ou trauma, no entanto, a presença de cinesiofobia nesta população é uma lacuna a ser investigada. OBJETIVO: Descrever o perfil de dor e cinesiofobia em atletas de Judô da categoria master. MÉTODO: Estudo observacional, descritivo, de corte transversal, realizado com 29 atletas de judô master inscritos na Federação Baiana. Para descrição da dor, foram utilizados o Inventário Breve de Dor (IBD) e Doleur Neuropathique Questionnaire (DN4) e a Escala de Cinesiofobia de Tampa (ECT). Os dados foram tabulados e analisados descritivamente através do software Excel for Windows® utilizando valor absoluto ou média (desvio padrão). RESULTADOS: Os dados do IBD mostraram que a média geral de dor foi de 5,1 ± 1,8, o tratamento optado foi majoritariamente o farmacológico e a região mais acometida foi a face anterior do joelho. Dos 29 participantes, 9 (31%) apresentavam o escore ≥3, indicando presença de dor neuropática e cinesiofobia leve com média geral de 33,8 ± 6,7 no escore da ECT. CONSIDERAÇÕES FINAIS: Os atletas apresentaram dor moderada com pouco impacto na vida pessoal e as regiões com maior incidência foram os joelhos. Cinesiofobia leve esteve presente em mais da metade dos participantes e um terço apresentou dor neuropática.
INTRODUCTION: Contact athletes are subject to musculoskeletal injuries due to repetitive techniques applied during training and championships. This can lead to acute and chronic pain, and depending on the technique applied, different regions of the body may be affected. Studies in this area focus on the description of injury or trauma, however, the presence of kinesiophobia in this population is a gap to be investigated. OBJECTIVE: To describe the profile of pain and kinesiophobia in judo athletes of the master category. METHOD: An observational, descriptive, cross-sectional study conducted with 29 judo master athletes enrolled in the Bahia Federation. For pain description, the Brief Pain Inventory (BPI) and Doleur Neuropathique Questionnaire (DN4) and the Tampa Scale for Kinesiophobia (TSK) were used. The data were tabulated and analyzed descriptively through the software Excel for Windows® using absolute or mean value (standard deviation). RESULTS: The BPI data showed that the overall pain mean was 5.1 ± 1.8, the treatment chosen was mostly pharmacological and the region most affected was the anterior knee. Of the 29 participants, 9 (31%) had score 3, indicating the presence of neuropathic pain and mild kinesiophobia with an overall mean of 33.8 ± 6.7 on the TSK score. FINAL CONSIDERATIONS: The athletes presented moderate pain with little impact on personal life and the regions with the highest incidence were the knees. Mild kinesiophobia was present in more than half of the participants and one third presented neuropathic pain.
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Dor , Artes Marciais , CinesiofobiaAssuntos
Dor Crônica , Hemofilia A , Humanos , Cinesiofobia , Dor Crônica/complicações , Hemofilia A/complicações , Catastrofização , MedoRESUMO
PURPOSE: To identify the best internal structure of the Tampa Scale for Kinesiophobia in chronic low back pain patients. DESIGN: Questionnaire validation study was designed for this study. SETTING: This study was conducted in physical therapy facility. SUBJECTS: Respondents reporting chronic low back pain (≥3 points on the 11-point Numerical Pain Rating Scale). MAIN MEASURES: We included participants of both sexes, with a self-report of low back pain ≥3 months and with pain intensity ≥3 on the 11-point Numerical Pain Rating Scale; participants also answered the Roland-Morris Disability Questionnaire and the Pain-Related Catastrophizing Thoughts Scale for low back pain disability and catastrophizing, respectively. The dimensionality and number of items of the Tampa Scale for Kinesiophobia were evaluated using the confirmatory factor analysis. Criterion validity was assessed using Spearman's correlation coefficient using the original version of the 17-item Tampa Scale for Kinesiophobia as the gold standard. RESULTS: A total of 122 participants were included, with mean values of low back pain duration ≥48 months, pain intensity >5 and disability >8. Tampa Scale for Kinesiophobia structure with two domains and nine items was the most suitable, with adequate values in all fit indices (Chi-square/degree of freedom <3, Comparative Fit Index and Tucker-Lewis Index >0.90, and root mean square error of approximation <0.08) and lower Akaike information criterion and Bayesian information criterion values. We observed a high correlation between the 17-item Tampa Scale for Kinesiophobia and the activity avoidance domain (rho = 0.850, P < 0.001) and somatic focus domain (rho = 0.792, P < 0.001) of the nine-item Tampa Scale for Kinesiophobia. CONCLUSION: Tampa Scale for Kinesiophobia structure with two domains (activity avoidance and somatic focus) and nine items is the most suitable for patients with chronic low back pain.
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Dor Crônica , Dor Lombar , Masculino , Feminino , Humanos , Dor Lombar/diagnóstico , Dor Lombar/terapia , Medo , Cinesiofobia , Teorema de Bayes , Inquéritos e Questionários , Reprodutibilidade dos Testes , Avaliação da Deficiência , Dor Crônica/diagnóstico , PsicometriaRESUMO
Introduction: Psychological processes can play an important role in the expression and clinical impact of fibromyalgia.Objective: To investigate the association between the severity of pain and disability and psychological factors in patients with fibromyalgia.Methods: The following outcomes were assessed in 104 patients with fibromyalgia: pain intensity, using the Pain Numerical Rating Scale; disability, using the Patient-Specific Functional Scale; depression, using the Beck Depression Scale; anxiety, using the State-Trait Anxiety Inventory; kinesiophobia, using the Tampa Scale for Kinesiophobia; pain catastrophizing, using the Pain Catastrophizing Scale; beliefs and attitudes toward pain, using the Survey of Pain Attitudes; and the occurrence of abuse during some stage of life. Statistical analysis was performed using SPSS version 15. Initially, a simple regression analysis was performed between the dependent variables (pain and disability) and the other variables with a significance level of p ≤ 0.20, and then a multiple regression analysis was performed with a significance level of p ≤ 0.05.Results: Depression was found to be associated with pain severity (ß = 0.07 [95% CI: 0.02 to 0.11], p = .00), and kinesiophobia was found to be associated with disability severity (ß = -0.06 [95% CI: -0.09 to -0.02], p = .00). Depression can explain 10% of the variability of pain intensity, while kinesiophobia can explain 9% of the variability of disability.Conclusion: There are weak associations that are not clinically relevant between depression and pain severity, and between kinesiophobia and disability severity. However, other psychological factors are not associated with the severity of pain or disability.
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Fibromialgia , Catastrofização , Estudos Transversais , Depressão/diagnóstico , Avaliação da Deficiência , Fibromialgia/diagnóstico , Humanos , DorRESUMO
INTRODUCTION: Physical exercise improves physical fitness and health, helping to reduce pain and prevent low back pain. This study aims to compare the intensity of low back pain (LBP), behavioral habits, and the level of disability and kinesiophobia among exercising and non-exercising subjects with LBP. METHODS: Consecutive sample of 102 individuals was divided into exercising group (EG) and non-exercising group (NEG). The data was extracted from the answers to the questionnaires Back Pain and Body Posture Evaluation Instrument (BackPEI-A), Oswestry Disability Index (ODI) and Fear-avoidance Beliefs Questionnaire (FABQ-Brazil). For statistical analysis, the chi-square test was used, α ≤ 0.05. RESULTS: Both groups presented predominance of mild to moderate pain intensity and absence of kinesiophobia in the practice of physical activity, with no statistically significant difference. However, there was significant difference between the groups for the risk of occurrence of LBP and for levels of incapacity and kinesiophobia related to work. CONCLUSION: Exercising individuals appear to present with a lower risk for occurrence of LBP, lower level of disability, and absence of work-related kinesiophobia.
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Dor Lombar , Estudos Transversais , Avaliação da Deficiência , Exercício Físico , Hábitos , Humanos , Dor Lombar/epidemiologia , Estudos Retrospectivos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The Star Excursion Balance Test (SEBT) is commonly used for testing dynamic balance in chronic ankle instability (CAI) in both clinical and research settings. However, the effect of verbal encouragement (VE) on the SEBT performance is not known. OBJECTIVE: To investigate the effects of VE on maximum reach distance performance between CAI and healthy participants on the SEBT. METHOD: Thirty-four college-aged adults, 17 with CAI and 17 healthy controls, performed the SEBT in the anterior, posteromedial, and posterolateral reach directions. Independent variables (VE versus No-VE) and group (CAI versus healthy) were analyzed using Analysis of Variance (ANOVA) to determine whether VE and group affected reach performance. RESULTS: There was a significant group-by-condition interaction (p = 0.02) for the anterior as well as for the posteromedial reach (p = 0.04). There was no statistically significant interaction (p = 0.48) for the posterolateral reach. There were moderate to large effect sizes in the reach distances found in the No-VE condition between the CAI and healthy controls, but with VE, the range of effect sizes from No-VE to VE were diminished. CONCLUSION: There was a significant group by condition interaction for anterior and posteromedial reaches which shows that providing VE resulted in a greater increase in performance for participants with CAI compared to healthy controls. Psychological constraints need to be considered while performing and interpreting the results of the SEBT.
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Tornozelo , Instabilidade Articular , Adulto , Articulação do Tornozelo , Humanos , Exame Físico , Equilíbrio Postural , Adulto JovemRESUMO
OBJECTIVE: To analyze the measurement properties of the Brazilian-Portuguese version of the Tampa Scale for Kinesiophobia-11 in patients with fibromyalgia. METHODS: Assessment was made at three time points: baseline (n=130) and 15 days (n=54) and eight weeks after baseline (n=51). Data collected at baseline were used to assess internal consistency, criterion and construct validity, and ceiling and floor effects. Data collected at baseline and 15 days after baseline were used to assess reliability and measurement error, and data collected before and after an eight-week exercise-based physical therapy intervention were used to assess interpretability of change scores. RESULTS: The Tampa Scale for Kinesiophobia-11 showed adequate internal consistency (Cronbach's alpha=0.77; alpha if item deleted: 0.74-0.77), substantial reliability (intraclass correlation coefficient2,1=0.85; 95% confidence interval: 0.75, 0.90), good measurement error (standard error of measurement: 2.65 points), and a minimal detectable change (90% confidence) of 6.16 points. For validity, the Tampa Scale for Kinesiophobia-11 showed a positive and good correlation with the original Tampa Scale for Kinesiophobia (r=0.84, p<0.01), positive and moderate correlation with the Pain Catastrophizing Scale (r=0.55, p<0.01), positive and weak correlation with the Numerical Pain Rating Scale (r=0.25, p<0.01), positive and moderate correlation with the Beck Depression Inventory (r=0.39, p<0.01), and no correlation with the Patient-Specific Functional Scale (r=0.11, p=0.23). Kinesiophobia, pain, function, catastrophizing, and depression statistically improved after the eight-week intervention (p<0.01). CONCLUSION: The Tampa Scale for Kinesiophobia-11 is consistent, reliable, and appropriate to assess fear of movement in patients with fibromyalgia in the clinical context. Responsiveness of the Tampa Scale for Kinesiophobia-11 should be tested in future studies.
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Fibromialgia/fisiopatologia , Movimento/fisiologia , Transtornos Fóbicos/psicologia , Brasil , Catastrofização/psicologia , Comparação Transcultural , Medo/psicologia , Humanos , Dor , Transtornos Fóbicos/diagnóstico , Transtornos Fóbicos/epidemiologia , Portugal , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Analyze return to sports and related factors after primary anterior cruciate ligament reconstruction. METHODS: Observational descriptive study. 173 patients operated by the same surgeon and standardized technique (patellar autograft) who answered a questionnaire at least 12 months post procedure were included. Questionnaire included Subjective IKDC, Tegner activity level (Pre and Postoperative) and questions elaborated by the group. RESULTS: Mean age was 30.8 years, 85% were men, 73% practiced soccer and median postoperative IKDC was 71. Follow up until questionnaire response was 28 months. Males had a better return to sports than females (70% vs 48%, p » 0.037). Tegner preinjury level was 5 vs 4.3 postoperative, (p < 0.001). Return to sports was 67% according to Tegner scale and 66% by self-assessment. Return to similar previous activity level was 57% by Tegner scale but 24% by direct questions. Of those patients, 51% have fear of reinjury and 26% by reasons other than knee or surgery. We didn't find association between meniscal injuries and return to sports rate. Patients with chondral injuries had lower rates in return to sports (35% vs 60%, p » 0.002). Subjects that returned to sports had higher IKDC scores (73.5 vs 64.3, p < 0.001). CONCLUSIONS: We found 67% return to sports and 57% to the preinjury level. Positive return to sports factors were male sex, absence of chondral injury and better functional outcome. Psychological factors such as fear of injury is frequent in patients who don't achieve previous levels of activity.
OBJETIVOS: Analizar el retorno deportivo y factores asociados tras la reconstrucción primaria de ligamento cruzado anterior (LCA). MÉTODOS: Estudio observacional descriptivo. Se incluyeron 173 operados entre 2014 y 2017 por el mismo cirujano, los cuales contestaron un cuestionario al menos 12 meses después de la cirugía. El cuestionario incluye IKDC subjetivo, Tegner activity level (pre y post operatorio) y preguntas de elaboración propia. RESULTADOS: La edad promedio es 30,8 años, el 85% son hombres, el 73% practicaba fútbol y la mediana del IKDC fue 71. La media de meses hasta responder el cuestionario fue de 28 meses. Tegner pre-lesión promedio fue de 5 vs 4,3 postoperatorio, p < 0,001. Según la escala Tegner el 57% retorna al mismo nivel previo, sin embargo, de acuerdo con el cuestionario propio solo el 24% lo haría. De ese subgrupo, el 51% tiene temor a lesionarse de nuevo y el 26% reporta razones no relacionadas a la rodilla. No encontramos asociación entre lesiones meniscales y la tasa de retorno. Aquellos que retornan tienen menor prevalencia de lesiones condrales (35% vs 60%, p » 0,002). Los pacientes que retornaron tuvieron un IKDC superior (73,5 vs 64,3, p < 0,001). El sexo masculino tiene una tasa de retorno de 70% vs 48% de su contraparte femenina (p » 0,037). CONCLUSIONES: El 67% retorna al deporte y el 57% lo hace al mismo nivel. Factores positivos relacionados al retorno fueron sexo masculino, ausencia de lesión condral y mejor resultado funcional. Factores psicológicos con el miedo a lesionarse de nuevo son frecuentes en pacientes que no recuperan el nivel previo.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Enxerto Osso-Tendão Patelar-Osso/métodos , Reconstrução do Ligamento Cruzado Anterior/métodos , Volta ao Esporte , Lesões do Ligamento Cruzado Anterior/cirurgia , Inquéritos e Questionários , Medo , Lesões do Ligamento Cruzado Anterior/psicologia , Relesões/psicologiaRESUMO
OBJECTIVES: The aim of this study was to empirically derive subgroups according to pain-related fear of movement beliefs using cluster analysis within a sample of TMD patients and asymptomatic volunteers. METHODS: 129 volunteers participated in this cross-sectional study (34.78, standard deviation [SD]: 12.49 years; 92 TMD patients and 37 symptom-free volunteers). Mechanical pain sensitivity through pressure pain threshold (PPT) on orofacial and remote sites, kinesiophobia, pain catastrophizing, anxiety and depression were assessed. A cluster analysis was used to derive subgroups according to kinesiophobia scores (TSK/TMD). RESULTS: Three subgroups were derived: cluster 1 (high kinesiophobia [nâ¯=â¯53], TSK score: 33, SD[standard deviation]â¯=â¯2.9), cluster 2 (moderate kinesiophobia [nâ¯=â¯50], TSK score: 26.2, SDâ¯=â¯2.14) and cluster 3 (no/low kinesiophobia [nâ¯=â¯26], TSK score 12.12, SDâ¯=â¯2.08) which included patients with higher overall PPT and lower scores on psychosocial variables. The group with high kinesiophobia showed high levels of pain catastrophizing, anxiety, and orofacial pain-related disability compared to the other subgroups and mechanical pain hyperalgesia in remote site compared to the low-kinesiophobia group. Also, we found a greater prevalence of triple diagnosis for the high-kinesiophobia subgroup compared to the moderate kinesiophobia group - odds ratio: 12.6 (95% confidence interval [CI]: 3.31-43.52, pâ¯<â¯0.01). CONCLUSION: These results suggested that patients with TMD and higher levels of kinesiophobia beliefs may show a more complex clinical feature, with high psychosocial distress, widespread mechanical pain sensitivity, and a more complex TMD disorder. In this way, we suggest a relationship between the number of TMD diagnoses and kinesiophobia severity.
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Transtornos Fóbicos/psicologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/psicologia , Adolescente , Adulto , Ansiedade/diagnóstico , Brasil , Catastrofização , Estudos Transversais , Depressão/diagnóstico , Avaliação da Deficiência , Medo/psicologia , Feminino , Humanos , Hiperalgesia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Medição da Dor , PsicometriaRESUMO
Patients undergoing carpal tunnel release surgery may continue to experience pain despite the intervention. This symptom may be modulated by psychosocial factors including depression, catastrophic thinking, and kinesiophobia. Pain neuroscience education (PNE) has been found to be effective when combined with therapeutic exercise in patients with chronic pain, but this strategy has not been evaluated in patients with persistent hand pain. The findings of this study indicate that a single preoperative PNE session in combination with therapeutic exercise does not provide added benefits in comparison to standard preoperative care plus therapeutic exercise. Future studies should evaluate if patients with carpal tunnel release are additionally benefited by the incorporation and consequent behavioural changes of more PNE sessions to multimodal treatment.
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Síndrome do Túnel Carpal/cirurgia , Síndrome do Túnel Carpal/terapia , Dor Crônica/terapia , Terapia por Exercício , Mãos/fisiopatologia , Educação de Pacientes como Assunto/métodos , Adulto , Idoso , Catastrofização/terapia , Terapia Combinada , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , Neurociências/educação , Transtornos Fóbicos/terapia , Modalidades de Fisioterapia , Cuidados Pré-Operatórios , Período Pré-Operatório , Resultado do TratamentoRESUMO
BACKGROUND: Low back pain is a significant health problem condition due to high prevalence among the general population. Emotions and physical factors are believed to play a role in chronic low back pain. Kinesiophobia is one of the most extreme forms of fear of pain due to movement or re-injury. The purpose of this study was to investigate the association between kinesiophobia and pain intensity, disability and quality of life in people with chronic low back pain. METHODS: The study included 132 individuals with chronic back pain, with ages between 18 and 65 years old. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia, pain intensity was measured using the Numeric Rating Scale with a cut-off more than 3 for inclusion in the study, disability was assessed using the Roland Morris questionnaire, quality of pain was assessed using the McGill questionnaire, and quality of life was assessed using the Quality of Life questionnaire SF-36. RESULTS: The results are statistically significant, but with weak associations were found between kinesiophobia and pain intensity (r = 0.187), quality of pain (sensory, r = 0.266; affective, r = - 0.174; and total r = 0.275), disability (r = 0.399) and physical quality of life (emotional r = - 0.414). CONCLUSION: Kinesiophobia is an important outcome to assess in patients with chronic low back pain. The results suggest that correlations between kinesiophobia and disability and quality of life are statistically significant.
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Dor Crônica/psicologia , Medo/psicologia , Dor Lombar/psicologia , Movimento , Transtornos Fóbicos/psicologia , Qualidade de Vida , Adulto , Idoso , Estudos Transversais , Avaliação da Deficiência , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/estatística & dados numéricosRESUMO
Fear of movement (kinesiophobia) seems to play an important role in the development of chronic pain. However, for temporomandibular disorders (TMD), there is a scarcity of studies about this topic. The Tampa Scale for Kinesiophobia for TMD (TSK/TMD) is the most widely used instrument to measure fear of movement and it is not available in Brazilian Portuguese. The purpose of this study was to culturally adapt the TSK/TMD to Brazilian Portuguese and to assess its psychometric properties regarding internal consistency, reliability, and construct and structural validity. A total of 100 female patients with chronic TMD participated in the validation process of the TSK/TMD-Br. The intraclass correlation coefficient (ICC) was used for statistical analysis of reliability (test-retest), Cronbach's alpha for internal consistency, Spearman's rank correlation for construct validity and confirmatory factor analysis (CFA) for structural validity. CFA endorsed the pre-specified model with two domains and 12-items (Activity Avoidance - AA/Somatic Focus - SF) and all items obtained a loading factor greater than 0·4. Acceptable levels of reliability were found (ICC > 0·75) for all questions and domains of the TSK/TMD-Br. For internal consistency, Cronbach's α of 0·78 for both domains were found. Moderate correlations (0·40 < r < 0.60) were observed for 84% of the analyses conducted between TSK/TMD-Br scores versus catastrophising, depression and jaw functional limitation. TSK/TMD-Br 12 items and two-factor demonstrated sound psychometric properties (transcultural validity, reliability, internal consistency and structural validity). In such a way, the instrument can be used in clinical settings and for research purposes.
Assuntos
Dor Crônica/diagnóstico , Idioma , Medição da Dor/normas , Transtornos Fóbicos/diagnóstico , Transtornos da Articulação Temporomandibular/diagnóstico , Traduções , Adulto , Brasil , Catastrofização/diagnóstico , Catastrofização/psicologia , Dor Crônica/etiologia , Dor Crônica/psicologia , Comparação Transcultural , Feminino , Humanos , Pessoa de Meia-Idade , Movimento , Transtornos Fóbicos/psicologia , Portugal/etnologia , Psicometria , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/psicologia , Adulto JovemRESUMO
ABSTRACT BACKGROUND AND OBJECTIVES: Fear of movement and re/injury (kinesiophobia) is factor associated to chronic pain and incapacity. Since elderly population is highly affected by chronic health problems followed by pain, especially musculoskeletal problems, it is important to understand the impact of pain-related fear on elderly females' health. This study aimed at determining the incidence of kinesiophobia in elderly females assisted in a geriatrics and gerontology ambulatory, as well as at investigating possible correlations with physical performance and other health and socio-demographic variables. METHODS: This is a crossover exploratory study with nonprobabilistic convenience sample of 30 elderly females, carried out with interviews, physical tests and medical charts review. Patients were evaluated for the presence of kinesiophobia, physical performance and other variables related to chronic musculoskeletal pain, in addition to socio-demographic information. RESULTS: There has been kinesiophobia in 80% of the sample. There has been significant moderate correlation between physical performance and kinesiophobia (r=541; p=0.002). No other correlations were found. CONCLUSION: Data have shown high incidence of kinesiophobia among evaluated elderly females, in addition to physical performance impairment associated to it.
RESUMO JUSTIFICATIVA E OBJETIVOS: O medo de movimento e reincidência de lesão (cinesiofobia) é um fator associado à dor crônica e incapacidade. Visto que a população idosa é altamente atingida por problemas crônicos de saúde acompanhados por dor, especialmente musculoesqueléticos, faz-se relevante a compreensão dos impactos do medo relacionado à dor sobre a saúde das idosas. O objetivo deste estudo foi determinar a ocorrência de cinesiofobia em idosas atendidas em um ambulatório geriátrico e gerontológico, bem como investigar possíveis correlações com desempenho físico e outras variáveis de saúde e sócio-demográficas. MÉTODOS: Estudo transversal exploratório com amostra por conveniência não probabilística de 30 idosas, realizado por meio de entrevista, teste físico e revisão de prontuário. Foram avaliadas quanto à presença de cinesiofobia, ao desempenho físico e a outras variáveis relacionadas à saúde e à dor crônica musculoesquelética, além de informações sócio-demográficas. RESULTADOS: A amostra estudada revelou ocorrência de cinesiofobia de 80%. Houve correlação significativa moderada entre desempenho físico e cinesiofobia (r=541; p=0,002). Não foram encontradas demais correlações. CONCLUSÃO: Os dados revelam alta ocorrência de cinesiofobia nas idosas avaliadas e comprometimento do desempenho físico associado à mesma.
RESUMO
OBJECTIVE: To evaluate the prevalence of anxiety, depression and kinesiophobia and their association with the symptoms of low back pain. METHODS: A total of 65 patients were divided into three groups: Organic, Amplified Organic and Non-Organic. They answered the Beck Anxiety Inventory, Beck Depression Inventory and Tampa Scale of Kinesiophobia and were evaluated according to their pain level using the Visual Analogic Scale. RESULTS: The average kinesiophobia scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 36.26, 36.21 and 23.06 points, respectively. Patients who were classified into the Organic group experienced the most kinesiophobia out of all three groups (p=0.007). The average anxiety scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 33.17, 32.79 and 32.81 points, respectively, with no significant difference among the groups (p=0.99). The average depression scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 32.54, 28.79 and 37.69 points, respectively, with no significant difference among the groups (p=0.29). CONCLUSION: There was no association between the groups and anxiety and depression. However, there was a positive correlation between kinesiophobia and the Organic group. Studies of other patient samples are needed to confirm the reproducibility and validity of these data in other populations.
Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Dor Lombar/epidemiologia , Movimento , Ansiedade/psicologia , Depressão/psicologia , Medo/psicologia , Humanos , Medição da Dor , Transtornos Fóbicos/psicologia , Prevalência , Reprodutibilidade dos TestesRESUMO
ABSTRACT Objective: To evaluate the prevalence of anxiety, depression and kinesiophobia and their association with the symptoms of low back pain. Methods: A total of 65 patients were divided into three groups: Organic, Amplified Organic and Non-Organic. They answered the Beck Anxiety Inventory, Beck Depression Inventory and Tampa Scale of Kinesiophobia and were evaluated according to their pain level using the Visual Analogic Scale. Results: The average kinesiophobia scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 36.26, 36.21 and 23.06 points, respectively. Patients who were classified into the Organic group experienced the most kinesiophobia out of all three groups (p = 0.007). The average anxiety scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 33.17, 32.79 and 32.81 points, respectively, with no significant difference among the groups (p = 0.99). The average depression scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 32.54, 28.79 and 37.69 points, respectively, with no significant difference among the groups (p = 0.29). Conclusion: There was no association between the groups and anxiety and depression. However, there was a positive correlation between kinesiophobia and the Organic group. Studies of other patient samples are needed to confirm the reproducibility and validity of these data in other populations.
RESUMO Objetivo: Avaliar a prevalência de ansiedade, depressão e cinesiofobia e sua associação com os sintomas da lombalgia. Métodos: Foram divididos 65 pacientes em três grupos: orgânicos, orgânicos amplificados e não orgânicos. Eles responderam ao Inventário de Ansiedade de Beck, Inventário de Depressão de Beck e Escala de Cinesiofobia de Tampa e foram avaliados de acordo com seu nível de dor pela Escala Análogo-Numérica. Resultados: Os escores médios de cinesiofobia dos pacientes dos grupos orgânicos, orgânicos amplificados e não orgânicos foram de 36,26, 36,21 e 23,06 pontos, respectivamente. Os pacientes que foram classificados no grupo orgânicos experimentaram maior cinesiofobia dentre os três grupos (p = 0,007). Os escores médios de ansiedade dos pacientes dos grupos orgânicos, orgânicos amplificados e não orgânicos eram de 33,17, 32,79 e 32,81 pontos, respectivamente, não houve diferença significativa entre os grupos (p = 0,99). Os escores médios de depressão dos pacientes dos grupos orgânicos, orgânicos amplificados e não orgânicos foram de 32,54, 28,79 e 37,69 pontos, respectivamente, não houve diferença significativa entre os grupos (p = 0,29). Conclusão: Não houve associação entre os grupos e a ansiedade e a depressão. No entanto, houve uma correlação positiva entre a cinesiofobia e o grupo orgânicos. São necessários estudos com outras amostras de pacientes para confirmar a reprodutibilidade e a validade desses dados em outras populações.