BackgroundFear avoidance behavior which is caused by painful injury resulting precision and extreme fear is defined as kinesiophobia. Rheumatoid arthritis (RA) is a chronic, inflammatory and systemic disease with symmetrical arthritis and visceral involvement. Ankylosing spondylitis (AS) is a chronic, inflammatory disease with involvement of the spine or peripheral joints.ObjectivesIn our study, we aimed to evaluate the relationships between kinesophobia and disease activity, quality of life (QoL), level of physical activity and emotional status in RA and AS patients.MethodsWe included 42 patients with RA (8 males-M, 34 females-F) (group 1), 49 patients with AS (34 M, 15 F) (group 2) and 29 healthy controls (9 M, 20 F) (group 3) in our study. The QoL was assessed using the health assessment questionnaire (HAQ), kinesiophobia was assesed with Tampa scale of kinesiophobia (TSK), pain was assesed with visual analog scale (VAS), fatigue was assesed with VAS and emotional status was assesed with Beck depression inventory (BDI). Disease activity was assesed with Bath ankylosing spondylitis disease acitivity index (BASDAI) and functional status was assesed with Bath ankylosing spondylitis functional index (BASFI) in patients with AS. Disease activity was assesed with DAS28 in patients with RA.ResultsThe mean age was 46.2 in group 1, 43.2 in group 2 and 40.17 in group 3. There was no difference among groups with respect to mean age (p>0.05). Kinesiophobia was present in 37 patients in group 1, 22 patients in group 2 and 7 patients in group 3. Statistically significant differences were found among groups with respect to the number of patients with kinesiophobia and to mean scores of pain intensity, fatigue, HAQ and BDI (p<0,05-<0,001). Patients with RA had higher rates of kinesiophobia than patients with AS and healthy controls (p=0.001, p=0,001). Patients with RA had worser scores than patients with AS and healthy controls. Patients with AS had worser scores than healthy controls. In patients with RA and AS, kinesiophobia is associated with pain severity, fatigue, emotional status and QoL.Table 1.Baseline features of the patients of AS and RA and healthy controlsGroup 1Group 2Group 3 Age46,2±11,4743,2±10,7340,17±7,77Gender (F/ M)34/815/3420/9VAS*47,02±24,4232,44±26,751,72±4,68TKS**44,73±7,2636±12,0329,58±9,37Fatigue (VAS)†55,47±24,3136,93±27,7037,93±20,59HAQ‡0,73±0,830,43±0,410,06±0,19BDI§14,17±9,4912,23±9,635,25±6,13*p=0.008 between group 1 and 2; p<0.001 between group 2 and 3; p<0.001 between group 1 and 3. **p<0.001between group 1 and 2; p=0.023 between group 2 and 3; p<0.001 between group 1 and 3. †p<0,05 between group 1 and 2; 2 and 3; 1 and 3. ‡p=0.039 between group 1 and 2; p=0.021 betwen group 2 and 3; p<0.001 between group 1 and 3. §p>0.05 between group 1 and 2; p=0.004 betwen group 2 and 3; p<0.001 between group 1 and 3.ConclusionsIn our study, patients with RA and AS had higher rates of kinesiophobia. We found that kinesiophobia was related with pain severity, fatigue, depression, disease activity and QoL of t...
BackgroundWork disability (WD) is the final stage of work problems and may be prevented by effective treatment and ergonomic interventions in earlier stage of work productivity loss and work instability. Contextual factors, disease related factors and local social security systems may also affect WD.ObjectivesWe aimed to determine the predictive factors of work productivity and work stability in Turkish patients with ankylosing spondylitisMethodsOne-hundred patients with ankylosing spondylitis (31 females and 69 males) were included into this study. Demographics, working state, Bath scores of disease activity, functional and radiologic state, quality of life, cardiopulmonary functions (echocardiography, exercise stress test and pulmonary function test) and general work impairments (work productivity impairment and work instability) were recorded. WPAI and AS-WIS were selected as work outcomes. The most predictive factors were analyzed in work productivity and work instability. SPSS 14.0 statistics (descriptives, pearson correlation, and stepwise regressions were used for statistical analyses.ResultsThirty-two patients (mean age: 42,6±11.7) were unemployed. Unemployed patients showed more female, less educated, low disease activity, and low fitness profile. The percentages of absenteeism (WPAI-1), presenteeism (WPAI-2), regular activity impairment (WPAI-3) and overall work impairment (WPAI-4) were determined as 8, 44, % 47, and % 37, respectively, in employee group. When affecting factors assessed with multiple stepwise linear regression analysed; the only determinant for absenteeism (WPAI-1) was the working day loss due to ilness at last year. Chest mobility, annual income level, AS quality of life (ASQoL), work change and co-morbid diseases were the determinants of presenteeism (WPAI-2), regular activity impairment (WPAI-3) and overall work impairment (WPAI-4). The score of mean work instability (AS-WIS) was 11.5±5.8, and 42.6% of patients had low and 57,4% of patients had moderate-high work instability. Multiple stepwise linear regression analysis showed that most predictive factors for work instability were regular activity impairment (WPAI-3) and AS-QoL. The factors affecting non-work status were older age, female sex and low annual income level in stepwise logistic regression.ConclusionsThe common predictive factor of work productivity and work stability was quality of life. For evaluation of work productivity; socioeconomic factors such as annual income level and frequent work change were determinative as well as clinical datas (chest expansion and comorbid diseases). We suggested both pharmacologic and nonpharmacologic interventions to improve quality of life should be enabled in early period to improve work productivity.Disclosure of InterestNone declared
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