Chronic pain in patients with hemophilia: Influence of kinesiophobia and catastrophizing thoughts

BackgroundThere is a lack of research on the relationship between pain catastrophizing, kinesiophobia, and physical activity (PA) in people with haemophilia (PWH), and the underlying mechanisms connecting these variables remain unclear.AimThe study's aim was to clarify the roles of kinesiophobia and self‐efficacy in the relationship between pain catastrophizing and PA in PWH.MethodsThis cross‐sectional study included adult PWH at the Haemophilia Centre of a Tertiary hospital in Beijing, China. The following questionnaires were used to collect data: the general information, the International Physical Activity Short Questionnaire, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia Scale, and the Exercise Self‐Efficacy Scale.ResultsThe study included a total of 187 PWH, including 154 having haemophilia A and 33 having haemophilia B. The median interquartile range of PA was 594 (198, 1554) MET‐min/wk. There were significant differences in PA of patients based on age stage, treatment modality, highest pain score within the last seven days, and presence of haemophilic arthropathy (p < .05). It was showed that pain catastrophizing could directly predict PA (p < .001), accounting for 38.13% of the total effect. Pain catastrophizing also had indirect effects on PA through the mediating factors of kinesiophobia or self‐efficacy, and through the chain‐mediating effect of kinesiophobia and self‐efficacy, accounting for 38.40%, 17.07%, and 6.40%, respectively.ConclusionThe study discovered that PWH have limited PA due to pain catastrophizing. This not only directly affects their activity but also indirectly influences it through kinesiophobia and self‐efficacy.

Section: Introductionmentioning

confidence: 99%

Chain‐mediating effects of kinesiophobia and self‐efficacy on pain catastrophizing and physical activity in haemophilia patients

Zhang,

Zhu,

Wang

et al. 2024

“…of pain through the engagement of endogenous pain modulation systems. [4][5][6] Exercise therapy is effective in alleviating pain associated with haemophilic arthropathy, yet it may not be adequate to alter sedentary behaviour on its own. Thus, a comprehensive approach that considers both physical and psychological aspects becomes imperative.…”

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confidence: 99%

Promoting pain coping skills in haemophilia: A remote intervention integrating exercise and pain education

Feldberg,

Ricciardi,

Zorzi

et al. 2024

Self Cite

BackgroundChronic joint pain is a significant and widespread symptom in people with haemophilia (PWH). Despite medical advancements, effective pain management remains challenging.AimThis study presents an innovative approach that integrates remote physical exercises, pain neuroscience education, and coping strategies to address chronic pain in PWH.MethodsThe remote intervention consisted of sixteen 5‐min videos encompassing physical exercises for chronic pain management and pain education strategies. These videos formed an 8‐week remote intervention program. Clinical and physical assessments were conducted before and after the intervention.ResultsA total of thirty‐one PWHs, with a median age of 34 years (ranging from 16 to 59 years), completed the remote intervention. The study revealed significant improvements in pain intensity, disability, and physical performance among PWH with chronic pain. Enhanced functional capacity was evident in the Timed Up and Go and Single Leg Stance tests, accompanied by improved scores on the Functional Independence Score in Haemophilia (FISH). Although lacking a control group, our findings are consistent with other successful exercise and pain education programs.ConclusionsThis innovative intervention holds promise for managing chronic pain in PWH, underscoring patient empowerment, education, and collaboration. Notably, our study stands out by uniquely combining pain education and coping strategies, bolstering evidence for effective pain management.

30‐sit‐to‐stand power is a better tool than isometric knee extensor strength to detect motor impairment in people with haemophilic arthropathy

Cruz‐Montecinos,

Moena‐León,

Durán‐Ovalle

et al. 2024

IntroductionRegular assessment of motor impairments is crucial in people with haemophilic arthropathy (PwHA). This study aimed to determine if there are differences in 30‐seconds sit‐to‐stand (30‐STS) power and maximal voluntary isometric contraction (MVIC) of the knee extensors between PwHA and healthy control group (CG). The secondary aims were to investigate the correlation between 30‐STS power and MVIC of knee extensors with clinical characteristics and to assess their effectiveness in identifying motor impairment in PwHA.MethodsA cross‐sectional study was conducted by collecting data from PwHA (n = 17) and a sedentary CG (n = 15). MVIC (torque) and 30‐STS power were normalised to body mass. Correlation analysis and simple linear regression adjusted for age were used to assess the association between tests and clinical variables. Using z‐scores derived from the mean and standard deviation of the CG, we compared the MVIC and the 30‐STS power in PwHA.ResultsPwHA showed lower MVIC and 30‐STS power compared to CG (p < .001; large effect size d > .8). Lower 30‐STS power was associated with greater joint impairment and greater fear of movement, whereas MVIC showed no association with clinical variables. 30‐STS power showed a lower z‐score compared to MVIC (p < .001). In addition, 30‐STS power detected 47% of PwHA with motor impairment compared to 0% for MVIC (p = .002).ConclusionsOur results suggest that 30‐STS power may be more effective than knee extensors MVIC in detecting motor impairment in PwHA. Consequently, lower limb skeletal muscle power, rather than maximum knee extensor strength, appears to be more affected in PwHA.