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ORIJINAL ARAŞTIRMA

Kinezyofobi, İnme Sonrası Nöropatik Ağrı ve İnme Şiddeti ile İlişkili midir?
Does Kinesiophobia Associated with Poststroke Neuropathic Pain and Stroke Severity?
Received Date : 10 May 2019
Accepted Date : 08 Jul 2019
Doi: 10.31609/jpmrs.2019-66862 - Makale Dili: EN
J PMR Sci. 2019;22(2):60-5
ÖZET
Amaç: Kinezyofobi, yaralanmaya yatkınlık inanışı nedeniyle hareket etmekten korkmak olarak tanımlanmaktadır. Fiziksel aktivite sınırlamasına neden olur. Yaşlı nüfusta inme sonrası kötü iyileşmeyi etkileyen birçok faktör vardır. İnme sonrası santral ağrı, patogenezi bilinmeyen bir nöropatik ağrı bozukluğudur. Burada, rehabilitasyon programındaki inme hastalarında kinezyofobinin poststroke santral ağrı ve inme şiddeti ile ilişkisini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Çalışmaya yaş ortalaması 55,5±13,1 yıl olan yetmiş beş (n=75) inme hastası dâhil edildi. Kontrol grubu (n=78) benzer yaş ve cinsiyette sağlıklı gönüllülerden oluşturuldu. Tüm hastalarda yaş, cinsiyet, inme süresi, tutulan taraf, inme tipi (iskemik, hemorajik, subaraknoid vb.) kaydedildi. İnme şiddeti, Ulusal Sağlık Enstitüsü İnme Skalası ile değerlendirildi. İnme sonrası ağrı, Self-Leeds Nöropatik Semptom ve Bulgu ağrı skalası ile değerlendirildi. Kinezyofobi, Tampa Kinezyofobi Skalası ile değerlendirildi. Bulgular: Hastaların %53,3’ü akut, %20'si subakut ve %20'si kronik dönemde idi. İnme süresi ortalama 13,6±22,2 yıldı. Sağ tarafın tutulma oranı %48 idi ve %58’i iskemik tipti. Ortalama Tampa skoru 44±7,7 idi ve kontrol grubundan istatistiksel olarak daha yüksekti. Ortalama Ulusal Sağlık Enstitüsü İnme Skalası skoru 4,5±3,9 idi; Self-Leeds Nöropatik Semptom ve Bulgu ağrı skalası skoru 7,2±6,7 idi; nöropatik ağrı prevalansı kontrol grubu ile benzerdi ve %21,3 (n=16) idi. Sonuç: Kinezyofobi inme hastalarında daha yüksek bulundu ve ileri yaş, hastalık süresi ve inme şiddeti ile pozitif korele idi. İnme rehabilitasyon programlarında kinezyofobiyi dikkate almalıyız.
ABSTRACT
Objective: Kinesiophobia is defined as fear of acting due to belief of predisposition to injury. It causes physical activity limitation. There are many factors in the older age population that affect poor recovery after stroke. Central pain after stroke is a neuropathic pain disorder with unknown pathogenesis. Here, we aimed to evaluate association of kinesiophobia with poststroke central pain and the stroke severity in stroke patients at rehabilitation program. Material and Methods: Seventy-five (n=75) stroke patients with the mean age range of 55.5±13.1 year were included in the study. The control group (n=78) consisted of healthy volunteers of similar age and gender. Age, gender, stroke duration, involved side, stroke type (ischemic, hemorrhagic, subarachnoid etc.) were recorded in all patients. The severity of stroke was assessed by the National Institute of Health Stroke Scale. Poststroke pain was assessed by the Self-Leeds Assessment of Neuropathic Symptoms and Sign pain scale. Kinesiophobia was assessed by the Tampa Scale for Kinesiophobia. Results: Of the patients, 53.3% were in acute, 20% were in subacute and 20% were in chronic period. The mean duration of the stroke was 13.6±22.2 years. The rate of right side involvement was 48% and 58% was ischemic type. The mean Tampa score was 44±7.7 and was statistically higher than control group. The mean National Institute of Health Stroke Scale score was 4.5±3.9; Self-Leeds Assessment of Neuropathic Symptoms and Sign pain score was 7.2±6.7; the prevelance of neuropathic pain was 21.3% (n=16) and was similar with control group. Conclusion: Kinesiophobia was found to be higher in stroke patients and was positively correlated with advanced age, disease duration and stroke severity. We should consider kinesiophobia in stroke rehabilitation programs.
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