An investigation of the relationship between cutaneous allodynia and kinesiophobia, gastrointestinal system symptom severity, physical activity and disability in individuals with migraine

Hafize Altay,Seyda Toprak Celenay 대한통증학회 2023 The Korean Journal of Pain Vol.36 No.1

Background: To investigate the relationship between cutaneous allodynia (CA) and kinesiophobia, gastrointestinal system (GIS) symptom severity, physical activity, and disability, and to determine whether CA, pain, and disability were influencing factors for kinesiophobia, GIS symptoms, and physical activity in individuals with migraine. Methods: The study included 144 individuals with migraine. CA, kinesiophobia, GIS symptoms, physical activity level, and migraine-related disability were evaluated with the Allodynia Symptom Checklist, the Tampa Kinesiophobia Scale (TKS), the Gastrointestinal Symptom Rating Scale (GSRS), the International Physical Activity Questionnaire-7, and the Migraine Disability Assessment Scale (MIDAS), respectively. Results: The CA severity was only associated with TKS (r = 0.515; P < 0.001), GSRS-total (r = 0.336; P < 0.001), GSRS-abdominal pain (r = 0.323; P < 0.001), GSRS-indigestion (r = 0.257; P = 0.002), GSRS-constipation (r = 0.371; P < 0.001), and MIDAS scores (r = 0.178; P = 0.033). Attack frequency (P = 0.015), attack duration (P = 0.035) and presence of CA (P < 0.001) were risk factors for kinesiophobia. Attack frequency (P = 0.027) and presence of CA (P = 0.004) were risk factors for GIS symptoms. Conclusions: There was a relationship between the CA and kinesiophobia, GIS symptoms, and disability. CA and attack frequency were found to be risk factors for kinesiophobia and GIS symptoms. Migraine patients with CA should be assessed in terms of kinesiophobia, GIS, and disability. Lifestyle changes such as exercise and dietary changes and/or pharmacological treatment options for CA may increase success in migraine management.

Comparison of the effects of transcutaneous electrical nerve stimulation and interferential current therapies in central sensitization in patients with knee osteoarthritis

Şahide Eda Artuç,Aslı Çalışkan Uçkun,Filiz Acar Sivas,Fatma Gül Yurdakul,Hatice Bodur 대한통증학회 2023 The Korean Journal of Pain Vol.36 No.3

Background: This study is primarily aimed to determine whether transcutaneous electrical nerve stimulation (TENS) and interferential current (IFC) treatments have any effect on central sensitization (CS) in patients with knee osteoarthritis (OA) and to investigate which treatment is more effective. Methods: In this randomized controlled trial, 80 patients were randomized into four treatment groups: TENS, Plasebo-TENS, IFC, and Plasebo-IFC. All interventions were applied 5 times a week for 2 weeks. Primary outcome was pressure pain threshold (PPT), which is accepted as the objective indicator of CS, at the painful knee and at the shoulder as a painless distant point. Other outcome measures were the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index, Timed Up and Go Test, pain catastrophizing scale, Beck Depression Inventory, and Tampa Scale of Kinesiophobia. Results: All assessment parameters were improved, without a significant difference among the groups except PPT. PPT scores were significantly improved in TENS and IFC groups when compared with the sham groups at 2 weeks and 3 months. In addition, this improvement was even more pronounced in the TENS group. Multivariable logistic regression analysis showed that the patient’s inclusion in the TENS group, an initial high PPT, and an initial low VAS score were independent risk factors for improvement in the PPT. Conclusions: This study shows that TENS and IFC reduced pain sensitivity as compared to placebo groups in patients with knee OA. This effect was more pronounced in the TENS group.

Comparisons for the Abnormality of Breathing Pattern, Kinesiophobia and Flexion Relaxation Phenomenon in Patients with Chronic Low Back Pain and Healthy Person during Flexion and Extension of the Trunk

Yoon, Junggyu International Academy of Physical Therapy Research 2019 Journal of International Academy of Physical Ther Vol.10 No.2

Background: Most of the previous researches on the abnormality of breathing pattern have focused on the silence of functional movements owing to such abnormality, however, have not been clearly identified the relationship between the abnormal breathing pattern on one hand and kinesiophobia and flexion relaxation phenomenon (FRP) on the other hand. Objective: To compare patients with chronic low back pain (CLBP) and healthy person in the abnormality of breathing pattern, kinesiophobia, and FRP during flexion and extension of the trunk. Design: Case-control study. Methods: The research subjects consisted of a group of 15 healthy adults and another group of 15 patients with CLBP. Capnography was used to measure the endtidal $CO_2$ ($EtCO_2$) and respiratory quotient (RQ). The muscle activity of multifidus and erector spinae of the subjects was measured during flexion and extension of the trunk to identify their FRP. The Nijmegen Questionnaire (NQ) and Tampa Scale of Kinesiophobia (TSK) were utilized to measure their breathing patterns and kinesiophobia, respectively. The Kolmogorov-Smirnov (K-S) test was conducted in order to analyze the normal distribution of the measured data. Their general characteristics were identified by the descriptive statistics and the independent t-test was performed to identify the differences between the two groups in terms of abnormality of breathing pattern, kinesiophobia, and FRP. The level of significance was set at ${\alpha}=.05$. Results: The patients with CLBP had significantly less $EtCO_2$ and shorter breathing hold time (BHT) than normal healthy person (p<.05). The patient with CLBP also had significantly greater kinesiophobia than healthy person (p<.05), and had less FRP than the healthy person (p<.01). Conclusions: These results suggest that the CLBP had greater abnormality of breathing pattern and kinesiophobia with less FRP than healthy person.

Comparisons for the Abnormality of Breathing Pattern, Kinesiophobia and Flexion Relaxation Phenomenon in Patients with Chronic Low Back Pain and Healthy Person during Flexion and Extension of the Trunk

윤정규 국제물리치료연구학회 2019 Journal of International Academy of Physical Ther Vol.10 No.2

Background: Most of the previous researches on the abnormality of breathing pattern have focused on the silence of functional movements owing to such abnormality, however, have not been clearly identified the relationship between the abnormal breathing pattern on one hand and kinesiophobia and flexion relaxation phenomenon (FRP) on the other hand. Objective: To compare patients with chronic low back pain (CLBP) and healthy person in the abnormality of breathing pattern, kinesiophobia, and FRP during flexion and extension of the trunk. Design: Case-control study. Methods: The research subjects consisted of a group of 15 healthy adults and another group of 15 patients with CLBP. Capnography was used to measure the endtidal CO2 (EtCO2) and respiratory quotient (RQ). The muscle activity of multifidus and erector spinae of the subjects was measured during flexion and extension of the trunk to identify their FRP. The Nijmegen Questionnaire (NQ) and Tampa Scale of Kinesiophobia (TSK) were utilized to measure their breathing patterns and kinesiophobia, respectively. The Kolmogorov-Smirnov (K-S) test was conducted in order to analyze the normal distribution of the measured data. Their general characteristics were identified by the descriptive statistics and the independent t-test was performed to identify the differences between the two groups in terms of abnormality of breathing pattern, kinesiophobia, and FRP. The level of significance was set at α=.05. Results: The patients with CLBP had significantly less EtCO2 and shorter breathing hold time (BHT) than normal healthy person (p<.05). The patient with CLBP also had significantly greater kinesiophobia than healthy person (p<.05), and had less FRP than the healthy person (p<.01). Conclusions: These results suggest that the CLBP had greater abnormality of breathing pattern and kinesiophobia with less FRP than healthy person.

Comparisons for the Abnormality of Breathing Pattern, Kinesiophobia and Flexion Relaxation Phenomenon in Patients with Chronic Low Back Pain and Healthy Person during Flexion and Extension of the Trunk

Junggyu Yoon 국제물리치료연구학회 2019 Journal of International Academy of Physical Ther Vol.10 No.2

Background: Most of the previous researches on the abnormality of breathing pattern have focused on the silence of functional movements owing to such abnormality, however, have not been clearly identified the relationship between the abnormal breathing pattern on one hand and kinesiophobia and flexion relaxation phenomenon (FRP) on the other hand. Objective: To compare patients with chronic low back pain (CLBP) and healthy person in the abnormality of breathing pattern, kinesiophobia, and FRP during flexion and extension of the trunk. Design: Case-control study. Methods: The research subjects consisted of a group of 15 healthy adults and another group of 15 patients with CLBP. Capnography was used to measure the endtidal CO2 (EtCO2) and respiratory quotient (RQ). The muscle activity of multifidus and erector spinae of the subjects was measured during flexion and extension of the trunk to identify their FRP. The Nijmegen Questionnaire (NQ) and Tampa Scale of Kinesiophobia (TSK) were utilized to measure their breathing patterns and kinesiophobia, respectively. The Kolmogorov-Smirnov (K-S) test was conducted in order to analyze the normal distribution of the measured data. Their general characteristics were identified by the descriptive statistics and the independent t-test was performed to identify the differences between the two groups in terms of abnormality of breathing pattern, kinesiophobia, and FRP. The level of significance was set at α=.05. Results: The patients with CLBP had significantly less EtCO2 and shorter breathing hold time (BHT) than normal healthy person (p<.05). The patient with CLBP also had significantly greater kinesiophobia than healthy person (p<.05), and had less FRP than the healthy person (p<.01). Conclusions: These results suggest that the CLBP had greater abnormality of breathing pattern and kinesiophobia with less FRP than healthy person.

Convergence Study on the Relationship between Kinesiophobia and Fear of Falling in Patients with Stroke

조성배,최원재,정지혜,박지유,이승원 한국융합학회 2019 한국융합학회논문지 Vol.10 No.10

This study aimed to investigate the convergence relationship between kinesiophobia and fear of falling in patients with stroke. A total of 113 patients with stroke participated in this study. Participants underwent inpatient rehabilitation and completed surveys with three different questionnaires including the fall efficacy scale (FES), translated Tampa Scale for Kinesiophobia 13 (TSK-13), and activity-specific balance confidence scale (ABC). TSK-13 and FES showed weak negative correlation (r=-0.226), and TSK-13 and ABC showed moderate negative correlation (r=-0.300). FES had a very strong positive relationship compared with ABC (r=0.838). Faller showed significantly low FES and ABC scores compared with non-faller (p<0.05). These results present that patients with stroke had mild kinesiophobia, and kinesiophobia is related to fear of falling. It is necessary to evaluate kinesiophobia in stroke rehabilitation.

The effect of graded motor imagery training on pain, functional performance, motor imagery skills, and kinesiophobia after total knee arthroplasty: randomized controlled trial

Busra Candiri,Burcu Talu,Emre Guner,Metehan Ozen 대한통증학회 2023 The Korean Journal of Pain Vol.36 No.3

Background: The aim was to investigate the effect of graded motor imagery (GMI) added to rehabilitation on pain, functional performance, motor imagery ability, and kinesiophobia in individuals with total knee arthroplasty (TKA). Methods: Individuals scheduled for unilateral TKA were randomized to one of two groups: control (traditional rehabilitation, n = 9) and GMI (traditional rehabilitation + GMI, n = 9) groups. The primary outcome measures were the visual analogue scale and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcome measures were knee range of motion, muscle strength, the timed up and go test, mental chronometer, Movement Imagery Questionnaire-3, lateralization performance, Central Sensitization Inventory, Pain Catastrophizing Scale, and Tampa Kinesiophobia Scale. Evaluations were made before and 6 weeks after surgery. Results: Activity and resting pain were significantly reduced in the GMI group compared to the control group (P < 0.001 and P = 0.004, respectively). Movement Imagery Questionnaire-3 scores and accuracy of lateralization performance also showed significant improvement (P = 0.037 and P = 0.015, respectively). The Pain Catastrophizing Scale and Tampa Kinesiophobia Scale scores were also significantly decreased in the GMI group compared to the control group (P = 0.039 and P = 0.009, respectively). However, GMI did not differ significantly in WOMAC scores, range of motion, muscle strength, timed up and go test and Central Sensitization Inventory scores compared to the control group (P > 0.05). Conclusions: GMI improved pain, motor imagery ability, pain catastrophizing, and kinesiophobia in the acute period after TKA.

Risk Factors of the Masticatory Function in Patients with Temporomandibular Disorders: A Cross-Sectional Cohort Study

Kim, Keon-Hyung,Park, Jo-Eun,Kim, Mee-Eun,Kim, Hye-Kyoung Korean Academy of Orofacial Pain and Oral Medicine 2019 Journal of Oral Medicine and Pain Vol.44 No.3

Purpose: To investigate the masticatory function of patients with different temporomandibular disorders (TMD) phenotypes, and to explore the risk factors for the masticatory function of TMD patients among multiple biopsychosocial variables using patient-reported outcomes (PROs). Methods: Clinical features and TMD diagnoses of 250 cases were investigated by reviewing medical records. Psychosocial factors were evaluated using four questionnaires representing pain severity and pain interference (Brief Pain Inventory), pain catastrophizing (Pain Catastrophizing Scale, PCS), psychological distress (Symptom Check List-90-Revised, SCL-90R) and kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders, TSK-TMD). Masticatory function, as a dependent variable, was determined using the Jaw Functional Limitation Scale (JFLS). Kruskal-Wallis test and Spearman's rank correlation were used for analyses. Results: A total of 145 cases were included and classified into four subgroups including group 1: TMD with internal derangement without pain (n=14), group 2: TMD with muscle pain (n=32), group 3: TMD with joint pain (n=60) and group 4: TMD with muscle-joint combined pain (n=39). Pain severity (p=0.001) and interference (p=0.022) were the highest in group 2, but the mean global score of JFLS was the highest in group 3, followed by group 4, group 2, and group 1 (p=0.013). Pain severity, pain interference, the mean global score of PCS and the mean global score of TSK-TMD showed significant and moderate correlation with the mean global score of JFLS. All subdimensions and the global severity index of SCL-90R had significant, but weak correlations with all scores of JFLS. Conclusions: The results suggest that masticatory functional limitation depends on the TMD phenotypes. Among the various PROs, pain perception, pain catastrophizing and kinesiophobia seem to be more influential risk factors on jaw function than psychological distress, such as depression and anxiety.

Influence of Pain Neuroscience Education Combined with Cervical and Thoracic Mobilization on Pain and Kinesiophobia for Forward Head Posture with Chronic Neck Pain

안호정 국제물리치료연구학회 2022 Journal of International Academy of Physical Ther Vol.13 No.2

Background: Pain neuroscience education (PNE) with other therapeutic approaches can reduce pain intensity in patients with Chronic musculoskeletal pain and chronic spine pain by improving quality of life and disability. However, in various clinical trials and reviews, the optimal dose of an intervention combined with PNE is still an area to be studied. Objectives: To investigated the effect of forward head posture (FHP) with chronic neck pain on the PNE combined with cervical and thoracic mobilization. Design: A non-randomized, controlled intervention study. Methods: Thirty-two subjects were allocated to pain neuroscience education combined with cervical and thoracic mobilization group (PCTMG, n=17) and cervical and thoracic mobilization with TENS group (CTMG, n=15). For 6 weeks, the PCTM group applied PNE and cervical and thoracic mobilization and the CTM group applied cervical and thoracic mobilization and TENS. Changes in intervention pre-post pain and kinesiophobia were observed. Results: Results from the study indicated that statistically significant decrease in VAS and TSK-11 in PCTMG. In CTMG, there was a statistically significant decrease in VAS. And in PCTMG, there was a statistically significant decrease in VAS and TSK-11 than in CTMG.. Conclusion: Therefore, this study confirmed that PNE combined with cervical thoracic mobilization is an effective intervention compared to ervical thoracic mobilization alone in reducing pain and kinesiophobia in FHP with chronic neck pain.

Risk Factors of the Masticatory Function in Patients with Temporomandibular Risk Factors of the Masticatory Function in Patients with Temporomandibular Disorders: A Cross-Sectional Cohort Study

김근형,박조은,김미은,김혜경 대한안면통증∙구강내과학회 2019 Journal of Oral Medicine and Pain Vol.44 No.3

Purpose: To investigate the masticatory function of patients with different temporomandibulardisorders (TMD) phenotypes, and to explore the risk factors for the masticatoryfunction of TMD patients among multiple biopsychosocial variables using patient-reportedoutcomes (PROs). Methods: Clinical features and TMD diagnoses of 250 cases were investigated by reviewingmedical records. Psychosocial factors were evaluated using four questionnaires representingpain severity and pain interference (Brief Pain Inventory), pain catastrophizing (Pain CatastrophizingScale, PCS), psychological distress (Symptom Check List-90-Revised, SCL-90R)and kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders, TSKTMD). Masticatory function, as a dependent variable, was determined using the Jaw FunctionalLimitation Scale (JFLS). Kruskal-Wallis test and Spearman’s rank correlation wereused for analyses. Results: A total of 145 cases were included and classified into four subgroups includinggroup 1: TMD with internal derangement without pain (n=14), group 2: TMD with musclepain (n=32), group 3: TMD with joint pain (n=60) and group 4: TMD with muscle-jointcombined pain (n=39). Pain severity (p=0.001) and interference (p=0.022) were the highestin group 2, but the mean global score of JFLS was the highest in group 3, followed bygroup 4, group 2, and group 1 (p=0.013). Pain severity, pain interference, the mean globalscore of PCS and the mean global score of TSK-TMD showed significant and moderate correlationwith the mean global score of JFLS. All subdimensions and the global severity indexof SCL-90R had significant, but weak correlations with all scores of JFLS. Conclusions: The results suggest that masticatory functional limitation depends on the TMDphenotypes. Among the various PROs, pain perception, pain catastrophizing and kinesiophobiaseem to be more influential risk factors on jaw function than psychological distress,such as depression and anxiety.