Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
A Comparison of Disability, Emotional Status, and Physical Activity Level According to the Pain Activity Pattern in Chronic Low Back and Neck Pain: A Cross-Sectional Study
Kronik Bel ve Boyun Ağrısında Ağrı Aktivite Paternine Göre Engellilik, Duygu Durum ve Fiziksel Aktivite Seviyesinin Karşılaştırılması: Kesitsel Çalışma
Oğuzhan METEa , Berna YILDIZb , Şeyda TOPRAK CELENAYc
aUniversity of Health Sciences, Gülhane Faculty of Physiotherapy and Rehabilitation, Department of Cardiopulmonary Physiotherapy and Rehabilitation, Ankara, Türkiye
bAnkara Gazi Mustafa Kemal Occupational and Environmental Diseases Hospital, Clinic of Physical Medicine and Rehabilitation, Ankara, Türkiye
cAnkara Yıldırım Beyazıt University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Türkiye
Turkiye Klinikleri J Health Sci. 2025;10(3):695-704
doi: 10.5336/healthsci.2025-108756
Article Language: EN
Full Text
ABSTRACT
 Objective: The study's purpose was to compare disability, emotional status, and physical activity level based on pain activity pattern (PAP) (avoiding, overdoing, and pacing) in chronic low back pain (CLBP) and chronic neck pain (CNP). Material and Methods: 103 patients with CLBP and 66 with CNP were involved in the study. PAPs, emotional status, physical activity level, and disability were evaluated with the Patterns of Activity Measure-Pain (POAM-P), Hospital Anxiety and Depression Scale (HADS), International Physical Activity Questionnaire (IPAQ), and Oswestry Disability Index (ODI) and Neck Disability Index (NDI); respectively. Patients were divided into avoidance, overdoing, and pacing groups based on POAM-P subscale dominance. Results: The prominent PAP in CLBP was avoidance, whereas the dominant PAP was overdoing in CNP. The pacing was the least reported pattern in both. The ODI (p=0.229), HADS-A (anxiety), and HADS-D (depression) (p=0.619, p=0.580), and IPAQ scores (p=0.972) were similar between avoiding, overdoing, and pacing groups in patients with CLBP. The scores of NDI (p=0.294), HADS-A (p=0.801), HADS-D (p=0.817), and IPAQ (p=0.726) were similar among avoiding, overdoing, and pacing groups in CNP. Conclusion: Disability, emotional status, and physical activity level were similar among patients with avoiding, overdoing, and pacing PAPs in CLBP and CNP. Therefore, PAPs may not directly affect disability, emotional status, or physical activity level. In clinical practice, the treatment strategies to improve disability, emotional disorders, and physical inactivity in CLBP and CNP may be considered independently of PAPs.

Keywords: Anxiety; depression; low back pain; neck pain; pain perception
ÖZET
 Amaç: Çalışmanın amacı, kronik bel ağrısı [chronic low back pain (CLBP)] ve kronik boyun ağrısında [chronic neck pain (CNP)] ağrı aktivite paternine (AAP) göre (kaçınma, aşırıya kaçma ve düzene sokma) engellilik, duygu durum ve fiziksel aktivite seviyelerini karşılaştırmaktı. Gereç ve Yöntemler: Çalışmaya, 103 CLBP'li ve 66 CNP'li hasta dâhil edildi. AAP Ağrı-Aktivite Paternleri Ölçeği (AAPÖ) ile duygu durum Hastane Anksiyete ve Depresyon Ölçeği (HADÖ) ile fiziksel aktivite seviyeleri Uluslararası Fiziksel Aktivite Anketi (UFAA) ile engellilik Oswerty Özür İndeksi (OÖİ) ve Boyun Özür İndeksi (BÖİ) ile değerlendirildi. Hastalar, AAPÖ alt başlıklarına göre kaçınma, aşırıya kaçma ve düzene sokma gruplarına ayrıldı. Bulgular: CLBP'de baskın AAP kaçınma iken, CNP'de aşırıya kaçmaydı. Her iki grupta da en az bildirilen patern düzene sokmaydı. Kaçınma, aşırıya kaçma ve düzene sokma paternlerine sahip CLBP'li arasında OÖİ (p=0,229), HADÖ-A (anksiyete) ve HADÖ-D (depresyon) (p=0,619, p=0,580), ve UFAA (p=0,972) skorları benzerdi. CNP'de kaçınma, aşırıya kaçma ve düzene sokma grupları arasında BÖİ (p=0,294), HADÖ-A (p=0,801), HADÖ-D (p=0,817), ve UFAA (p=0,726) skorları benzerdi. Sonuç: CLBP ve CNP'de kaçınma, aşırıya kaçma ve düzene sokma ağrı paternine sahip hastaların engellilik, duygu durum ve fiziksel aktivite seviyeleri benzerdi. Bu nedenle, AAP engelliliği, duygu durumu veya fiziksel aktiviteyi doğrudan etkilemeyebilir. Klinik pratikte, CLBP ve CNP'de engelliliği, duygu durum bozuklukları ve fiziksel hareketsizliği iyileştirmeye yönelik tedavi stratejileri, AAP'den bağımsız olarak ele alınabilir.

Anahtar Kelimeler: Anksiyete; depresyon; bel ağrısı; boyun ağrısı; ağrı algısı
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