Objective: Shoulder pain is a common problem after stroke and causes functional limitations in patients. Pain leads to keep away from the movement and physical activities. The aim of this study was to evaluate the fear of movement in stroke patients with shoulder pain and to investigate its relationship with balance and fear of falling. Material and Methods: Forty six stroke patients were included in the study and divided into two groups, with and without shoulder pain. Fear of movement was evaluated by the Tampa Scale for Kinesiophobia, functional balance was by the Berg Balance Scale and fear of falling was by the Tinetti's Falls Efficacy Scale. Results: The mean age of patients with and without pain were 65.60±11.37 years and 60.56±14.18 years respectively. In the shoulder painful group, it was determined that there was a negative correlation between balance and the fear of movement (r=-0.417; p=0.048) and that there was a positive correlation between the fear of falling and the fear of movement (r=0.429; p=0.041). In the shoulder painless group, there was no significant correlation (p>0.05). There was a statistically significant difference between the kinesiophobia values of two groups (p˂0.05). Conclusion: When balance problems and falls observed in stroke patients are combined with pain and fear of movement, it becomes important to take into account and evaluate the fear of movement in rehabilitation practices.
Keywords: Hemiplegia; kinesiophobia; balance; falling, pain
Amaç: Omuz ağrısı, inme sonrası yaygın görülen bir problemdir ve hastalarda fonksiyonel kısıtlılıklara neden olur. Ağrı, hareketten ve fiziksel aktivitelerden uzak durmaya yol açar. Bu çalışmanın amacı, omuz ağrısı olan inmeli hastalarda hareket korkusunu değerlendirmek, denge ve düşme korkusu ile ilişkisini araştırmaktır. Gereç ve Yöntemler: Çalışmaya 46 inme hastası dâhil edildi ve omuz ağrısı olanlar ve olmayanlar olarak 2 gruba ayrıldı. Hareket korkusu Tampa Kinezyofobi Ölçeği ile fonksiyonel denge Berg Denge Ölçeği ile ve düşme korkusu Tinetti Düşme Etkinlik Ölçeği ile değerlendirildi. Bulgular: Ağrısı olan ve olmayan hastaların yaş ortalaması sırasıyla 65,60±11,37 yıl ve 60,56±14,18 yıl idi. Omuz ağrılı grupta denge ve hareket korkusu arasında negatif (r=-0,417; p=0,048), düşme korkusu ile hareket korkusu arasında pozitif (r=0,429; p=0,041) korelasyon olduğu belirlendi. Omuz ağrısı olmayan grupta anlamlı korelasyon yoktu (p>0,05). İki grubun hareket korkusu değerleri arasında istatistiksel olarak anlamlı fark vardı (p˂0,05). Sonuç: İnme hastalarında görülen denge problemleri ve düşmeler, ağrı ve hareket korkusu ile birleştiğinde, rehabilitasyon uygulamalarında hareket korkusunun dikkate alınması ve değerlendirilmesi önem kazanmaktadır.
Anahtar Kelimeler: Hemipleji; kinezyofobi; denge; düşme, ağrı
- Harrison RA, Field TS. Post stroke pain: identification, assessment, and therapy. Cerebrovasc Dis. 2015;39(3-4):190-201. [Crossref] [PubMed]
- Karaahmet OZ, Eksioglu E, Gurcay E, Karsli PB, Tamkan U, Bal A, et al. Hemiplegic shoulder pain: associated factors and rehabilitation outcomes of hemiplegic patients with and without shoulder pain. Top Stroke Rehabil. 2014;21(3):237-45. [Crossref] [PubMed]
- Holmes RJ, McManus KJ, Koulouglioti C, Hale B. Risk Factors for Poststroke Shoulder Pain: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis. 2020;29(6):104787. [Crossref] [PubMed]
- Gamble GE, Barberan E, Laasch HU, Bowsher D, Tyrrell PJ, Jones AK, et al. Poststroke shoulder pain: a prospective study of the association and risk factors in 152 patients from a consecutive cohort of 205 patients presenting with stroke. Eur J Pain. 2002;6(6):467-74. [Crossref] [PubMed]
- Myers JB, Wassinger CA, Lephart SM. Sensorimotor contribution to shoulder stability: effect of injury and rehabilitation. Man Ther. 2006;11(3):197-201. [Crossref] [PubMed]
- Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36(3):189-98. [Crossref] [PubMed]
- Baierle T, Kromer T, Petermann C, Magosch P, Luomajoki H. Balance ability and postural stability among patients with painful shoulder disorders and healthy controls. BMC Musculoskelet Disord. 2013;14:282. [Crossref] [PubMed] [PMC]
- Philips HC. Avoidance behaviour and its role in sustaining chronic pain. Behav Res Ther. 1987;25(4):273-9. [Crossref] [PubMed]
- Vlaeyen JW, Kole-Snijders AM, Boeren RG, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62(3):363-72. [Crossref] [PubMed]
- Hapidou EG, O'Brien MA, Pierrynowski MR, de Las Heras E, Patel M, Patla T, et al. Fear and Avoidance of Movement in People with Chronic Pain: Psychometric Properties of the 11-Item Tampa Scale for Kinesiophobia (TSK-11). Physiother Can. 2012;64(3):235-41. [Crossref] [PubMed] [PMC]
- Castro-Costa E, Fuzikawa C, Uchoa E, Firmo JO, Lima-Costa MF. Norms for the mini-mental state examination: adjustment of the cut-off point in population-based studies (evidences from the Bambuí health aging study). Arq Neuropsiquiatr. 2008;66(3A):524-8. Erratum in: Arq Neuropsiquiatr. 2009;66(4):932-3. [Crossref] [PubMed]
- Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain. 2014;155(12):2545-50. [Crossref] [PubMed]
- Folstein MF, Robins LN, Helzer JE. The Mini-Mental State Examination. Arch Gen Psychiatry. 1983;40(7):812. [Crossref] [PubMed]
- Yılmaz ÖT, Yakut Y, Uygur F, Uluğ N. [Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability]. Fiz Rehabil. 2011;22(1):44-9. [Link]
- Şahin F, Büyükavci R, Sağ S, Dogu B, Kuran B. Reliability and validity of the Turkish version of the Berg Balance Scale in patients with stroke. Turk J Phys Med Rehabil. 2013;59(3):170-5. [Link]
- Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45(6):P239-43. [Crossref] [PubMed]
- Nickel R, Lange M, Stoffel DP, Navarro EJ, Zetola VF. Upper limb function and functional independence in patients with shoulder pain after stroke. Arq Neuropsiquiatr. 2017;75(2):103-6. [Crossref] [PubMed]
- Rosén E, Sunnerhagen KS, Kreuter M. Fear of falling, balance, and gait velocity in patients with stroke. Physiother Theory Pract. 2005;21(2):113-20. [Crossref] [PubMed]
- Dromerick AW, Edwards DF, Kumar A. Hemiplegic shoulder pain syndrome: frequency and characteristics during inpatient stroke rehabilitation. Arch Phys Med Rehabil. 2008;89(8):1589-93. [Crossref] [PubMed]
- Adey-Wakeling Z, Liu E, Crotty M, Leyden J, Kleinig T, Anderson CS, et al. Hemiplegic Shoulder Pain Reduces Quality of Life After Acute Stroke: A Prospective Population-Based Study. Am J Phys Med Rehabil. 2016;95(10):758-63. [Crossref] [PubMed]
- Weerdesteyn V, de Niet M, van Duijnhoven HJ, Geurts AC. Falls in individuals with stroke. J Rehabil Res Dev. 2008;45(8):1195-213. [Crossref] [PubMed]
- Taub NA, Wolfe CD, Richardson E, Burney PG. Predicting the disability of first-time stroke sufferers at 1 year. 12-month follow-up of a population-based cohort in southeast England. Stroke. 1994;25(2):352-7. [Crossref] [PubMed]
- Schmid AA, Rittman M. Fear of falling: an emerging issue after stroke. Top Stroke Rehabil. 2007;14(5):46-55. [Crossref] [PubMed]
- Goh HT, Nadarajah M, Hamzah NB, Varadan P, Tan MP. Falls and Fear of Falling After Stroke: A Case-Control Study. PM R. 2016;8(12):1173-80. [Crossref] [PubMed]
- Cumming RG, Salkeld G, Thomas M, Szonyi G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci. 2000;55(5):M299-305. [Crossref] [PubMed]
- Tinetti ME, Williams CS. The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol A Biol Sci Med Sci. 1998;53(2):M112-9. [Crossref] [PubMed]
- Belgen B, Beninato M, Sullivan PE, Narielwalla K. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil. 2006;87(4):554-61. [Crossref] [PubMed]
- Kim O, Kim JH. Falls and Use of Assistive Devices in Stroke Patients with Hemiparesis: Association with Balance Ability and Fall Efficacy. Rehabil Nurs. 2015;40(4):267-74. [Crossref] [PubMed]
- Thomas JS, France CR. Pain-related fear is associated with avoidance of spinal motion during recovery from low back pain. Spine (Phila Pa 1976). 2007;32(16):E460-6. [Crossref] [PubMed]
- Veldman PH, Reynen HM, Arntz IE, Goris RJ. Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lancet. 1993;342(8878):1012-6. [Crossref] [PubMed]
- Sethy D, Sahoo S, Bajpai P, Kujur ES, Biswas A, Mohakud K. Effect of cognitive behaviour therapy on kinesiophobia after CRPS-I in a case of stroke hemiplegia: A case report. Int J Health Scı Res. 2017;7(9):340-6. [Link]
- Karos K, Meulders A, Gatzounis R, Seelen HAM, Geers RPG, Vlaeyen JWS, et al. Fear of pain changes movement: Motor behaviour following the acquisition of pain-related fear. Eur J Pain. 2017;21(8):1432-42. [Crossref] [PubMed]
- Jo S, Choi W, Jung J, Park J, Lee S. Convergence study on the relationship between kinesiophobia and fear of falling in patients with stroke. Journal of the Korea Convergence Society. 2019;10(10):33-41. [Link]
.: İşlem Listesi