TURKISH JOURNAL OF PHYSIOTHERAPY REHABILITATION-FIZYOTERAPI REHABILITASYON, vol.29, pp.11-17, 2018 (Peer-Reviewed Journal)
Purpose: Patients with rheumatoid arthritis (RA) frequently have experience difficulties during daily activities since decrease in upper and lower extremity functions. The aim of this study was to investigate the association between fear of movement and age, upper and lower extremity function and functional disability in patients with RA.
Methods: A total of 88 patients (mean age: 56.01±11.51 years) with RA participated in the study. Disease activity was assessed using the Disease Activity Score in 28 joints (DAS28). Functional disability was assessed using the Health Assessment Questionnaire-Disability Index (HAQ-DI). The Disabilities of the Arm, Shoulder and Hand Score (QuickDASH) was used to assess upper extremity function. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to evalute the lower extremity function. The Tampa Scale for Kinesiophobia (TSK) was used to assess pain-related fear of movement. The multiple stepwise linear regression model with R-square (R2) was used to compare across the models and explain the total variance.
Results: Eight independent variables namely, age (r=0.215, p=0.044), QuickDASH (r=0.504, p<0.001), HAQ-DI (r=0.315, p=0.003), WOMAC Pain (r=0.512, p<0.001), WOMAC Stiffness (r=0.419, p<0.001), WOMAC Function (r=0.398, p<0.001), WOMAC Total (r=0.429, p<0.001), WOMAC range (r=0.419, p<0.001), demonstrated significant correlations with TSK. Besides, there were correlations between two independent variables (QuickDASH, p=0.013, WOMAC Pain, p=0.034) and TSK (R2=0.293).
Conclusion: The results of the study suggested that fear of movement was likely to be associated with poorer upper extremity functional disability and lower extremity pain levels in spite of varied drug therapies in patients with RA. Therefore, assessment of upper and lower extremity function and related factors should be a part of rehabilitation process for a complimentary treatment.