The relationship between kinesiophobia due to chronic pain and physical functioning in patients with COPD

Background: Chronic pain is reported in 44-88% of patients with COPD and might be associated to avoidance of physical activities. A better understanding of the kinesiophobia caused by chronic pain will help inform approaches for managing pain in COPD. Objective: The aim of this study was to examine whether kinesiophobia caused by chronic associated to symptoms and physical functioning in COPD patients. Methods: Fifty-eight COPD patients (age 77±9 years, male 74%, FEV1 1.2±0.6L) with chronic pain according to IASP definition were included. Patients were classified into two groups using the Tampa scale for kinesiophobia (TSK), where TSK≥37 indicates kinesophobia. Medical Research Council dyspnea scale (mMRC), Pulmonary function, 6-minute walk test, leg fatigue using Borg scale, the Nagasaki University Respiratory ADL questionnaire (NRADL), International physical activity questionnaire, COPD assessment test (CAT), Pain catastrophizing scale, Hospital anxiety and depression scale were evaluated and compared between two groups. Results: 67% of patients showed TSK≥ 37. mMRC, leg fatigue and CAT were significantly higher in patients with kinesiophobia (mMRC, 2.4±1.2 vs 1.6±1.4; leg fatigue, 1.5±1.5 vs 0.2±0.7, CAT, 19.1±7.7 vs 10.1±5.4, all p<0.05). NRADL was significantly lower (61.7±24.4 vs 80.5±24.7, p<0.01), and a higher proportion was classified as low active (56% vs 26%). There was no between group difference in other outcomes. Conclusion: The kinesiophobia caused by chronic pain in COPD may promote higher dyspnea and leg fatigue, more restricted ADL, lower physical activity and HRQoL.