Is there a relationship between kinesiophobia, pain, depression, disease activity, functional status and quality of life in patients with ankylosing spondylitis? Running Short Title: Kinesiophobia in patients with ankylosing spondylitis

Abstract

Aim: To evaluate the presence of kinesiophobia and its potential effects on depression, disease activity and quality of life in patients with ankylosing spondylitis (AS). Materials and methods: The study included 58 AS patients and 55 healthy controls. Tampa Kinesiophobia Scale (TKS) was used to evaluate the presence of kinesiophobia, Visual Analogue Scale (VAS) for pain severity, Beck Depression Index (BDI) for depression level, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for disease activity, Bath Ankylosing Spondylitis Functional Index (BAS-FI) for functional status, and Ankylosing Spondylitis Functional Index (ASQoL) for Quality of life. Results: In patient group, kinesiophobia rate was significantly higher (68%) than in healthy controls (27%) (p<0.001). TKS score, VAS pain level, and BDI levels were significantly higher in patients with AS compared to the healthy controls (for all p <0.001). In the AS group, patients with high kinesiophobia score had higher VAS, BDI, BAS-FI, BASDAI, and ASQoL scores compared to the patients with low kinesiophobia score (p<0.001) and the relationships between kinesiophobia and VAS, BDI, BAS-FI, BASDAI, and ASQoL scores (for all p<0.001) were significant. In addition, there was no significant relationship was found between kinesiophobia and age, and disease duration (p>0.05). Conclusions: Kinesiophobia is more common in patients with AS compared to healthy controls, and presence of kinesophobia is associated with increased pain and impaired quality of life. Therefore, we suggest that approaches to increase awareness of fear of movement and physical activity and cognitive behavioral therapy related to fear of movement should be included in the treatment program.