ROLE OF KINESIOPHOBIA ON PAIN, DISABILITY AND QUALITY OF LIFE IN PATIENTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW

Background and Aim: The majority of people suffered with low back pain (LBP) at least once during their lifetime. As such, LBP is a highly prevalent and costly condition. People respond inappropriately as a result of current or possible risks and establish defensive habits (for example, hyper-vigilance) that aim at avoiding new injuries. A continued reconciling of studies which provide various answers for the same issue will be necessary for treatment decisions. This study is performed to conclude the function of Kinesiophobia and check it on   Pain, Disability and Quality of Life in Patients that are suffering from Chronic Low Back Pain: A Systematic Review. Methodology: A Systematic Review has been conducted. Secondary data collected from Electronic database including PubMed, Medline and Cochrain Library from inception to 2010. Total 554 Article found out of which 10 articles included in the study after excluding the duplicate article, Quality screening through Pedro Scale, and article don’t fulfilling the inclusion criteria of the study. Review completed within 9 months after approval of synopsis. Results: According to this Review total Sample size was 554 with mean Sample size 130±90, mean Age 46±5 years, Mean of Pain Intensity (VAS 0-10) 6.12±1.5, mean Pain Duration 30±14, mean Kinesiophobia Measures (Tampa Scale of Kinesiophobia 0-68) 37±6.5, mean Disability (Oswestry Disability Index 0-100%) 56±27, mean Quality of Life (SF 36 0-100) 39.17±15.197.  Conclusion: TSK scores showed a statistically significant correlation with Pain, Disability, education level, and SF-36 QOL. As the education level decreases, kinesiophobia scores increase and as kinesiophobia scores increase, Level of disability increases and the quality of life decreases. Patients with kinesiophobia presented greater pain intensity, a greater fear of movement and of performing physical activities and it was also associated with worse quality of life.

Gender Differences in Psychological Disorders, Religiosity and Meaning of Life

The purpose of the study was to investigate the levels of anxiety, depression, and meaning of life and degree of religiosity in clinical and non-clinical groups. The clinical group (n=250) comprised individuals suffering from GAD, OCD and MDD and the non-clinical group (n=250) consisted of those who were not suffering from any psychological disorder. The groups were compared in terms of their degrees of religiosity and meaning of life. The sample (N=500) was purposive, comprising equal number of males and females, ranging in age from 18 to 45 years (M=29.86, SD=8.10) and with educational level of graduation (14 years of schooling) or higher than that, which was taken from hospitals and other areas of Peshawar. It was hypothesized that the clinical group would have lower degrees of religiosity and meaning of life than the non-clinical group and that females would have higher degrees of religiosity and meaning of life as compared to males. The respondents’ degree of religiosity was determined by their scores obtained through the Index of Religiosity (IR). Their meaning of life was assessed through Life Regard Index-R (LRI-R). IPAT Anxiety Scale and Beck Depression Inventory-II (BDI-II) were used to measure the levels of anxiety and depression respectively. The data was statistically analyzed by using t-test, Pearson product-moment correlation and stepwise regression. The results show that the non-clinical group had a significantly higher level of religiosity (t = 10.616, p = .000, d = .95) and meaning of life (t = 31.84, p = .000,d = 2.85) than the clinical group. Religiosity was found to be significantly (p <.01) negatively correlated with anxiety (r = -.50) and depression (r = -.49). Similarly meaning of life was also significantly (p <.01) negatively correlated with anxiety (r = -.86) and depression (r = -.71). Stepwise regression analysis revealed that meaning of life is the strongest negative predictor of both anxiety and depression. The females had a significantly higher level of religiosity than males (t = 3.991, p = .000, d = .31). The females scored higher on IPAT Anxiety scale and BDI-II but lower on LRI-R as compared to males. The gender differences were low and non-significant with small effect sizes in anxiety (t = 1.430, p = .153, d = 0.13), depression (t = .518, p = .605,d = 0.04) and meaning of life (t = .663, p = .508, d = 0.06). The main hypotheses were supported by the study. It is concluded that individuals suffering from GAD, OCD and MDD experience lower levels of religiosity and meaning of life and females live through more religious lives. Females are only marginally more anxious and depressed than males and the males demonstrate slightly higher level of meaning of life than females. The study has implications for clinicians and general public.