Chronic pain in patients with hemophilia: Influence of kinesiophobia and catastrophizing thoughts

Abstract

To the Editor, People with haemophilia (PWH) usually begin to suffer pain at a young age. Physical and psychological components can accentuate patients' pain. Pain has been identified as the most challenging and prevalent symptom, affecting up to 80% of PWH, and is the leading cause of disability in these patients. 1 Some factors such as cognitive and social behaviour contribute to the impact of pain and are associated with poor prognosis following the onset of musculoskeletal pain. 1,2 There is a complex interaction of factors that influence pain perception, such as mood swings, emotional problems, hypervigilance, kinesiophobia, catastrophic thoughts and negative beliefs. Negative thoughts can affect the sensation of pain. As a result, pain can be interpreted as a threat, and an overreaction can be initiated in response to this threat. 3 Kinesiophobia is defined as an excessive, irrational and debilitating fear to carry out a movement resulting from a feeling of vulnerability due to a painful injury and may be associated with pain and disability. Kinesiophobia alters how people move, causing adjustments in motor behaviour, which affects the performance of actions related to the management and control of pain. 3 This study aimed to measure kinesiophobia and catastrophic thoughts in PWH and analyze their impact on clinical and functional parameters, especially in PWH with chronic pain.In this study, we enrolled patients diagnosed with haemophilia A or B aged over 12 years. The evaluation was performed from August 2018 to July 2019, during PWH routine consultation at the haemophilia unit of Hemocentro UNICAMP, Brazil. Patients were considered eligible for the study when they could perform all clinical and functional assessments and adequately respond to all applied questionnaires.

Functional clinical motor performance tests to assess potential fall risks in patients with haemophilia: A case‐control study

“…7,23,24 Besides, the SPPB function declines, which was also previously described for PwH. 27 Indeed, a vicious circle might occur as it is known that subjective physical performance negatively correlates with kinesiophobia, 28,29 which is also observed in the study presented herein (r s = −0.483). Therefore, the fear of movement might result in lower subjective physical as well as in lower objectively measurable performance as observed in the present clinical tests in PwH but also in other cohorts (e.g., chronic pain-free older adults 30 ).…”

30‐sit‐to‐stand power is a better tool than isometric knee extensor strength to detect motor impairment in people with haemophilic arthropathy

“…that chronic pain in PwHA is related to Kinesio phobia and catastrophic thoughts. 37,38 More studies are needed to understand how morphological, neuromuscular, and physiological aspects may influence the differentiation of muscle strength and power impairment in other joints (e.g., elbow and ankle) in PwHA. Furthermore, future studies are needed to understand the association of rapid force capacity (i.e., rate of force development) with muscle power in PwHA.…”

Chain‐mediating effects of kinesiophobia and self‐efficacy on pain catastrophizing and physical activity in haemophilia patients

“…13,14 Currently, there been studies exploring how pain catastrophizing, kinesiophobia, pain level, and quality of life are related to PWH. [15][16][17] However, despite recognizing the separate connections between pain catastrophizing, kinesiophobia, self-efficacy, and PA in PWH, the underlying mechanisms connecting these variables remain unclear. It…”