Background/Purpose: Patients with Ankylosing Spondylitis (AS) consistently report exercise frequencies that are lower than healthy controls and ACSM/EULAR recommended frequencies; even though exercise has consistently been demonstrated to improve function and disease activity in patients with AS. This study explored the presence of kinesiophobia in populations with AS, specifically exploring if kinesiophobia has any correlation with disease activity, functionality, quality of life, and exercise habits of individuals with AS.

Methods: This study recruited 182 participants with AS via digital AS support groups and social media organizations. Recruited participants responded to a survey via Qualtrics that included the following validated patient reported outcome measures (PROMs): Tampa Scale of Kinesiophobia 11 (TSK-11), Baths Ankylosing Spondylitis Functional Index (BASFI), Baths Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Quality of Life Questionnaire (AS QoL), and a modified National Health Interview Survey (NHIS) to assess exercise habits.

Results: The results of this study suggest a high level of kinesiophobia in this population with a mean TSK-11 score of 29.45 ± 6.18, with 20% reporting “severe” ( >35/44) scores for kinesiophobia. Participants with high kinesiophobia also demonstrated more active disease (r=.419, p >0.001), more functional limitations (r=.532, p >0.001), and more Quality-of-Life limitations (r=.611, p >0.001).Participants with high kinesiophobia also demonstrated less activity frequency for vigorous, moderate, and strengthening activities (r=-.279, r=-.256, r=.400; p >0.001).Patients that did report engaging in moderate activity 3 or more times a week also reported significantly better results in all 4 outcome measures versus patients who did not.A similar significant improvement in outcome measures was found for patients who reported engaging in strengthening activity 2 or more times per week versus patients who did not.

Conclusion: This study shows a significant correlation of TSK-11 scores with other clinical measures in AS patients and self-reported exercise habits. Thus, kinesiophobia may play a role in the clinical presentation of AS and so tests such as the TSK-11 may be a valuable screening tool for AS treatment.

Conservative treatment with physical therapy and regular activity is an important aspect of management of autoinflammatory disorders such as AS. Studies in populations with general low back pain (LBP) have showed success in treating chronic LBP by treating the biopsychosocial aspects associated with kinesiophobia when patients demonstrate kinesiophobia and fear-avoidant behaviors. Understanding the presence and characteristics of kinesiophobia in populations with AS can help shape and drive effective intervention models for clinicians and so the TSK-11 can be a valuable tool in screening and evaluating patients in the AS population.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-role-of-kinesiophobia-on-ankylosing-spondylitis-disease-activity-exercise-habits-and-quality-of-life/