Kinesiophobia, catastrophizing and anticipated symptoms before stair climbing

[Firestormm]

Kinesiophobia, catastrophizing and anticipated symptoms before stair climbing in chronic fatigue syndrome: an experimental study

Posted online on February 12, 2012: http://informahealthcare.com/doi/abs/10.3109/09638288.2011.641661

Jo Nijs1,2,3, Mira Meeus1,2, Marianne Heins4, Hans Knoop4, Greta Moorkens5, Gijs Bleijenberg4

Purpose:

'Kinesiophobia and catastrophizing are frequent among people with chronic fatigue syndrome (CFS). This study was aimed at examining (1) whether kinesiophobia, anticipated symptoms and fatigue catastrophizing are related to stair climbing performance in people with CFS; and (2) whether kinesiophobia and fatigue catastrophizing are related to daily physical activity in CFS.

Method:

Patients with CFS filled in a set of questionnaires, performed a physical demanding task (two floors stair of climbing and descending) with pre-test and post-test heart rate monitoring and immediate post-stair climbing symptom assessment. Real-time activity monitoring was used between the baseline and second assessment day (7 days later).

Results:

Kinesiophobia and fatigue catastrophizing were strongly related (ρ = 0.62 and 0.67, respectively) to poorer stair climbing performance (i.e. more time required to complete the threatening activity). Kinesiophobia and fatigue catastrophizing were unrelated to the amount of physical activity on the first day following stair climbing or during the seven subsequent days.

Conclusion:

These findings underscore the importance of kinesiophobia and fatigue catastrophizing for performing physical demanding tasks in everyday life of people with CFS, but refute a cardinal role for kinesiophobia and fatigue catastrophizing in determining daily physical activity level in these patients.

Implications for Rehabilitation

    People with chronic fatigue syndrome (CFS) can easily perform stair climbing, a daily physical activity perceived by themselves as threatening, without triggering symptom flares. This is important as it can be used clinically to convince people with CFS of undertaking such a threatening task during treatment programs such as graded activity or graded exposure.

    The finding that kinesiophobia and fatigue catastrophizing are strongly related to stair climbing performance in CFS underscores the importance of restructuring the beliefs of these patients about the relationship between activity and symptoms. This should be a key component of the early stages of rehabilitation for people with CFS.

    In rehabilitation practice, diminishing kinesiophobia and fatigue catastrophizing in patients with CFS appears only relevant for targeting physical activities that are perceived as threatening (e.g. stair climbing), and not for increasing work-related or social (physical) activities.

    Clinicians can use the Tampa Scale Kinesiophobia version CFS for assessing the fear of patients with CFS to exacerbate their symptoms (including pain, fatigue and brain fog) due to physical activities.

    Clinicians can use the Tampa Scale fatigue for assessing the fear of patients with CFS to exacerbate their fatigue level due to physical activities.'

Note:

Am only reposting. I haven't read it in full neither can I understand how the heck 'Kinesiophobia' came to be associated with CFS!

[Duncan]

Well, Firestormm, since you were so kind as to repost this, may I ask what your opinion of it is? Do you support the article? Decry it? Are you indifferent? What is your intent in showcasing it?

[Cytokine]

"anticipated symptoms". This utter garbage makes my blood boil. More propaganda from Weasel School to keep hold of their turf. I assume they'll be trying to get their friends at the Lancet and BMJ to try and publish it.

Duncan, you should cut Firestormm some slack, I've seen enough of his posts to know he's not down with the psyche brigade BS. Just because he disagrees with some of the detail of Gerwyn's communication with Mr Tuller, doesn't mean he's an "agent" of the vested interests.


P.S. My own view on Mr Tuller / Gerwyn's communication, is that I don't know if Firestormm has a point or not, as my frazzled ME brain is still trying to get my head round a lot the virology science and remember what I do understand, BUT in anticipation of what possibly might happen, I would prefer if people don't end up getting into big arguments with the few people who seem interested in our disease. Just saying.

[Duncan]

I am cutting him some slack. 

[Cytokine]

I am cutting him some slack. 

 

[peggy-sue]

What is being studied here is our ability to be able to estimate our ability - the "listen to your body" bit.
That is, of course, if they studied ME, not CFS or a mixed bag of several conditions.

Utter claptrap, pie-in-the-sky, theoretical misrepresentation.

[Cytokine]

There is one positive I can draw from this steaming heap of dung of a paper, and that is that I've learnt a new word, "catastrophizing", which I will promptly file under "bollocks".

[Thegodofpleasure]

Is there no limit to the twisted depths of these people's collective imagination, because I don't see this garbage as being remotely representative of the real world that I inhabit.   

[Firestormm]

Well, Firestormm, since you were so kind as to repost this, may I ask what your opinion of it is? Do you support the article? Decry it? Are you indifferent? What is your intent in showcasing it?

I think it's a load of bollocks. Is that all right Duncan? What about you?

Of course as I haven't read the full paper - don't really feel the need - I probably shouldn't conclude too much at this point, but based on the above: yeah, bollocks.

[Firestormm]

What is being studied here is our ability to be able to estimate our ability - the "listen to your body" bit.
That is, of course, if they studied ME, not CFS or a mixed bag of several conditions.

Utter claptrap, pie-in-the-sky, theoretical misrepresentation.

I think (don't know), but I 'presume' that as they appear to have entered this 'research' with a rather large assumption i.e. that of 'fear' of activity; this paper has turned out rather nicely for the authors. Which comes as little surprise.

Indeed there are other assumptions being made here - from what I can see of the extract - namely, that people weren't 'pacing' themselves as all disabled people might (I should add).

I don't know about you guys, but if I absolutely have to do something (say for example I lived in a flat with stairs to the ground floor - which I did before crashing the last time and having to live with my parents in their bungalow), then I would bloody well do it; and suffer afterwards.

I remember once - a while ago now - when some assessment chap asked me 'Right. Imagine you find yourself in a burning building. Would you be able to exit that building? Would you even try?' From my perspective these studies are no different.

However, from what I can see, they did attempt to measure stuff, and do some follow-up? But how does one measure PEM? I mean isn't that the point? That up until now this apparent 'main symptom' cannot be measured?

Ah sod it. Maybe I will have to read the darn paper now. Better had I suppose for balance if nothing else [sigh]. Our lives really suck don't they?! 

[Duncan]

Firestormm, I hope, at least, I am not a load of bollocks, but it's a fair question.   I think the piece boils down to a classic assumptive close from a group of people with nothing to sell.

[Firestormm]

Err...yeah lol. Bollocks. Like wat I said! 

[peggy-sue]

I used to have to climb the stairs to get to the loo, until Michael had a downstairs one put in for me.

It means a lot - that's several stair climbs a day I don't have to include in my basic essential activity.

I was seriously contemplating getting the commode out before M decided the downstairs loo was an essential priority.


Climbing the stairs HURTS.

[Frustration Personified]

I love it when people who have no real perspective on a situation make assumptions about those who do.

Flightless birds are just scared of flight. FACT.

[oceanblue]

People with chronic fatigue syndrome (CFS) can easily perform stair climbing, a daily physical activity perceived by themselves as threatening, without triggering symptom flares.

Disappointing they don't give sample size in the abstract (which I believe is best practice), but certainly extrapolating stair climbing findings to 'people with CFS' would at best only apply to patients with the same characteristics (eg case definition and activity levels) as the sample they used.

Kinesiophobia and fatigue catastrophizing were strongly related (ρ = 0.62 and 0.67, respectively) to poorer stair climbing performance (i.e. more time required to complete the threatening activity).

This could be because patients who were closer to their PEM threshold climbed more slowly to minimise any PEM. Or put another way, patients for whom stair climbing was a comfortable activity climbed faster with less fear because they knew it was withing their capabilities.

Overall, it is an interesting approach, though, since they made some measure of activity (if not symptoms) in the 7 days after the perceived threatening activity.