Association of Kinesiophobia with Catastrophism and Sensitization-Associated Symptoms in COVID-19 Survivors with Post-COVID Pain

Manuel Herrero-Montes; César Fernández-de-Las-Peñas; Diego Ferrer-Pargada; Sheila Izquierdo-Cuervo; Beatriz Abascal-Bolado; Juan Antonio Valera-Calero; Paula Paras-Bravo

doi:10.3390/diagnostics13050847

Association of Kinesiophobia with Catastrophism and Sensitization-Associated Symptoms in COVID-19 Survivors with Post-COVID Pain

Diagnostics (Basel). 2023 Feb 23;13(5):847. doi: 10.3390/diagnostics13050847.

Authors

Manuel Herrero-Montes^{1

2}, César Fernández-de-Las-Peñas³, Diego Ferrer-Pargada⁴, Sheila Izquierdo-Cuervo⁴, Beatriz Abascal-Bolado⁴, Juan Antonio Valera-Calero^{5

6}, Paula Paras-Bravo^{1

2}

Affiliations

¹ Departamento de Enfermería, Universidad de Cantabria, 39005 Santander, Spain.
² Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Grupo de Investigación en Enfermería, 39005 Santander, Spain.
³ Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Madrid, Spain.
⁴ Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, 39008 Cantabria, Spain.
⁵ Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain.
⁶ Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.

Abstract

Pain symptoms after the acute phase of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are present in almost 50% of COVID-19 survivors. The presence of kinesiophobia is a risk factor which may promote and perpetuate pain. This study aimed to investigate variables associated with the presence of kinesiophobia in a sample of previously hospitalized COVID-19 survivors exhibiting post-COVID pain. An observational study was conducted in three urban hospitals in Spain, including one hundred and forty-six COVID-19 survivors with post-COVID pain. Demographic (age, weight, height), clinical (intensity and duration of pain), psychological (anxiety level, depressive level, sleep quality), cognitive (catastrophizing), sensitization-associated symptoms, and health-related quality of life variables were collected in 146 survivors with post-COVID pain, as well as whether they exhibited kinesiophobia. Stepwise multiple linear regression models were conducted to identify variables significantly associated with kinesiophobia. Patients were assessed a mean of 18.8 (SD 1.8) months after hospital discharge. Kinesiophobia levels were positively associated with anxiety levels (r: 0.356, p < 0.001), depression levels (r: 0.306, p < 0.001), sleep quality (r: 0.288, p < 0.001), catastrophism (r: 0.578, p < 0.001), and sensitization-associated symptoms (r: 0.450, p < 0.001). The stepwise regression analysis revealed that 38.1% of kinesiophobia variance was explained by catastrophism (r² adj: 0.329, B = 0.416, t = 8.377, p < 0.001) and sensitization-associated symptoms (r² adj: 0.381, B = 0.130, t = 3.585, p < 0.001). Kinesiophobia levels were associated with catastrophism and sensitization-associated symptoms in previously hospitalized COVID-19 survivors with post-COVID pain. Identification of patients at a higher risk of developing a higher level of kinesiophobia, associated with post-COVID pain symptoms, could lead to better therapeutic strategies.

Keywords: COVID-19; catastrophism; kinesiophobia; pain; post-COVID; sensitization.

Abstract

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