Association of Kinesiophobia with Catastrophism and Sensitization-Associated Symptoms in COVID-19 Survivors with Post-COVID Pain 2023 Herrero-Montes

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.

Open access, https://www.mdpi.com/2075-4418/13/5/847

 

Nociplastic pain = central sensitisation

"Current findings would support that both biological and cognitive mechanisms are important for patients with post-COVID pain. In fact, the presence of kinesiophobia levels and sensitization-associated symptoms would support that post-COVID pain could be considered as a nociplastic pain condition, a hypothesis which has been recently proposed" ref = Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition which is all a bit redolent of hypothesis building at the cost of appropriate scepticism.

The patient cohort comprised 146 previously hospitalised COVID survivors - no details of ICU, ventilation etc. M/F = 67/78, age range F = 42 >68, M = 50 >70, weight/height range indicates a % of overweight and obese individuals. No details of broader health status, socio-economic status or co-morbidities. Given the cohort age, multiple pain co-morbidities should be expected, there is no control cohort.

 

All this mindless pseudoscience really shows is that in psychology, you can confirm anything you want if you want it to, even if you define it in a circular way, and even when it's exactly what you expect. Which is known.

This is as nonsensical as asking poor people whether they want to buy expensive stuff they don't need, then when they say no because they 1) don't have the money and 2) don't need it, you decide to call this fear of spending, or whatever, and that it must, MUST, be the reason they are poor. This is just mindless nonsense.

The old joke was "Doctor, it hurts when I do this", and the doctor, a genius, says: "Well, don't do this".

But really it's: "Doctor, it hurts when I do this", and the doctor, a true genius, says: "What are you, a chicken? Buck-buck-buck, just move your ass you lazy bum".

 

What a Kafkaesque nightmare.

If a pwLC is somehow forced to do a GET and CBT program. Especially if they have PEM and POTS.

 

I've started to think my PEM, which often happens after errand days is caused by being continually upright for a few hours.

 

It is hard to sort out what is caused by exertion and what by being upright as the two interact. Unless of course you could try doing the errands lying down.

I think my orthostatic intolerances is worse when in PEM, but also being upright can of itself trigger PEM.

 

Totally agree. It is very difficult to sort out which causes what on the micro level per pwME as well as on the macro level for biomedical researchers.

Exertion also causes PEM for me. But while at home I can rest by laying down, but while out and about I'm not able to.

My exertion while doing errands involves about 15 to 30 minutes of walking. (On tolerable days, I can also do this same amount at home.) The rest of the time while out and about I'm sitting upright as a vehicle passenger.

I usually go into PEM after errand days. Whereas I may be able to putter a bit at home, pace/rest supine, do a little that exerts me, and may less often go into PEM, unless the exertion is over and above my norm.

I need to spend a lot of time supine in order to not become lightheaded, weak, fatigued, uncoordinated, and brain fogged.

I think there might be something to the extended upright position causing PEM. We do know upright positions bring on symptoms for those of us with OI.