Comparação da intensidade da dor e da qualidade de vida entre mulheres com dor pélvica crônica com e sem cinesiofobia grave: um estudo transversal

Abstract

Introduction: Chronic Pelvic Pain (CPP) is defined as a multifactorial-origin pain that persists for a minimum of 6 months, resulting in negative consequences in cognitive, behavioral, sexual, and emotional aspects. Women with CPP may develop excessive and debilitating fear of performing physical movement, defined as kinesiophobia, which can significantly interfere with various outcomes. Literature encompasses several perspectives involving the population of women with CPP. However, studies are necessary to analyze the relationships of kinesiophobia with outcomes such as pain and quality of life, specifically in this population. Objectives: To compare the intensity of pain and quality of life between women with CPP with and without severe kinesiophobia. Materials and Methods: A cross-sectional study carried out with women with CPP, between 18 and 45 years old assisted the outpatient clinics of the Maternidade Escola Assis Chateaubriand (MEAC) in Fortaleza. Data collection was carried out between December 2020 and October 2022. Sociodemographic and clinical data, anthropometric measures, urogynecological and obstetric history, and physical activity practice were collected using a structured form. Furthermore, participants responded to the following instruments: Tampa Scale for Kinesiophobia (TSK), Numerical Pain Scale (NPS), and 12-Item Short-Form Health Survey (SF-12). Student's T-test (significance level of 5%) through SPSS software, version 20.0, was used to analyze the comparison of pain intensity and quality of life between women with CPP with and without severe kinesiophobia. Results: The sample consisted of 168 women, with a mean age of 34.27 (± 6.99) years. Analyzing pain characteristics, the mean pain intensity in the 30 days before assessment was 7.65 (± 2.00) points, and 45.8% (n=77) reported that pain originated from endometriosis. Only 29.2% (n=49) of women engaged in regular physical activity. The mean TSK score was 45.49 (± 8.59) points, with 28% exhibiting severe kinesiophobia. These individuals showed higher pain levels (p < 0.001) and worse quality of life (p < 0.05), except in social (p = 0.06) and emotional aspects dimensions (p = 0.93). Conclusion: Women with CPP classified with severe kinesiophobia exhibited higher pain intensity and poorer quality of life, particularly in functional capacity, physical aspects, pain, general health, vitality, and mental health dimensions. A multidisciplinary and comprehensive approach based on the biopsychosocial aspects of these women is necessary.