The Relationship Between Kinesiophobia, Physical Activity Level and Quality of Life in Asthma Patients

Asthma is a heterogeneous disease characterized by chronic airway inflammation characterized by time-varying respiratory symptoms such as wheezing, shortness of breath, chest tightness and cough, with limitation of expiratory airflow. These variations are often triggered by exercise, exposure to allergens or an irritation, weather changes or viral respiratory diseases (Karakış, 2018). Increased respiratory distress decreases the patient's activity, decreases the condition and makes the individual dependent in daily life. In the studies conducted in asthma patients, the cases stated that they perceived their illness as an obstacle against physical activity and thus they were pushed to immobility (Kırtay \& Oğuz, 2011). In the literature, no study on the variable of kinesiophobia in asthma was found. The aim of this study was to investigate the relationship between kinesiophobia and physical activity level and quality of life in asthma patients.

Asthma is a chronic inflammatory disease characterized by increased airway sensitivity to various stimuli and reversible airway obstruction (Soyuer et al., 2013). Bronchial hypersensitivity associated with chronic airway inflammation causes wheezing, dyspnea, chest tightness, and cough attacks, especially at midnight or morning. These attacks are associated with varying degrees of airway obstruction and usually improve with treatment or spontaneously (Arslan, 2011). Three mechanisms are responsible for the pathogenesis of asthma. These include reversible airway obstruction, airway inflammation, and increased airway sensitivity (Soyuer et al., 2013). Although it is known that genetic and environmental factors play a role in asthma formation, etiopathogenesis has not been fully explained (Arslan, 2011). Approximately 300 million people worldwide suffer from asthma and this prevalence increases by 50% every ten years. Hospitalization is frequently seen in patients with asthma (Autumn, 2015). It is estimated that approximately 250,000 people die annually due to asthma. No relationship was found between prevalence and mortality (Autumn, 2015). Asthmatic patients have intermittent symptoms such as wheezing, dyspnea, chest tightness, and dry cough. Stimulants such as allergens, air pollution, gastroesophageal reflux, stress and exercise cause these symptoms. 90% of untreated asthmatics develop asthma symptoms during exercise (Dursun et al., 2013). Airway obstruction due to exercise occurs in 40-90% of asthmatics, decreases the ability to exercise and patients prefer a more sedentary lifestyle. Patients with asthma have low physical activity levels because they avoid exercising due to anxiety and depression, inactivity, fatigue, dyspnea (Autumn, 2015). The ability to perform activities and the ability to perform daily living activities are components of quality of life. In many studies, it has been found that quality of life is affected in individuals with chronic lung disease. Quality of life can be assessed with many disease-specific questionnaires. Asthma patients experience problems in many areas in terms of quality of life, including day and night disease symptoms, impaired daily living activities, and reduced quality of life. Asthma is associated with decreased quality of life and morbidity. Asthma symptoms reduce performance at school and at work; affects learning and reduces quality of life. It is stated that asthma has a negative effect on quality of life, physical, physiological and social function (Autumn, 2015).

Airway obstruction due to exercise decreases physical activity in asthmatic patients. This may give rise to fear of movement over time. Avoidance of movement is called kinesiophobia. Kinesiophobia is a condition that occurs when patients want to perform their previous functions, especially in chronic painful disease processes.

Kinesiophobia is an avoidance phenomenon within the cognitive behavioral avoidance model and patients may limit their activity in daily life in case of symptoms of deterioration or the occurrence of symptoms. This may result in emotional problems and life dissatisfaction in later periods (Yumin et al., 2017). Kinesiophobia has been the subject of study in cardiopulmonary cases, but there is no research on kinesiophobia in asthma. In this study, the effect of kinesiophobia on physical activity level and quality of life in asthma will be investigated.

Eligibility Criteria:
Inclusion Criteria:

* Being 18-65 years old T
* Turkish reading, writing, understanding
* Volunteering to participate in the research

Exclusion Criteria:

* Having communication problems, not being cooperative, having a psychiatric diagnosis or using medication
* Severe comorbid diseases (heart, respiratory, gastrointestinal, neurological diseases) that may cause movement limitation.