AB0929 THE IMPACT OF KINESIOPHOBIA ON GAIT KINEMATICS IN PATIENTS WITH SPONDYLOARTHROPATHIES
Authors: I. Schweiger, J. Koschinsky, E. T. Godonou, K. Tascilar, B. Coppers, A. Kleyer, H. Morf, D. Simon, S. Bayat, D. Bohr, L. Valor, M. G. Raimondo, A. Ramming, V. Schönau, J. Knitza, G. Schett, A. M. Liphardt
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> In light of much needed functional assessments to monitor disease activity and functional status in spondyloarthritis (SpA), gait analysis is gaining interest. While it is generally known that the functional status and gait kinematics are closely related, it is unclear how fear of movement (kinesiophobia) affects gait kinematics in SpA patients. <h3>Objectives:</h3> To assess the influence of kinesiophobia on gait kinematics in patients with SpA and how sex mediates this relationship. <h3>Methods:</h3> A standardized 2-minute walk with self-selected walking speed was performed with 104 patients (psoriatic arthritis (PsA, CASPAR criteria) and ankylosing spondylitis (axSpa, ASAS criteria) (Internal Medicine 3 outpatient clinics Erlangen, Germany) in the hospital hallway. Spatio-temporal gait parameters (number of analyzed steps, cadence, gait velocity, double stance length and duration, swing left and right, stance left and right, temporal and spatial gait cycle variability) were recorded using the inertial sensor system RehaGait® (Hasomed, Magdeburg, Germany) and sagittal joint angles were computed and analyzed via MATLAB [1] (of the whole gait cycle the maximal and minimal flexion angle of left and right hip, knee, ankle). Patient characteristics and clinical assessments were retrieved from the patients record on the day of the gait analysis. Additionally, patients were asked to fill out the tampa scale of kinesiophobia (TSK) and an anamnestic questionnaire. Multivariate multiple linear regression was used to investigate the relationship between TSK score and kinematic gait parameters; mediation analysis was computed with sex as the control variable (potential mediator). <h3>Results:</h3> Patients characteristics of the 104 participants in this study are summarized in Table 1. Kinesiophobia affected the mediator sex (0.039; CI (0.005, 0.074), p=0.026) and the effect of kinesiophobia on gait kinematics differs between sexes. When controlling for the TSK score, male subjects took fewer steps and had a longer stance length. This may be due to them being taller (female: 166.6 cm, male: 179.9 cm; p&lt;0.001). When controlling for sex, kinesiophobia is significantly associated with gait velocity (Coef: -0.009, p=0.003), double stance length (Coef: -0.005, p=0.031), double stance duration (Coef: 0.004, p=0.007), cadence (Coef: -0.39, p=0.006), swing phase left (Coef: -0.089, p=0.006) and the minimal left knee angle (Coef: -0.002, p=0.046). <h3>Conclusion:</h3> Patients with higher fear of movement scores by TSK walked slower, had a lower cadence, took smaller steps and had an increased extension of the left knee. While previous studies [2, 3] reported a decreased range of motion in axSpa patients compared to healthy subjects our results suggest that this can not only result from disease status itself, but that gait kinematics are associated with fear of movement. This is important to consider when gait analysis is used to assess the effect of interventions on functional status in SpA patients. <h3>REFERENCES:</h3> [1] Ismailidis et al. 2021. Gait &amp; Posture 84: 24-30 [2] Zebouni et al. 1992. Annals of Rheumatic Diseases 51:898-899 [3] Del Din et al. 2011. Med Biol Eng Comut 49:801-809 <h3>Acknowledgements:</h3> This study was partially funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – SFB 1483 – Project-ID 442419336, EmpkinS. <h3>Disclosure of Interests:</h3> <b>None declared.</b>