Journals / Online Türk Sağlık Bilimleri Dergisi / 2026 / Cilt: 11 Sayı: 3

Biopsychosocial and Functional Factors Associated with Quality of Life in Individuals with Chronic Low Back Pain

Kronik Bel Ağrılı Bireylerde Yaşam Kalitesiyle İlişkili Biyopsikososyal ve Fonksiyonel Faktörler

Mehmet Canlı(KIRŞEHİR AHİ EVRAN ÜNİVERSİTESİ)0000-0002-8868-9599
Raziye Çelik(KIRŞEHİR AHİ EVRAN ÜNİVERSİTESİ)0009-0007-0941-0873
Sıla Çalışkan(KIRŞEHİR AHİ EVRAN ÜNİVERSİTESİ)0009-0005-5785-9152
Tuğbanur Hasbolat(KIRŞEHİR AHİ EVRAN ÜNİVERSİTESİ)0009-0000-4568-845X
İrem Canlı(KIRŞEHİR AHİ EVRAN ÜNİVERSİTESİ)0000-0003-4478-3660
Hikmet Kocaman(KARAMANOĞLU MEHMETBEY ÜNİVERSİTESİ)0000-0001-5971-7274
Hasan Yıldırım(KARAMANOĞLU MEHMETBEY ÜNİVERSİTESİ)0000-0003-4582-9018
Pages
311–319
Publication Date
2026-09-15
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This finding indicates that psychological status should be considered alongside pain and disability in the assessment of individuals with CLBP.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: This study aimed to identify the biopsychosocial and functional factors associated with the physical and mental components of health-related quality of life (HRQoL) in individuals with chronic low back pain (CLBP).
📊
Key Findings & Data:Materials and Methods: This cross-sectional study included 120 adults with CLBP.
💡
Conclusion & Impact:This finding indicates that psychological status should be considered alongside pain and disability in the assessment of individuals with CLBP.
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Anksiyete · bel ağrısı · kinezyofobi

Abstract

Objective: This study aimed to identify the biopsychosocial and functional factors associated with the physical and mental components of health-related quality of life (HRQoL) in individuals with chronic low back pain (CLBP). Materials and Methods: This cross-sectional study included 120 adults with CLBP. HRQoL was assessed using the 12-Item Short Form Health Survey. Pain intensity, disability, kinesiophobia, fear-avoidance beliefs, anxiety, depressive symptoms, physical activity, balance, and functional mobility were evaluated using standardized questionnaires and clinical tests. Relationships among the variables were examined using Pearson correlation analysis and hierarchical multiple linear regression analysis. Results: The Physical Component Summary score was moderately and negatively associated with kinesiophobia, anxiety, and physical activity-related fear-avoidance beliefs (p<0.05). The Mental Component Summary score showed weak negative associations with pain, disability, psychological symptoms, fear-avoidance beliefs, and functional mobility, and weak positive associations with physical activity and balance (p<0.05). After adjustment for demographic variables, clinical variables explained an additional 36.1% of the variance in physical HRQoL (ΔR²=0.361) and 19.4% of the variance in mental HRQoL (ΔR²=0.194). Anxiety independently predicted lower physical HRQoL (β=−0.25, p=0.010) and mental HRQoL (β=−0.27, p=0.017), while age weakly predicted higher mental HRQoL (β=0.19, p=0.045). Conclusion: Anxiety was the most consistent independent predictor of both physical and mental HRQoL in individuals with CLBP. This finding indicates that psychological status should be considered alongside pain and disability in the assessment of individuals with CLBP.

Özet

Amaç: Bu çalışmanın amacı, kronik bel ağrılı (KBA) bireylerde sağlıkla ilişkili yaşam kalitesinin fiziksel ve mental bileşenleriyle ilişkili biyopsikososyal ve fonksiyonel faktörleri belirlemekti. Materyal ve Metot: Bu kesitsel çalışmaya KBA’lı 120 yetişkin dahil edildi. SİYK, 12 maddelik kısa form sağlık anketi ile değerlendirildi. Ağrı şiddeti, özürlülük, kinezyofobi, korku-kaçınma inanışları, anksiyete, depresif belirtiler, fiziksel aktivite, denge ve fonksiyonel mobilite standart ölçekler ve klinik testler kullanılarak değerlendirildi. Değişkenler arasındaki ilişkiler Pearson korelasyon analizi ve hiyerarşik çoklu doğrusal regresyon analizi ile incelendi. Bulgular: Fiziksel Bileşen Özeti puanı; kinezyofobi, anksiyete ve fiziksel aktiviteye yönelik korku-kaçınma inanışlarıyla orta düzeyde negatif ilişkiliydi (p<0,05). Mental Bileşen Özeti puanı; ağrı, özürlülük, psikolojik belirtiler, korku-kaçınma inanışları ve fonksiyonel mobiliteyle zayıf düzeyde negatif, fiziksel aktivite ve dengeyle ise zayıf düzeyde pozitif ilişkiliydi (p<0,05). Demografik değişkenler kontrol edildikten sonra klinik değişkenler, fiziksel SİYK varyansının ek %36,1’ini (ΔR²=0,361) ve mental SİYK varyansının ek %19,4’ünü (ΔR²=0,194) açıkladı. Anksiyete, daha düşük fiziksel SİYK’nin (β=−0,25; p=0,010) ve mental SİYK’nin (β=−0,27; p=0,017) bağımsız prediktörü iken yaş, daha yüksek mental SİYK’nin zayıf bir prediktörüydü (β=0,19; p=0,045). Sonuç: Anksiyete, KBA’lı bireylerde fiziksel ve mental SİYK’nin en tutarlı bağımsız prediktörüydü. Bu bulgu, KBA değerlendirmesinde ağrı ve özürlülüğün yanı sıra psikolojik durumun da dikkate alınması gerektiğini göstermektedir.

🔖

Cite This Article

Canlı, M., Çelik, R., Çalışkan, S., Hasbolat, T., Canlı, İ., Kocaman, H., Yıldırım, H., *, M. C. (2026). Biopsychosocial and Functional Factors Associated with Quality of Life in Individuals with Chronic Low Back Pain. Online Türk Sağlık Bilimleri Dergisi, Cilt: 11 Sayı: 3, 311–319. https://doi.org/10.26453/otjhs.1982349

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (32)

  1. Ferreira ML, De Luca K, Haile LM, et al. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023;5(6). doi:10.1016/S2665-9913(23)00098-X
  2. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-2367. doi:10.1016/S0140-6736(18)30480-X
  3. Nieminen LK, Pyysalo LM, Kankaanpää MJ. Prognostic factors for pain chronicity in low back pain: A systematic review. Pain Rep. 2021;6(1). doi:10.1097/PR9.0000000000000919
  4. Hong JH, Kim HD, Shin HH, Huh B. Assessment of depression, anxiety, sleep disturbance, and quality of life in patients with chronic low back pain in Korea. Korean J Anesthesiol. 2014;66(6):444-450. doi:10.4097/kjae.2014.66.6.444
  5. Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain. 2000;85(3):317-332. doi:10.1016/S0304-3959(99)00242-0
  6. Comachio J, Magalhães MO, Campos Carvalho e Silva APdM, Marques AP. A cross-sectional study of associations between kinesiophobia, pain, disability, and quality of life in patients with chronic low back pain. Adv Rheumatol. 2018;58(1):8. doi:10.1186/s42358-018-0011-2
  7. Keeley P, Creed F, Tomenson B, Todd C, Borglin G, Dickens C. Psychosocial predictors of health-related quality of life and health service utilisation in people with chronic low back pain. Pain. 2008;135(1-2):142-150. doi:10.1016/j.pain.2007.05.015
  8. Marshall PW, Schabrun S, Knox MF. Physical activity and the mediating effect of fear, depression, anxiety, and catastrophizing on pain-related disability in people with chronic low back pain. PLoS One. 2017;12(7). doi:10.1371/journal.pone.0180788
  9. Ruhe A, Fejer R, Walker B. Center of pressure excursion as a measure of balance performance in patients with non-specific low back pain compared to healthy controls: A systematic review of the literature. Eur Spine J. 2011;20(3):358-368. doi:10.1007/s00586-010-1543-2
  10. Radebold A, Cholewicki J, Polzhofer GK, Greene HS. Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine (Phila Pa 1976). 2001;26(7):724-730. doi:10.1097/00007632-200104010-00004
  11. Rajkumar E, John R, Joshua George A. Determinants of quality of life in individuals with chronic low back pain: A systematic review. Health Psychol Behav Med. 2022;10(1):124-144. doi:10.1080/21642850.2021.2022487
  12. Schaller A, Dejonghe L, Haastert B, Froboese I. Physical activity and health-related quality of life in chronic low back pain patients: A cross-sectional study. BMC Musculoskelet Disord. 2015;16(1):62. doi:10.1186/s12891-015-0527-0
  13. Ekediegwu EC, Onwukike CV, Onyeso OK. Pain intensity, physical activity, quality of life, and disability in patients with mechanical low back pain: A cross-sectional study. Bull Fac Phys Ther. 2024;29(1):1. doi:10.1186/s43161-023-00167-2
  14. Soylu C, Kütük B. Reliability and validity of the Turkish version of SF-12 Health Survey. Turk Psikiyatri Derg. 2022;33(2):108-117. doi:10.5080/u25700
  15. Shafshak TS, Elnemr R. The visual analogue scale versus numerical rating scale in measuring pain severity and predicting disability in low back pain. J Clin Rheumatol. 2021;27(7):282-285. doi:10.1097/RHU.0000000000001320
  16. Celenay ST, Secer E, Biceroglu H, Ozer Kaya D. Responsiveness and minimal clinically important difference of the Turkish version of the Oswestry Disability Index in patients with acute discogenic lumbar radiculopathy. Percept Mot Skills. 2025. doi:10.1177/00315125251407383
  17. Uluğ N, Yakut Y, Alemdaroğlu İ, Yılmaz Ö. Comparison of pain, kinesiophobia and quality of life in patients with low back and neck pain. J Phys Ther Sci. 2016;28(2):665-670. doi:10.1589/jpts.28.665
  18. Korkmaz N, Akinci A, Yörükan S, Sürücü HS, Saraçbaşi O, Ozçakar L. Validation and reliability of the Turkish version of the Fear-Avoidance Beliefs Questionnaire in patients with low back pain. Eur J Phys Rehabil Med. 2009;45(4):527-535.
  19. Küçükelçi DT. Hastane anksiyete ve depresyon ölçeği (HADS) üzerine bir çalışma. Yaşam Becerileri Psikoloji Dergisi. 2019;3(5):85-91.
  20. Saglam M, Arikan H, Savci S, et al. International Physical Activity Questionnaire: Reliability and validity of the Turkish version. Percept Mot Skills. 2010;111(1):278-284. doi:10.2466/06.08.PMS.111.4.278-284
  21. Sahin F, Yilmaz F, Ozmaden A, Kotevoglu N, Sahin T, Kuran B. Reliability and validity of the Turkish version of the Berg Balance Scale. J Geriatr Phys Ther. 2008;31(1):32-37. doi:10.1519/00139143-200831010-00006
  22. Buraschi R, Pollet J, Villafañe JH, Piovanelli B, Negrini S. Temporal and kinematic analyses of the Timed Up and Go Test in chronic low back pain patients. Gait Posture. 2022;96:137-142. doi:10.1016/j.gaitpost.2022.05.027
  23. Schober P, Boer C, Schwarte LA. Correlation coefficients: Appropriate use and interpretation. Anesth Analg. 2018;126(5):1763-1768. doi:10.1213/ANE.0000000000002864
  24. Ge L, Pereira MJ, Yap CW, Heng BH. Chronic low back pain and its impact on physical function, mental health, and health-related quality of life: A cross-sectional study in Singapore. Sci Rep. 2022;12(1):20040. doi:10.1038/s41598-022-24703-7
  25. Hnatešen D, Pavić R, Radoš I, et al. Quality of life and mental distress in patients with chronic low back pain: A cross-sectional study. Int J Environ Res Public Health. 2022;19(17):10657. doi:10.3390/ijerph191710657
  26. Petrelis M, Soultanis K, Michopoulos I, Nikolaou V. Associations of somatic symptom disorder with pain, disability and quality of life in patients with chronic low back pain. Psychiatriki. 2023;34(3):221-230. doi:10.22365/jpsych.2023.005
  27. Tiaho Y, Tiendrebeogo W, Sougue C, et al. Kinesiophobia: Frequency, associated factors and impact on the life quality of participants with chronic low back pain in sub-Saharan Africa. Wiad Lek. 2021;74(12):3179-3183. doi:10.36740/WLek202112110
  28. Yihunie M, Abich Y, Demissie SF, Kassa T, Ranganathan P, Janakiraman B. Fear-avoidance beliefs for physical activity among chronic low back pain: A multicenter cross-sectional study. J Pain Res. 2023;16:233-243. doi:10.2147/JPR.S388002
  29. Karayannis NV, Smuck M, Law C, et al. Self-reported physical function is strongly related to pain behavior and pain interference and weakly related to physical capacity in people with chronic low back pain. Musculoskelet Sci Pract. 2023;63:102721. doi:10.1016/j.msksp.2023.102721
  30. Moreno-Ligero M, Moral-Munoz JA, Failde I, Duenas M. Physical activity levels in adults with chronic low back pain: A national survey in the general Spanish population. J Rehabil Med. 2023;55:4352. doi:10.2340/jrm.v55.4352
  31. Schilaty N, Bates N, Holmes B, Nagai T. Group differences and associations between patient-reported outcomes and physical characteristics in chronic low back pain patients and healthy controls. Clin Biomech (Bristol). 2023;106:106009. doi:10.1016/j.clinbiomech.2023.106009
  32. Mikkonen J, Leinonen V, Kaski D, et al. Postural sway does not differentiate individuals with chronic low back pain, single and multisite chronic musculoskeletal pain, or pain-free controls: A cross-sectional study of 229 subjects. Spine J. 2022;22(9):1523-1534. doi:10.1016/j.spinee.2022.04.013