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Multiple psychological factors predict pain and disability among community-dwelling knee osteoarthritis patients: a five-year prospective study.

Abstract：

OBJECTIVE:To identify predictors of long-term pain and disability in knee osteoarthritis. DESIGN:A longitudinal cohort study of five years. SETTING:Primary care providers. SUBJECTS:In all, 108 patients (mean age = 63.6 years, standard deviation (SD) = 7.2 years) with knee pain (⩾40 mm on a 100 mm visual analogue scale in the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index pain scale) and radiographic grading (Kellgren-Lawrence: 2-4) of knee osteoarthritis who participated in a randomized controlled trial. MAIN MEASURES:Disease-specific pain and functioning were assessed using the corresponding WOMAC subscales. Generic functioning was assessed by the RAND-36 subscales for function and physical and mental component summary scores. Possible baseline predictors for these outcomes were (1) demographic and disease-related variables and (2) psychological variables of mood (anxiety, depression), pain-related cognitions (pain self-efficacy, pain catastrophizing, kinesiophobia), and positive resource factors (life satisfaction, sense of coherence). RESULTS:Multivariate linear mixed model analyses revealed that minimal anxiety at baseline predicted significantly better results for pain (WOMAC, P = 0.019) and function (WOMAC, P = 0.001, RAND-36 function P = 0.001). High pain self-efficacy predicted significantly better scores in RAND-36 function (P = 0.006), physical (P = 0.004) and mental (P = 0.001) component summaries. Pain catastrophizing predicted higher pain (P = 0.015), whereas fear of movement predicted poorer functioning in RAND-36 physical (P = 0.016) and mental (P = 0.009) component summaries. Those satisfied with life reported higher scores in RAND-36 function (P = 0.002) and mental component summary (P = 0.041). A low number of comorbidities predicted significantly better results in pain (WOMAC P = 0.019) and function (WOMAC P = 0.033, RAND-36 P = 0.009). CONCLUSION:Anxiety, pain-related cognitions, and psychological resources predict symptoms in knee osteoarthritis in the long term.

journal_name

Clin Rehabil

journal_title

Clinical rehabilitation

authors

Helminen EE,Arokoski JP,Selander TA,Sinikallio SH

doi

10.1177/0269215519900533

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

404-415

issue

eissn

0269-2155

issn

1477-0873

journal_volume

pub_type

杂志文章

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Multiple psychological factors predict pain and disability among community-dwelling knee osteoarthritis patients: a five-year prospective study.