Eeva-Eerika Helminen1, Jari Pa Arokoski2, Tuomas A Selander3, Sanna H Sinikallio4. 1. Mental Health and Substance Abuse, Social Services and Health Care, City of Helsinki, Helsinki, Finland. 2. Department of Physical Medicine and Rehabilitation, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 3. Science Service Center, Kuopio University Hospital, Kuopio, Finland. 4. School of Educational Sciences and Psychology, University of Eastern Finland, Kuopio, Finland.
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.
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.
Authors: Carl Stubbs; Sean Mc Auliffe; Adrian Mallows; Kieran O'sullivan; Terence Haines; Peter Malliaras Journal: PLoS One Date: 2020-11-30 Impact factor: 3.240