Overweight and obese patients with osteoarthritis (OA) experience more OA pain and disability than patients who are not overweight. This study examined the long-term efficacy of a combined pain coping skills training (PCST) and lifestyle behavioral weight management (BWM) intervention in overweight and obese OA patients. Patients (N=232) were randomized to a 6-month program of: 1) PCST + BWM; 2) PCST-only; 3) BWM-only; or 4) standard care control. Assessments of pain, physical disability (Arthritis Impact Measurement Scales [AIMS] physical disability, stiffness, activity, and gait), psychological disability (AIMS psychological disability, pain catastrophizing, arthritis self-efficacy, weight self-efficacy), and body weight were collected at four time points (pretreatment, post-treatment, and 6 months and 12 months after the completion of treatment). Patients randomized to PCST+ BWM demonstrated significantly better treatment outcomes (average of all three post-treatment values) in terms of pain, physical disability, stiffness, activity, weight self-efficacy, and weight when compared to the other three conditions (p’s <.05). PCST+BWM also did significantly better than at least one of the other conditions (i.e., PCST-only, BWM-only, or standard care) in terms of psychological disability, pain catastrophizing, and arthritis self-efficacy. Interventions teaching overweight and obese OA patients pain coping skills and weight management simultaneously may provide the more comprehensive long-term benefits.
This study examined the degree to which pain catastrophizing and pain-related fear explain pain, psychological disability, physical disability, and walking speed in patients with osteoarthritis (OA) of the knee. Participants in this study were 106 individuals diagnosed as having OA of at least one knee, who reported knee pain persisting six months or longer. Results suggest that pain catastrophizing explained a significant proportion (all P's ≤ 0.05) of variance in measures of pain (partial r 2 [pr 2 ] = 0.10), psychological disability (pr 2 = 0.20), physical disability (pr 2 = 0.11), and gait velocity at normal (pr 2 = 0.04), fast (pr 2 = 0.04), and intermediate speeds (pr 2 = 0.04). Painrelated fear explained a significant proportion of the variance in measures of psychological disability (pr 2 = 0.07) and walking at a fast speed (pr 2 = 0.05). Pain cognitions, particularly pain catastrophizing, appear to be important variables in understanding pain, disability, and walking at normal, fast, and intermediate speeds in knee OA patients. Clinicians interested in understanding variations in pain and disability in this population may benefit by expanding the focus of their inquiries beyond traditional medical and demographic variables to include an assessment of pain catastrophizing and pain-related fear.
Significant differences in forefoot loading patterns existed between cleat types. Based on the results of this study, it might be beneficial to increase the forefoot cushioning in cleats in an attempt to decrease loading in these regions of the foot.
The results of this study indicate that the increase in plantar loading on the lateral portion of the midfoot and forefoot in men could be one possible explanation for the increased incidence of fifth metatarsal stress fractures in men. Gender differences in loading patterns need to be considered when comparing different movements as well as different footwear conditions.
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