Fear of Movement and Associated Factors Among Adults With Symptomatic Knee Osteoarthritis

Gunn, Alexander; Schwartz, Todd A.; Arbeeva, Liubov; Callahan, Leigh F.; Golightly, Yvonne M.; Goode, Adam P.; Hill, Collin S; Huffman, Kim M.; Iversen, Maura D.; Pathak, Ami; Taylor, Shannon Stark; Allen, Kelli D.

doi:10.1002/acr.23226

Cited by 56 publications

(66 citation statements)

References 28 publications

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“…Our results are consistent with previous research demonstrating greater fear of movement [11,[29][30][31][32] and greater pain catastrophizing [14,29] are associated with less physical activity among several populations including patients with knee OA. Our quantitative findings are also supported by the fear-avoidance model [33], whereby pain catastrophizing and pain-related fear of movement are theorized to lead to avoidance of physical activity [33,34].…”

Section: Discussionsupporting

confidence: 92%

The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

Uritani

Kasza

Campbell

et al. 2020

BMC Musculoskelet Disord

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Background: The aim of this study was to examine the relationship between psychological characteristics and physical activity levels, measured as the average number of steps per day, in people with knee osteoarthritis (OA). Methods: This study analysed baseline data from a randomized controlled trial (Australian New Zealand Clinical Trials Registry reference: ACTRN12612000308897). A total of 167 adults aged over 50 years, with knee pain rated as four or more on an 11-point numeric rating scale, and knee OA diagnosed using American College of Rheumatology clinical criteria, were recruited from the community (62 men and 105 women, mean age, 62.2 ± 7.5 years). The average number of steps per day over seven consecutive days was measured using an accelerometerbased device. Psychological characteristics evaluated were: depressive symptoms (Depression Anxiety Stress Scale), self-efficacy (Arthritis Self-Efficacy Scale for pain and other symptoms), fear of movement (Brief Fear of Movement Scale for Osteoarthritis), and pain catastrophizing (Pain Catastrophizing Scale). The association between the average number of steps per day and psychological characteristics was analyzed using a multiple linear regression analysis, with the average number of steps per day as the dependent variable, adjusting for each psychological characteristic separately, and age, sex, body mass index, and pain entered as covariates. Results: There was evidence that the amount of physical activity was associated with fear of movement (coefficient [B]: − 117, 95% confidence interval [95%CI]: − 227 to − 8) and with pain catastrophizing (B:-44, 95%CI: − 86 to − 1). The association with self-efficacy was similar (B:117, 95%CI: − 12 to 246). However, the direction of the association with depressive symptoms was less clear (B:-59, 95%CI: − 138 to 19). Conclusions: The results of this study revealed that the relationship was such that lower fear of movement and lower pain catastrophizing may be associated with more steps per day. It may be hypothesized that fear of moving and pain catastrophizing lead to activity avoidance and that strategies to improve these disease-related psychological aspects may be useful in enhancing physical activity participation, although this hypothesis is highly speculative and needs further testing given the cross-sectional design of this study.

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Section: Discussionsupporting

confidence: 92%

The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

Uritani

Kasza

Campbell

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…Our results are consistent with previous research demonstrating greater fear of movement [11,[29][30][31][32] and greater pain catastrophizing [14,29] are associated with less physical activity among several populations including patients with knee OA. Our quantitative findings are also supported by the fearavoidance model [33], whereby pain catastrophizing and pain-related fear of movement are theorized to lead to avoidance of physical activity [33,34].…”

Section: Discussionsupporting

confidence: 92%

The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

Uritani

Kasza

Campbell

et al. 2020

Preprint

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Background The aim of this study was to examine the relationship between psychological characteristics and physical activity levels, measured as the average number of steps per day, in people with knee osteoarthritis (OA).Methods This study analysed baseline data from a randomized controlled trial (Australian New Zealand Clinical Trials Registry reference: ACTRN12612000308897). A total of 167 adults aged over 50 years, with knee pain rated as four or more on an 11-point numeric rating scale, and knee OA diagnosed using American College of Rheumatology clinical criteria, were recruited from the community (62 men and 105 women; mean age, 62.2 ± 7.5 years). The average number of steps per day over seven consecutive days was measured using an accelerometer-based device. Psychological characteristics evaluated were: depressive symptoms (Depression Anxiety Stress Scale), self-efficacy (Arthritis Self-Efficacy Scale for pain and other symptoms), fear of movement (Brief Fear of Movement Scale for Osteoarthritis), and pain catastrophizing (Pain Catastrophizing Scale). The association between the average number of steps per day and psychological characteristics was analyzed using a multiple linear regression analysis, with the average number of steps per day as the dependent variable, adjusting for each psychological characteristic separately, and age, sex, body mass index, and pain entered as covariates.Results There was evidence that the amount of physical activity was associated with fear of movement (coefficient [B]: -133, 95% confidence interval [95%CI]: -257 to -8) and with pain catastrophizing (B: -44, 95%CI: -86 to -1). The association with self-efficacy was similar (B:153, 95%CI: -2 to 308). However, the direction of the association with depressive symptoms was less clear (B:75, 95%CI: -165 to 14). ConclusionsThe results of this study revealed that the relationship was such that lower fear of movement and lower pain catastrophizing may be associated with more steps per day. It may be hypothesized that fear of moving and pain catastrophizing lead to activity avoidance and that strategies to improve these disease-related psychological aspects may be useful in enhancing physical activity participation, although this hypothesis is highly speculative and needs further testing

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“…A similar pattern also emerges for surgical outcomes, including arthroplasty, as pre-operative catastrophizing is a unique predictor of post-operative pain and physical functioning in OA [42–45]. Pain-related fear is also common among individuals with OA [46], and refers to excessive worry regarding pain-associated activity or (re)injury (i.e., kinesiophobia). Often this generates a maladaptive cycle whereby negative pain cognitions lead to activity avoidance, thus promoting physical deconditioning and maintenance of pain.…”

Section: Mechanisms Underlying Osteoarthritis Painmentioning

confidence: 94%

Predictors of Osteoarthritis Pain: the Importance of Resilience

2017

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Whereas previous research has mostly focused on risk factors for worsening of OA pain, recently emerging evidence places greater emphasis on the identification of protective mechanisms that enhance pain adaptation and palliate the negative effects of joint pain. In view of this new and important research, more emphasis should be placed on endogenous pain modulation and, in particular, pain attenuation. The result of such work could serve as a basis for optimizing treatment in the OA population.

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Fear of Movement and Associated Factors Among Adults With Symptomatic Knee Osteoarthritis

Cited by 56 publications

References 28 publications

The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

Predictors of Osteoarthritis Pain: the Importance of Resilience

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