Mindfulness Is Associated With Treatment Response From Nonpharmacologic Exercise Interventions in Knee Osteoarthritis

Abstract

Objective To examine the association between baseline mindfulness and response from exercise interventions in knee osteoarthritis (OA). Design Cohort Study; Responder analysis of a clinical trial subset Setting Urban tertiary care academic hospital Participants 86 participants with symptomatic, radiographic knee OA (mean age, 60 years; 74% female; 48% white) Interventions 12 weeks (twice per week) of Tai Chi or Physical Therapy exercise Main Outcome Measure(s) Treatment response was defined using Osteoarthritis Research Society International criteria indicating meaningful improvements in the Western Ontario and McMaster Osteoarthritis Index (WOMAC) pain, function, or Patient Global Assessment scores. At baseline, participants completed the Five Facet Mindfulness Questionnaire (FFMQ; mean total score ±SD: 142±17) and were grouped into three categories of total mindfulness: higher, medium, or lower. Relative risk (RR) ratios were used to compare treatment response across groups. Results Participants with higher total mindfulness appeared to be 38% (95% CI: 1.05, 1.83) more likely to meet responder criteria than those with lower mindfulness. We found no significant difference between medium and lower mindfulness groups (RR=1.0; 95% CI: 0.69, 1.44). Among the 5 mindfulness facets, medium Acting-with–Awareness was 46% (95% CI: 1.09, 1.96) more likely to respond than lower Acting-with–Awareness, and higher Acting-with–Awareness was 34% more likely to respond, but this did not reach significance (95% CI: 0.97, 1.86). Conclusions In this study, higher mindfulness, primarily driven by its Acting-with-Awareness facet, was significantly associated with a greater likelihood of response to non-pharmacological exercise interventions in knee OA. This suggests that mindfulness-cultivating interventions may increase the likelihood of response from exercise.

The effect of a multidisciplinary lifestyle program for patients with rheumatoid arthritis, an increased risk for rheumatoid arthritis or with metabolic syndrome-associated osteoarthritis: the “Plants for Joints” randomized controlled trial protocol

“…For OA, a small pilot study showed a significant reduction of pain and improvement of function in patients who followed an 8-week meditation program. In OA patients, higher baseline "mindfulness" scores were also associated with a better response to exercise than patients with lower baseline mindfulness, suggesting again the synergistic effects of combining more disciplines within one intervention [27].…”

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“…A recent work observed that mindfulness exercises were significantly associated with a greater likelihood of response to non-pharmacological exercise interventions in knee OA [ 22 ]. In addition, the same group found a correlation between a predisposition to mindfulness and less pain and/or better quality of life in patients with knee OA [ 23 ]. Therefore, we conducted a randomized controlled trial (RCT) aiming to evaluate the efficacy on pain and function of a MBSR program, comparatively to its absence, in symptomatic knee and hip OA patients undergoing usual care during a 6-month follow-up.…”

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