Outcome Expectations and Osteoarthritis: Association of Perceived Benefits of Exercise With Self‐Efficacy and Depression

Abstract

Objective Outcome expectancy is recognized as a determinant of exercise engagement and adherence. However, little is known about which factors influence outcome expectations for exercise among people with knee osteoarthritis. This is the first study to examine the association of outcome expectations for exercise with demographic, physical and psychosocial outcomes in individuals with knee osteoarthritis. Methods We performed a cross-sectional analysis of the baseline data from a randomized trial of Tai Chi versus physical therapy in participants with symptomatic knee osteoarthritis. Knee pain was evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Outcome expectations for exercise, self-efficacy, depression, anxiety, stress, and social support were measured using standard instruments. Logistic regression models were utilized to determine associates of outcome expectations. Results There were 262 participants with a mean age of 59.8 years, BMI 32.1 kg/m2, 69.1% female, 51.5% white, mean disease duration 8.6 years, and mean WOMAC knee pain and function scores of 260.8 and 906.8, respectively. Higher outcome expectations for exercise were associated with greater self-efficacy (odds ratio [OR] 1.25, 95% confidence interval [95% CI] 1.11–1.41; P=0.0004) as well as with less depressive symptoms (OR 0.84 for each 5-point increase, 95% CI 0.73–0.97; P=0.01). Outcome expectancy was not significantly associated with gender, race, education, pain, function, radiographic severity, social support, anxiety, or stress. Conclusions Our results suggest significant associations between outcome expectations for exercise and self-efficacy and depression. Future studies should examine how these relationships longitudinally affect long-term clinical outcomes of exercise-based treatment for knee osteoarthritis.

Outcome Expectations and Older Adults with Knee Osteoarthritis: Their Exercise Outcome Expectations in Relation to Perceived Health, Self-Efficacy, and Fear of Falling

“…We did not find that depression was significantly associated with exercise outcome expectations, although other previous studies suggest that depressed individuals are more inclined to hold a pessimistic attitude about exercise outcomes [24,26,32,37]. These studies showed that patients with depressive moods exhibit a motivational deficit and have lower outcome expectations for exercise.…”

“…The results are consistent with previous studies on other populations [44,45]. However, another recent study on knee OA population rejected an association between outcome expectations for exercise and level of education [24]. In support of our finding, a study conducted by Resnick et al demonstrated that individuals afflicted with osteoporosis who are more educated may have a better understanding of the benefits of exercise [45].…”

“…Our results show that OA-specific variables of pain are not associated with higher outcome expectations for exercise, similar to what was reported in another recent study on patients with knee OA [24]. These participants, however, were recruited in clinical settings, and may have received encouragement to exercise in order to relieve pain.…”

Evaluation of mindfulness based stress reduction in symptomatic knee or hip osteoarthritis patients: a pilot randomized controlled trial

“…Furtherly, although no significant difference was noted in anxiety and depression based on HAD score, nor in the quality of life evaluated by SF-36, a trend towards better improvement in each outcome measurement could be observed immediately after the program and 3 months later in the MBSR group. Notably, our results were consistent with the literature regarding HAD score [ 17 , 34 – 37 ], and SF-36 score [ 38 , 39 ].…”

Evaluation of Mindfulness Based Stress Reduction in Symptomatic Knee or Hip Osteoarthritis Patients:a Pilot Randomized Controlled Trial

“…Furtherly, although no significant difference was noted in anxiety and depression based on HAD score, nor in the quality of life evaluated by SF-36, a trend towards better improvement in each outcome measurement could be observed immediately after the program and 3 months later in the MBSR group. Notably, our results were consistent with the literature regarding HAD score [17,[34][35][36][37], and SF-36 score [38,39].…”