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Physical and Psychological Correlates of Disability among a Cohort of Individuals with Knee Osteoarthritis

Published online by Cambridge University Press:  31 March 2010

Ray Marks
Ray Marks*
Affiliation:
York College, City University of New York, Columbia University
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Dr. Ray Marks, Department of Health & Behavior Studies, Box 114, Teachers College, Columbia University, 525W 120th Street, New York, NY 10027. ([email protected])
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Abstract

While the physical correlates of knee osteoarthritis are well documented, less well documented are aspects of psychological functioning that may affect overall health and functional status. This paper describes the findings of a cross-sectional analysis that examined the strength of the relationship between selected psychological factors and the walking ability of adults with knee joint osteoarthritis. The variables assessed were pain, depression, levels of self-efficacy for pain and other-symptoms management, walking endurance, walking speed, and perceived exertion when walking. The sample, including 57 persons with unilateral and 43 persons with bilateral radiographic and symptomatic knee osteoarthritis, mean age, 69.9 ± 1 years, underwent standard assessment procedures on a single test occasion using several validated questionnaires and a series of walking tests on level ground. Bivariate and multiple regression analyses revealed that (a) higher pain and other-symptoms self-efficacy scores were associated with lower levels of pain (r = −0.29, −0.20.), perceived exertion during a walking task (r = −0.29, −0.31), and depression scores (r = −0.46, −0.54) (p < 0.001); (b) subjects with higher levels of self-efficacy for managing symptoms other than pain also recorded faster and fast speed walking velocities than those with lower self-efficacy scores (r = 0.30, 0.31) (p < 0.001); (c) self-efficacy for pain was the strongest predictor of pain intensity, and self-efficacy for symptom management was the strongest predictor of perceived exertion during walking, depression, and pain self-efficacy. Although no cause–effect relationship can be deduced from a cross-sectional analysis, these data imply that efforts to heighten self-efficacy for pain and other-symptoms management may influence the affective status, function, and effort-related perceptions of people with knee osteoarthritis quite significantly.

Résumé

Bien que les corrélats physiques de la gonarthrose soient bien documentés, certains aspects du fonctionnement psychologique pouvant avoir un effet sur les conditions générales et fonctionnelles le sont moins bien. Le présent article décrit les résultats d'une analyse transversale ayant porté sur la force de la relation entre des facteurs psychologiques sélectionnés et la capacité de marcher des adultes souffrant de gonarthrose. Les variables étudiées étaient la douleur, la dépression, le degré d'autoefficacité de la gestion de la douleur et d'autres symptômes, l'endurance à la marche, la vitesse de marche, et l'effort perçu lors de la marche. L'échantillon, qui comprenait 57 personnes présentant une gonarthrose unilatérale et 43 personnes présentant une gonarthrose bilatérale, radiographique et symptomatique, dont l'âge moyen était de 69,9 ans ±1 an, a fait l'objet d'une évaluation standard lors d'un seul essai à l'aide de plusieurs questionnaires validés et d'une série d'essais de marche sur terrain plat. Des analyses de régression multiples et bidimensionnelles ont révélé que 1) des scores d'autoefficacité plus élevés en matière de douleur et d'autres symptômes étaient associés à des degrés de douleur plus faibles (r = −0,29, −0,20.); à l'effort perçu pendant la marche (r = −0,29, −0,31) et à la dépression (r = −0,46, −0,54) (p < 0,001); 2) les sujets démontrant une plus grande autoefficacité en matière de gestion des symptômes autres que la douleur ont aussi affiché une vitesse de marche plus rapide et marché plus rapidement que ceux ayant des scores plus faibles en autoefficacité (r = −0,30, −0,31) (p < 0,001); 3) l'autoefficacité pour la douleur était le plus fort prédicteur de l'intensité de la douleur, et l'autoefficacité pour la gestion des symptômes était le plus fort prédicteur de l'effort perçu pendant la marche, de la dépression et de l'autoefficacité lors de la douleur. Bien qu'aucune relation de cause à effet n'ait pu être déduite de l'analyse transversale, ces données suggèrent que les efforts visant à accroître l'autoefficacité en matière de gestion de la douleur et d'autres symptômes pourraient avoir une influence sur l'état affectif, les fonctions, et les perceptions liées à l'effort de personnes souffrant d'une importante gonarthrose.

Keywords

agingdisabilityjointkneeosteoarthritispainvieillissementincapacitéarticulationgonarthrosedouleur
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 26 , Issue 4 , Winter/Hiver 2007 , pp. 367 - 377
Copyright
Copyright © Canadian Association on Gerontology 2007

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References

Arden, N.K., Crozier, S., Smith, H., Anderson, F., Edwards, C., Raphael, H., et al. (2006). Knee pain, knee osteoarthritis, and the risk of fracture. Arthritis and Rheumatism, 55, 610–615.CrossRefGoogle ScholarPubMed
Arnstein, P. (2000). The mediation of disability by self efficacy in different samples of chronic pain patients. Disability and Rehabilitation, 22, 794–801.CrossRefGoogle ScholarPubMed
Arnstein, P., Caudill, M., Mandle, C.L., Norris, A., & Beasley, R. (1999). Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain, 80, 483–491.CrossRefGoogle ScholarPubMed
Asgari, A., & Nicholas, M.K. (2001). Pain self-efficacy beliefs and pain behavior: A prospective study. Pain, 94, 85–100.CrossRefGoogle Scholar
Baker, K.R., Nelson, M.E., Felson, D.T., Layne, J.E., Sarno, R., & Roubenoff, R. (2001). The efficacy of home based progressive strength training in older adults with knee osteoarthritis: A randomized controlled trial. Journal of Rheumatology, 28, 1655–1665.Google ScholarPubMed
Bandura, A. (1986). Self-efficacy mechanism in physiological activation and health promoting behavior. In J., Madden, S., Madden, & J., Barchas (Eds.), Adaptation, learning and affect (pp. 229–269). New York: Raven Press.Google Scholar
Barlow, J.H., Williams, B., & Wright, C.C. (1999). “Instilling the strength to fight the pain and get on with life”: Learning to become an arthritis self-manager through an adult education programme. Health Education Research, 14, 533–544.CrossRefGoogle ScholarPubMed
Bennett, A.N., Crossley, K.M., Brukner, P.D., & Hinman, R.S. (2007). Predictors of symptomatic response to glucosamine in knee osteoarthritis: An exploratory study. British Journal of Sports Medicine, 41(7), 415–419.CrossRefGoogle ScholarPubMed
Bookwala, J., Harralson, T.L., & Parmelee, P.A. (2003). Effects of pain on functioning and well-being in older adults with osteoarthritis of the knee. Psychology and Aging, 18, 844–850.CrossRefGoogle ScholarPubMed
Bradley, J.D., Katz, B.P., & Brandt, K.D. (2001). Severity of knee pain does not predict a better response to an anti-inflammatory dose of ibuprofen than to analgesic therapy in patients with osteoarthritis. Journal of Rheumatology, 28, 1073–1076.Google ScholarPubMed
Brooks, P.M., & Day, R.O. (1991). Non-steroidal anti-inflammatory drugs: Differences and similarities. New England Journal of Medicine, 324, 1716–1725.Google ScholarPubMed
Brus, H., van de Laar, M., Taal, E., Rasker, J., & Wiegman, O. (1997). Determinants of compliance with medication in patients with rheumatoid arthritis: The importance of self-efficacy expectations. Patient Education and Counseling, 36, 57–64.CrossRefGoogle Scholar
Buckwalter, J.A., Stanish, W.D., Rosier, R.N., Schenck, R.C., Douglas, D.A., & Coutts, R. (2001). The increasing need for nonoperative treatment of patients with osteoarthritis. Clinical Orthopedics and Related Research, 385, 36–45.CrossRefGoogle Scholar
Buszewicz, M., Rait, G., Griffin, M., Nazareth, I., Patel, A., Atkinson, A., et al. (2006). Self management of arthritis in primary care: Randomised controlled trial. British Medical Journal Retrieved 14 Nov. 2007 from http://www.bmj.com/cgi/content/full/333/7574/879.CrossRefGoogle ScholarPubMed
Creamer, P., Lethbridge-Cejku, M., & Hochberg, M.C. (2000). Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology, 39, 490–496.CrossRefGoogle ScholarPubMed
Douglas, J., Simon, T., & Aberman, H.M. (2001). Symptomatic articular cartilage degeneration: The impact in the new millennium. Clinical Orthopedics Related Research, 391, S14–S25.Google Scholar
Felson, D.T. (1993). The course of osteoarthritis and factors that affect it. Rheumatic Disease Clinics of North America, 19, 607–615.CrossRefGoogle Scholar
Fitzgerald, G.K. (2005). Therapeutic exercise for knee osteoarthritis: Considering factors that may influence outcome. Europa Medicophysico, 41, 163–171.Google ScholarPubMed
Focht, B.C., Rejeski, W.J., Ambrosius, W.T., Katula, J.A., & Messier, S.P. (2005). Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis. Arthritis and Rheumatism, 53, 659–665.CrossRefGoogle ScholarPubMed
Gaines, J.M., Talbot, L.A., & Metter, E.J. (2002). The relationship of arthritis self-efficacy to functional performance in older men and women with osteoarthritis of the knee. Geriatric Nursing, 23, 167–170.CrossRefGoogle ScholarPubMed
Griffin, M.R., Brandt, K.D., Liang, M.H., Pincus, T., & Ray, W.A. (1995). Practical management of osteoarthritis. Integration of pharmacologic and nonpharmacologic measures. Archives of Family Medicine, 4, 1049–1055.CrossRefGoogle ScholarPubMed
Guccione, A.A., Felson, D.T., Anderson, J.J., Anthony, J.M., Zhang, Y., Wilson, P.W., et al. (1994). The effects of specific medical conditions on the functional limitations of elders in the Framingham study. American Journal of Public Health, 84, 351–358.CrossRefGoogle ScholarPubMed
Harrison, A.L. (2004). The influence of pathology, pain, balance, and self-efficacy on function in women with osteoarthritis of the knee [Electronic version]. Physical Therapy, 84, 822–831 Retrieved 6 Nov. 2000 from http://www.health.gov/healthypeople/.CrossRefGoogle ScholarPubMed
Jordan, K.M., Arden, N.K., Doherty, M., Bannwarth, B., Bijlsma, J.W.J., Dieppe, P., et al. (2003). EULAR recommendations 2003: An evidence based approach to the management of knee osteoarthritis (Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials [ESCISIT]). Annals of the Rheumatic Diseases, 62, 1145–1155.CrossRefGoogle Scholar
Kilminster, S.G., & Mould, G.P. (1999). Comparison of diclofenac spray and gel on knee joints of patients with osteoarthritic pain. Clinical Drug Investigation, 18, 345–354.CrossRefGoogle Scholar
Lefebre, J.C., Keefe, F.J., Affleck, G., Raezer, L.B., Starr, K., Caldwell, D.S., et al. (1999). The relationship of arthritis self-efficacy to daily pain, daily mood, and daily pain coping in rheumatoid arthritis patients. Pain, 80, 425–435.CrossRefGoogle Scholar
Lorig, K., Chastain, R.L., Ung, E., Shoor, S., & Holman, H.R. (1989). Development and evaluation of a scale to measure self-efficacy in people with arthritis. Arthritis and Rheumatism, 32, 37–44.CrossRefGoogle ScholarPubMed
Lorig, K., Lubeck, D., Kraines, R.G., Selznick, M., & Holman, H.R. (1985). Outcomes of self-help education for patients with arthritis. Arthritis and Rheumatism, 28, 680–685.CrossRefGoogle ScholarPubMed
Maly, M.R., Costigan, P.A., & Olney, S.J. (2005). Contribution of psychosocial and mechanical variables to physical performance measures in knee osteoarthritis. Physical Therapy, 85, 1318–1328.CrossRefGoogle ScholarPubMed
Maly, M.R., Costigan, P.A., & Olney, S.J. (2006a). Determinants of self efficacy for physical tasks in people with knee osteoarthritis. Arthritis and Rheumatism, 15, 94–101.CrossRefGoogle Scholar
Maly, M.R., Costigan, P.A., & Olney, S.J. (2006b). Determinants of self-report outcome measures in people with knee osteoarthritis. Archives of Physical Medicine and Rehabilitation, 87, 96–104.CrossRefGoogle ScholarPubMed
Manek, N.J. (2001). Medical management of osteoarthritis. Mayo Clinic Proceedings, 76, 533–539.CrossRefGoogle ScholarPubMed
Mankin, H.J., & Treadwell, B.V. (1986). Osteoarthritis: A 1986 update. Bulletin of the Rheumatic Diseases, 36, 173–182.Google ScholarPubMed
Marks, R. (2001). Efficacy theory and its utility in arthritis rehabilitation: Review and recommendations. Disability and Rehabilitation, 23, 271–280.CrossRefGoogle Scholar
Mendes de Leon, C.F., Seeman, T.E., Baker, D.I., Richardson, E.D., & Tinetti, M.E. (1996). Self-efficacy, physical decline, and change in functioning in community-living elders: A prospective study. Journals of Gerontology B: Psychology Science and Social Science, 51, S183–S190.CrossRefGoogle ScholarPubMed
Monson, R.R., & Hall, A.P. (1976). Mortality among arthritics. Journal of Chronic Diseases, 28, 459–467.CrossRefGoogle Scholar
Peat, G., McCarney, R., & Croft, P. (2001). Knee pain and osteoarthritis in older adults: A review of community burden and current use of primary health care. Annals of the Rheumatic Diseases, 60, 89–90.CrossRefGoogle ScholarPubMed
Penninx, B.W.J., Van Tilburg, T., Deeg, D.J.H., Kriegsman, D.M.W., Boeke, A.J.P., & Van Eijk, J.T.M. (1997). Direct and buffer effects of social support and personal coping resources in individuals with arthritis. Social Science and Medicine, 44, 393–402.CrossRefGoogle ScholarPubMed
Peters, T.J., Sanders, C., Dieppe, P., & Donovan, J. (2005). Factors associated with change in pain and disability over time: A community-based prospective observational study of hip and knee osteoarthritis. British Journal of General Practice, 55, 205–211.Google Scholar
Poolsup, N., Suthisisang, C., Channark, P., & Kittikulsuth, W. (2005). Glucosamine long-term treatment and the progression of knee osteoarthritis: Systematic review of randomized controlled trials. Annals of Pharmacotherapy, 39, 1080–1087.CrossRefGoogle ScholarPubMed
Rejeski, W.J., Craven, T., Ettinger, W.H. Jr, McFarlane, M., & Shumaker, S. (1996). Self-efficacy and pain in disability with osteoarthritis of the knee. Journals of Gerontology B: Psychology Science and Social Science, 51, P24–P29.CrossRefGoogle ScholarPubMed
Rejeski, W.J., Ettinger, W.H., Martin, K., & Morgan, T. (1998). Treating disability in knee osteoarthritis with exercise therapy: A central role for self-efficacy and pain. Arthritis Care and Research, 11, 94–101.CrossRefGoogle ScholarPubMed
Rejeski, W.J., Miller, M.E., Foy, C., Messier, S., & Rapp, S. (2001). Self-efficacy and the progression of functional limitations and self-reported disability in older adults with knee pain. Journals of Gerontology B: Psychology Science Social Science, 56, S261–S265.CrossRefGoogle ScholarPubMed
Riesma, R.P., Rasker, J.J., Taal, E., Griep, E.N., Wouters, JMGW, & Wiegman, O. (1998). Fatigue in rheumatoid arthritis: The role of self-efficacy and problematic social support. British Journal of Rheumatology, 37, 1042–1046.CrossRefGoogle Scholar
Roddy, E., Zhang, W., Dohety, M., Arden, N.K., Barlow, J., Birrell, F., et al. (2005). Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee: The MOVE consensus. Rheumatology, 44, 67–73.CrossRefGoogle ScholarPubMed
Schnitzer, T.J. (1993). Osteoarthritis treatment update: Minimizing pain while limiting patient risk. Postgraduate Medicine, 93, 89–95.CrossRefGoogle ScholarPubMed
Sharma, L., Cahue, S., Song, J., Hayes, K., Pai, Y., & Dunlop, D. (2003). Physical functioning over the three years in knee osteoarthritis: Role of psychosocial, local mechanical, and neuromuscular factors. Arthritis and Rheumatism, 48, 3359–3370.CrossRefGoogle ScholarPubMed
Taal, E., Rasker, J.J., Seydel, E.R., & Wiegman, O. (1993). Health status, adherence with health recommendations, self-efficacy and social support in patients with rheumatoid arthritis. Patient Education and Counseling, 20, 63–76.CrossRefGoogle ScholarPubMed
Topp, R., Woolley, S., Khuder, S., Hornyak, J., & Bruss, A. (2000). Predictors of four functional tasks in patients with osteoarthritis of the knee. Orthopedic Nursing, 19, 49–58.CrossRefGoogle ScholarPubMed
Venohr, I.M. (1994). Arthritic elders' psychological well-being as influenced by pain, functional impairment, self-efficacy, and social support. Unpublished doctoral dissertation. University of Michigan.Google Scholar
Weinberger, M., Tierney, W.M., & Booher, P. (1989). Common problems experienced by adults with osteoarthritis. Arthritis Care and Research, 2, 94–100.CrossRefGoogle ScholarPubMed
White, A. (2006). Osteoarthritis of the knee: An introduction. Acupuncture in Medicine, 24, S1–S6.CrossRefGoogle Scholar