From the *Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven; †Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp; ‡Pain in Motion International Research Group; §Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent; ∥Division of Rheumatology, UZ-KU Leuven, Leuven; and ¶Departments of Physiotherapy, Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
J Clin Rheumatol. 2017 Sep;23(6):308-316. doi: 10.1097/RHU.0000000000000560.
The aim of this study was to examine the relationship of psychosocial factors, namely, pain catastrophizing, kinesiophobia, and maladaptive coping strategies, with muscle strength, pain, and physical performance in patients with knee osteoarthritis (OA)-related symptoms.
A total of 109 women (64 with knee OA-related symptoms) with a mean age of 65.4 years (49-81 years) were recruited for this study. Psychosocial factors were quantified by the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Pain Coping Inventory. Clinical features were assessed using isometric and isokinetic knee muscle strength measurements, visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index, and functional tests. Associations were examined using correlation and regression analysis.
In knee OA patients, pain catastrophizing, kinesiophobia, and coping strategy explained a significant proportion of the variability in isometric knee extension and flexion strength (6.3%-9.2%), accounting for more overall variability than some demographic and medical status variables combined. Psychosocial factors were not significant independent predictors of isokinetic strength, knee pain, or physical performance.
In understanding clinical features related to knee OA, such as muscle weakness, pain catastrophizing, kinesiophobia, and coping strategy might offer something additional beyond what might be explained by traditional factors, underscoring the importance of a biopsychosocial approach in knee OA management. Further research on individual patient characteristics that mediate the effects of psychosocial factors is, however, required in order to create opportunities for more targeted, personalized treatment for knee OA.
本研究旨在探讨心理社会因素(即疼痛灾难化、运动恐惧症和适应不良应对策略)与膝骨关节炎(OA)相关症状患者的肌肉力量、疼痛和身体机能之间的关系。
本研究共纳入 109 名女性(64 名膝 OA 相关症状患者),平均年龄 65.4 岁(49-81 岁)。采用疼痛灾难化量表、坦帕运动恐惧症量表和疼痛应对量表来量化心理社会因素。通过等长和等速膝关节肌肉力量测量、视觉模拟量表、西部安大略省和麦克马斯特大学骨关节炎指数以及功能测试来评估临床特征。使用相关分析和回归分析来检验相关性。
在膝 OA 患者中,疼痛灾难化、运动恐惧症和应对策略解释了等长膝关节伸展和屈曲力量变化的很大一部分(6.3%-9.2%),比一些人口统计学和医学状况变量的总和解释了更多的总体变异性。心理社会因素不是等速力量、膝关节疼痛或身体机能的独立显著预测因素。
在理解与膝 OA 相关的临床特征(如肌肉无力、疼痛灾难化、运动恐惧症和应对策略)时,除了传统因素可以解释的内容之外,这些因素可能提供了一些额外的信息,强调了生物心理社会方法在膝 OA 管理中的重要性。然而,需要进一步研究个体患者特征,这些特征可以调节心理社会因素的影响,以便为膝 OA 提供更有针对性、个性化的治疗机会。