Department of Physical Therapy, Faculty of Health Science, Kio University, Nara, Japan.
Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
PLoS One. 2022 May 5;17(5):e0267877. doi: 10.1371/journal.pone.0267877. eCollection 2022.
The aim of this study was to investigate differences in psychological characteristics between people with knee osteoarthritis (OA) from Japan and Australia. Sixty-two adults from Japan and 168 adults from Australia aged over 50 years with knee pain were included. Japanese data were collected from patients with knee OA diagnosed by medical doctors. Australian data were baseline data from a randomized controlled trial. Participants were not exercising regularly or receiving physiotherapy at the time. Psychological characteristics evaluated were depressive symptoms, fear of movement, and pain catastrophizing. These psychological characteristics were compared between the Japanese and Australian cohorts by calculating 95% confidence intervals (CIs) for difference of the mean. To test for equivalence, an equivalence margin was set at 0.5 standard deviations (SD) of the mean, where these SDs were based on the Australian data. When the 95%CI for the difference of the mean value lay entirely within the range of equivalence margin (i.e. between -0.5 and 0.5 times the Australian SD), the outcome was considered equivalent. There were no differences between the groups from Japan and Australia for depressive symptoms and the two groups were considered equivalent. There was no difference between groups for fear of movement, however the criteria for equivalence was not met. People from Japan with knee OA had higher scores for pain catastrophizing than people from Australia. The findings should be confirmed in other samples of people with knee OA from Japan and Australia due to the limitations of the participant recruitment strategy in this study. However, our findings suggest there may be a greater need to consider pain catastrophizing and build pain self-efficacy when managing Japanese people with knee OA. Implementation of international clinical practice guidelines for OA management may require different strategies in different countries due to different psychological profiles.
本研究旨在探讨日本和澳大利亚膝关节骨关节炎（OA）患者心理特征的差异。共纳入 62 名日本和 168 名澳大利亚 50 岁以上膝关节疼痛的成年人。日本组数据来自经医生诊断为膝关节 OA 的患者，澳大利亚组数据来自一项随机对照试验的基线数据。参与者当时没有进行规律运动或接受物理治疗。评估的心理特征包括抑郁症状、运动恐惧和疼痛灾难化。通过计算均值差值的 95%置信区间（CI），比较日本和澳大利亚队列之间的这些心理特征。为了检验等效性，等效性边界设定为澳大利亚数据均数标准差（SD）的 0.5 倍，这些 SD 基于澳大利亚数据。当均值差值的 95%CI 完全落在等效性边界范围内（即澳大利亚 SD 的 0.5 到 1.5 倍之间）时，结果被认为是等效的。日本组和澳大利亚组在抑郁症状方面没有差异，两组被认为是等效的。两组在运动恐惧方面没有差异，但等效性标准未达到。与澳大利亚的患者相比，日本膝关节炎患者的疼痛灾难化评分更高。由于本研究参与者招募策略的局限性，需要在日本和澳大利亚的其他膝关节骨关节炎患者样本中进一步证实这些发现。然而，我们的研究结果表明，在管理日本膝关节骨关节炎患者时，可能需要更多地考虑疼痛灾难化和建立疼痛自我效能。由于不同的心理特征，实施国际 OA 管理临床实践指南可能需要在不同国家采取不同的策略。
