Overton Mark, Swain Nicola, Falling Carrie, Gwynne-Jones David, Fillingim Roger, Mani Ramakrishnan
Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
Department of Surgical Sciences, Otago School of Medicine, University of Otago, Dunedin, New Zealand.
Pain Rep. 2024 Jul 12;9(4):e1172. doi: 10.1097/PR9.0000000000001172. eCollection 2024 Aug.
Psychological, social, and lifestyle factors contribute to the knee osteoarthritis (OA) pain experience. These factors could be measured more accurately using smartphone ecological momentary assessment (EMA).
The objective of this study was to characterise the pain experiences of those with knee OA by a smartphone EMA survey and explain how momentary psychological and social states influence knee OA pain experiences.
A smartphone EMA survey was designed and piloted. Eligible participants completed smartphone EMA assessing the knee OA pain experience 3 times daily for 2 weeks. Descriptive statistics were used to characterise factors involved in knee OA pain followed by the development of mixed-effects location scale models to explore heterogeneity and relationships between symptoms involved in the knee OA pain experience.
Eighty-six community-dwelling volunteers with knee OA were recruited. Pain, psychosocial, and lifestyle factors involved in knee OA pain experience were heterogeneous and variable. Those with greater variability in pain, fatigue, negative affect, and stress had worse levels of these symptoms overall. In addition, fatigue, negative affect, stress, anxiety, loneliness, and joint stiffness demonstrated within-person relationships with knee OA pain outcomes.
Knee OA pain is a heterogeneous biopsychosocial condition. Momentary experiences of psychological, social, fatigue, and joint stiffness explain individual and between-individual differences in momentary knee OA pain experiences. Addressing these momentary factors could improve pain and functional outcomes in those with knee OA. Validation studies, including individuals with more severe knee OA presentations, are required to support findings and guide clinical interventions to improve outcomes for those with knee OA.
心理、社会和生活方式因素会影响膝关节骨关节炎（OA）的疼痛感受。使用智能手机进行生态瞬时评估（EMA）能够更准确地测量这些因素。
本研究旨在通过智能手机EMA调查来描述膝关节OA患者的疼痛感受，并解释瞬时心理和社会状态如何影响膝关节OA的疼痛感受。
设计并试运行了一项智能手机EMA调查。符合条件的参与者完成智能手机EMA，连续2周每天3次评估膝关节OA的疼痛感受。使用描述性统计来描述膝关节OA疼痛相关因素，随后建立混合效应位置量表模型，以探索膝关节OA疼痛感受中各症状之间的异质性和关系。
招募了86名社区居住的膝关节OA志愿者。膝关节OA疼痛感受中涉及的疼痛、心理社会和生活方式因素具有异质性且各不相同。疼痛、疲劳、消极情绪和压力变化较大的参与者，这些症状的总体水平更差。此外，疲劳、消极情绪、压力、焦虑、孤独和关节僵硬在个体内部与膝关节OA疼痛结果存在关联。
膝关节OA疼痛是一种异质性的生物心理社会状况。心理、社会、疲劳和关节僵硬的瞬时体验解释了膝关节OA瞬时疼痛感受中的个体差异和个体间差异。解决这些瞬时因素可能会改善膝关节OA患者的疼痛和功能结局。需要进行验证研究，纳入更多膝关节OA严重程度较高的个体，以支持研究结果并指导临床干预，从而改善膝关节OA患者的结局。
