Gacto-Sánchez Mariano, Lozano-Meca José, Lozano-Guadalajara Juan Vicente, Montilla-Herrador Joaquina
Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Murcia, Spain.
Physiotherapy and Disability, Biomedical Research Institute of Murcia Pascual Parrilla-IMIB, Murcia, Spain.
Physiother Theory Pract. 2025 Jun 30:1-10. doi: 10.1080/09593985.2025.2522912.
Knee osteoarthritis (KOA) is a prevalent chronic condition. While uncertainty is linked to poorer quality of life in chronic conditions, its impact on KOA remains unexplored.
This study aims to investigate the relationship between illness uncertainty and key outcomes such as quality of life and multidimensional variables in patients with knee osteoarthritis.
Observational cross-sectional study conducted among patients with essential clinical diagnosis of knee osteoarthritis according to the diagnostic criteria established by the American Rheumatism Association, recruited by consecutive sampling. Different psychosocial components linked to chronic pain and physical function variables were assessed. Pearson and Kendall correlation analyses were used to examine the relationship between illness uncertainty and quality of life or multidimensional variables. Linear regression analyses were used to assess potential causal relationships.
A total of 79 patients met inclusion criteria. Illness uncertainty showed a negative, low, and significant correlation ( = -0.265; = .018) with quality of life, whilst correlations between illness uncertainty and kinesiophobia ( = 0.497; < .001), catastrophizing ( = 0.533; < .001), central sensitization ( = 0.443; < .001), and anxiety and depression ( = 0.471; < .001) showed positive moderate significant correlations. No association with physical function performance was evidenced whatsoever ( = -0.106; = .355). The five statistically significant variables were retained for a multivariate linear regression model (adjusted-R = 0.373), in which central sensitization ( = .038) and kinesiophobia ( = .040) showed statistical significance.
This study highlights the importance of assessing and treating illness uncertainty in patients with KOA through interventions based in personalized, biopsychosocial, and multidimensional approaches to improve the psychosocial components associated with knee osteoarthritis.
膝关节骨关节炎（KOA）是一种常见的慢性疾病。虽然不确定性与慢性疾病中较差的生活质量相关，但其对KOA的影响仍未得到探索。
本研究旨在调查疾病不确定性与膝关节骨关节炎患者的关键结局（如生活质量和多维变量）之间的关系。
根据美国风湿病协会制定的诊断标准，对确诊为膝关节骨关节炎的患者进行观察性横断面研究，采用连续抽样法招募患者。评估了与慢性疼痛和身体功能变量相关的不同心理社会成分。采用Pearson和Kendall相关性分析来检验疾病不确定性与生活质量或多维变量之间的关系。采用线性回归分析来评估潜在的因果关系。
共有79名患者符合纳入标准。疾病不确定性与生活质量呈负相关、低度且显著相关（r = -0.265；p = 0.018），而疾病不确定性与运动恐惧（r = 0.497；p < 0.001）、灾难化思维（r = 0.533；p < 0.001）、中枢敏化（r = 0.443；p < 0.001）以及焦虑和抑郁（r = 0.471；p < 0.001）之间呈正相关、中度且显著相关。未发现与身体功能表现有任何关联（r = -0.106；p = 0.355）。将五个具有统计学意义的变量纳入多元线性回归模型（调整R = 0.373），其中中枢敏化（p = 0.038）和运动恐惧（p = 0.040）具有统计学意义。
本研究强调了通过基于个性化、生物心理社会和多维方法的干预措施来评估和治疗KOA患者疾病不确定性的重要性，以改善与膝关节骨关节炎相关的心理社会成分。
