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

  • Ray Marks (a1)

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.

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.

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Corresponding author

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. (rm226@columbia.edu)

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

  • Ray Marks (a1)

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