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Citation
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Sánchez-Herán Á, Agudo-Carmona D, Ferrer-Peña R, López-de-Uralde-Villanueva I, Gil-Martínez A, Paris-Alemany A, La Touche R. PM R 2015; 8(7): 618-628. |
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Affiliation
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Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain; Research Group on Movement and Behavioral Science and Study of Pain, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid; Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain; Hospital La Paz Institute for Health Research, IdiPAZ. Madrid, Spain. Electronic address: roylatouche@yahoo.es. |
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Abstract
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BACKGROUND: Population with knee OA are at risk of suffering sensations of instability, and experience buckling. The instability has been associated with psychosocial dysfunction, such as fear of movement, and impaired physical functioning. A high degree of fear of movement is positive correlated with avoidance in other conditions.
OBJECTIVE: To evaluate the relationship between postural stability, the degree of pain catastrophizing, and fear avoidance beliefs in subjects with knee and hip osteoarthritis (OA).
DESIGN: Descriptive, cross-sectional study. SETTING: Four primary healthcare centers. SUBJECTS: 80 subjects with knee or combined knee and hip OA. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUREMENTS: Postural stability was evaluated using the Multi-Directional Functional Reach Test (MDFRT), and a battery of self-reports was used to assess the other following aspects: pain catastrophizing (pain catastrophizing scale), fear-avoidance beliefs (Tampa Scale for Kinesiophobia [TSK-11] and the Fear-Avoidance Beliefs Questionnaire), pain (visual analogue scale), disability (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and self-efficacy (Chronic Pain Self-Efficacy Scale [CPSS]).
RESULTS: The correlation analysis showed that scores on the MDFRT were negatively associated with scores on the TSK-11 for activity avoidance (r = -0.54; P <.001) and positively associated with the scores on the CPSS for coping (r = 0.59; P <.001). The scores for the MDFRT to the right and the total WOMAC were negatively associated (r = -0.61, P <.001). The scores for the MDFRT to the left were positively associated with the CPSS scores for coping (r = 0.64, P <.001). The scores for the MDFRT forward were predicted by CPSS and TSK-11 scores (28.9% of variance) as well as activity avoidance, avoidance of physical activity, helplessness (34.7% of variance), and CPSS pain coping (34.3% of variance).
CONCLUSIONS: These findings suggest that pain catastrophizing and fear-avoidance beliefs are related with postural stability in subjects with knee and hip OA. Postural stability is negatively correlated with pain catastrophizing and TSK activity avoidance. Thus, based on these results, psychosocial factors should be taken into consideration in the assessment and treatment of patients with hip and knee OA.
Language: en |