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Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 1/2012

01-08-2012 | Original Article

Avoidance of Activities in Early Symptomatic Knee Osteoarthritis: Results from the CHECK Cohort

Authors: Jasmijn F. M. Holla, MSc, Marike van der Leeden, PT, PhD, Dirk L. Knol, PhD, Wilfred F. H. Peter, PT, Leo D. Roorda, MD, PhD, Willem F. Lems, MD, PhD, Janet Wesseling, PT, MSc, Martijn P. M. Steultjens, PhD, Joost Dekker, PhD

Published in: Annals of Behavioral Medicine | Issue 1/2012

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Abstract

Background

Pain-related avoidance of activities is hypothesized to lead to lower muscle strength and thereby activity limitations. Negative affect (e.g., low vitality, depression) is thought to strengthen the tendency to avoid activities.

Purpose

The aim of this study was to assess the validity of this “avoidance model” in patients with early symptomatic knee osteoarthritis (OA).

Methods

Cross-sectional data (n = 151) were used. The associations between pain, negative affect, avoidance, muscle strength, and activity limitations were modeled using structural equation modeling.

Results

Pain and negative affect were associated with lower muscle strength via avoidance (mediation by avoidance). Avoidance was associated with activity limitations via lower muscle strength (mediation by muscle strength). There were also direct associations between pain, negative affect, avoidance, muscle strength, and activity limitations.

Conclusions

The results support the validity of the avoidance model, which explains the associations between pain, negative affect, avoidance, muscle strength, and activity limitations in patients with early symptomatic knee OA.
Literature
1.
Brooks PM. Impact of osteoarthritis on individuals and society: How much disability? Social consequences and health economic implications. Curr Opin Rheumatol 2002; 14(5):573-577.PubMedCrossRef
2.
Dekker J, van Dijk GM, Veenhof C. Risk factors for functional decline in osteoarthritis of the hip or knee. Curr Opin Rheumatol 2009; 21(5):520-524.PubMedCrossRef
3.
Hopman-Rock M, Kraaimaat FW, Odding E, Bijlsma JW. Coping with pain in the hip or knee in relation to physical disability in community-living elderly people. Arthritis Care Res 1998; 11(4):243-252.PubMedCrossRef
4.
Steultjens MP, Dekker J, Bijlsma JW. Coping, pain, and disability in osteoarthritis: A longitudinal study. J Rheumatol 2001; 28(5):1068-1072.PubMed
5.
van Baar ME, Dekker J, Lemmens JA, Oostendorp RA, Bijlsma JW. Pain and disability in patients with osteoarthritis of hip or knee: The relationship with articular, kinesiological, and psychological characteristics. J Rheumatol 1998; 25(1):125-133.PubMed
6.
Linton SJ. New avenues for the prevention of chronic musculoskeletal pain and disability. Amsterdam: Elsevier Health Sciences, 2002.
7.
Turk DC, Flor H. Etiological theories and treatments for chronic back pain. II. Psychological models and interventions. Pain 1984; 19(3):209-233.PubMedCrossRef
8.
Philips HC. Avoidance behaviour and its role in sustaining chronic pain. Behav Res Ther 1987; 25(4):273-279.PubMedCrossRef
9.
Keefe FJ, Gil KM. Behavioral concepts in the analysis of chronic pain syndromes. J Consult Clin Psychol 1986; 54(6):776-783.PubMedCrossRef
10.
Dolce JJ, Raczynski JM. Neuromuscular activity and electromyography in painful backs: Psychological and biomechanical models in assessment and treatment. Psychol Bull 1985; 97(3):502-520.PubMedCrossRef
11.
Dekker J, Tola P, Aufdemkampe G, Winckers M. Negative affect, pain and disability in osteoarthritis patients: The mediating role of muscle weakness. Behav Res Ther 1993; 31(2):203-206.PubMedCrossRef
12.
Steultjens MP, Dekker J, Bijlsma JW. Avoidance of activity and disability in patients with osteoarthritis of the knee: The mediating role of muscle strength. Arthritis Rheum 2002; 46(7):1784-1788.PubMedCrossRef
13.
Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev 1977; 84(2):191-215.PubMedCrossRef
14.
Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol 1986; 51(6):1173-1182.PubMedCrossRef
15.
Rose BM, Holmbeck GN, Coakley RM, Franks EA. Mediator and moderator effects in developmental and behavioral pediatric research. J Dev Behav Pediatr 2004; 25(1):58-67.PubMedCrossRef
16.
Rosqvist E, Heikkinen E, Lyyra TM, Hirvensalo M, Kallinen M, Leinonen R et al. Factors affecting the increased risk of physical inactivity among older people with depressive symptoms. Scand J Med Sci Sports 2009; 19(3):398-405.PubMedCrossRef
17.
Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain 2000; 85(3):317-332.PubMedCrossRef
18.
Wesseling J, Dekker J, van den Berg WB, Bierma-Zeinstra SM, Boers M, Cats HA et al. CHECK: Cohort Hip & Cohort Knee; similarities and differences with the Osteoarthritis Initiative. Ann Rheum Dis 2009; 68:1413-1419.PubMedCrossRef
19.
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988; 15(12):1833-1840.PubMed
20.
Roorda LD, Jones CA, Waltz M, Lankhorst GJ, Bouter LM, van der Eijken JW et al. Satisfactory cross cultural equivalence of the Dutch WOMAC in patients with hip osteoarthritis waiting for arthroplasty. Ann Rheum Dis 2004; 63(1):36-42.PubMedCrossRef
21.
Veenhof C, Bijlsma JW, van den Ende CH, van Dijk GM, Pisters MF, Dekker J. Psychometric evaluation of osteoarthritis questionnaires: A systematic review of the literature. Arthritis Rheum 2006; 55(3):480-492.PubMedCrossRef
22.
Ware JE, Jr., Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30(6):473-483.PubMedCrossRef
23.
Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston, MA: New England Medical Center, The Health Institute; 1993.
24.
Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R et al. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 1998; 51(11):1055-1068.PubMedCrossRef
25.
Kraaimaat FW, Evers AW. Pain-coping strategies in chronic pain patients: Psychometric characteristics of the pain-coping inventory (PCI). Int J Behav Med 2003; 10(4):343-363.PubMedCrossRef
26.
Perrot S, Poiraudeau S, Kabir M, Bertin P, Sichere P, Serrie A et al. Active or passive pain coping strategies in hip and knee osteoarthritis? Results of a national survey of 4,719 patients in a primary care setting. Arthritis Rheum 2008; 59(11):1555-1562.PubMedCrossRef
27.
Tan J, Balci N, Sepici V, Gener FA. Isokinetic and isometric strength in osteoarthrosis of the knee. A comparative study with healthy women. Am J Phys Med Rehabil 1995; 74(5):364-369.PubMedCrossRef
28.
Madsen OR, Bliddal H, Egsmose C, Sylvest J. Isometric and isokinetic quadriceps strength in gonarthrosis; inter-relations between quadriceps strength, walking ability, radiology, subchondral bone density and pain. Clin Rheumatol 1995; 14(3):308-314.PubMedCrossRef
29.
Steultjens MP, Dekker J, van Baar ME, Oostendorp RA, Bijlsma JW. Muscle strength, pain and disability in patients with osteoarthritis. Clin Rehabil 2001; 15(3):331-341.PubMedCrossRef
30.
Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16(4):494-502.PubMedCrossRef
31.
Rejeski WJ, Ettinger WH, Jr., Schumaker S, James P, Burns R, Elam JT. Assessing performance-related disability in patients with knee osteoarthritis. Osteoarthritis Cartilage 1995; 3(3):157-167.PubMedCrossRef
32.
Field A. Discovering Statistics Using SPSS. 2nd ed. London: SAGE Publications Ltd, 2005.
33.
Muthén LK, Muthén BO. Mplus User’s Guide. Sixth ed. Los Angeles, CA: Muthén & Muthén, 2010.
34.
Shrout PE, Bolger N. Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychol Methods 2002; 7(4):422-445.PubMedCrossRef
35.
Mackinnon DP, Warsi G, Dwyer JH. A Simulation Study of Mediated Effect Measures. Multivariate Behav Res 1995; 30(1):41.PubMedCrossRef
36.
Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 2008; 40(3):879-891.PubMedCrossRef
37.
Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Modeling 1999; 6(1):1-55.CrossRef
38.
Satorra A, Bentler PM. A scaled difference chi-square test statistic for moment structure analysis. Psychometrika 2001; 66(4):507-514.CrossRef
39.
40.
Somers TJ, Keefe FJ, Godiwala N, Hoyler GH. Psychosocial factors and the pain experience of osteoarthritis patients: New findings and new directions. Curr Opin Rheumatol 2009; 21(5):501-506.PubMedCrossRef
41.
Axford J, Heron C, Ross F, Victor CR. Management of knee osteoarthritis in primary care: Pain and depression are the major obstacles. J Psychosom Res 2008; 64(5):461-467.PubMedCrossRef
42.
Knoop J, van der Leeden M, Thorstensson CA, Roorda LD, Lems WF, Knol DL et al. Identification of phenotypes with different clinical outcomes in knee osteoarthritis: Data from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2011; 63(11):1535-1542.CrossRef
43.
Creamer P, Lethbridge-Cejku M, Hochberg MC. Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology (Oxford) 2000; 39(5):490-496.CrossRef
44.
van der Esch M, Steultjens M, Harlaar J, Knol D, Lems W, Dekker J. Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee. Arthritis Rheum 2007; 57(5):787-793.PubMedCrossRef
45.
O’Reilly SC, Jones A, Muir KR, Doherty M. Quadriceps weakness in knee osteoarthritis: The effect on pain and disability. Ann Rheum Dis 1998; 57(10):588-594.PubMedCrossRef
Metadata
Title
Avoidance of Activities in Early Symptomatic Knee Osteoarthritis: Results from the CHECK Cohort
Authors
Jasmijn F. M. Holla, MSc
Marike van der Leeden, PT, PhD
Dirk L. Knol, PhD
Wilfred F. H. Peter, PT
Leo D. Roorda, MD, PhD
Willem F. Lems, MD, PhD
Janet Wesseling, PT, MSc
Martijn P. M. Steultjens, PhD
Joost Dekker, PhD
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Annals of Behavioral Medicine / Issue 1/2012
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-012-9353-x

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