Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2020

01-12-2020 | Osteoarthrosis | Research article

High self-efficacy – a predictor of reduced pain and higher levels of physical activity among patients with osteoarthritis: an observational study

Authors: Åsa Degerstedt, Hassan Alinaghizadeh, Carina A. Thorstensson, Christina B. Olsson

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

Login to get access

Abstract

Background

Self-efficacy is considered a core component in self-management. However, there is a lack of knowledge about the association between self-efficacy and health-related outcomes in osteoarthritis. The aim of this study was to investigate whether self-efficacy at baseline was associated with change over time in pain and physical activity after a supported osteoarthritis self-management programme.

Methods

A total of 3266 patients with hip or knee osteoarthritis attended this observational, register-based study. Self-efficacy was assessed using the Arthritis Self-Efficacy Scale. Pain was estimated on a visual analogue scale and physical activity by self-reporting number of days per week the patients were physically active ≥30 min. Data were self-reported at baseline and at follow-ups after 3 and 12 months. Analyses were performed using a mixed linear model analysis and are presented with an unadjusted and an adjusted model.

Results

High vs low self-efficacy for pain management at baseline resulted in reduced pain and increased physical activity at the follow-ups; least squares means and standard error were 37.43 ± 0.40 vs 44.26 ± 0.40, for pain, and 5.05 ± 0.07 vs 4.90 ± 0.08 for physical activity. High self-efficacy for management of other symptoms resulted in lower pain and higher physical activity at follow-up: 35.78 ± 0.71 vs 41.76 ± 0.71 for pain, and 5.08 ± 0.05 vs 4.72 ± 0.05 for physical activity. Patients with obesity reported lower activity levels at the follow-ups.

Conclusion

Self-efficacy at baseline was associated with change over time in pain and physical activity at 3 and 12 months after the supported osteoarthritis self-management programme. High self-efficacy had a positive effect on pain and physical activity, indicating the need for exploring and strengthening patients’ self-efficacy. Patients with obesity may need further interventions and support during a self-management programme to achieve an increase in physical activity.
Literature
1.
Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1323–30.PubMedCrossRef
2.
Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthr Cartil. 2013;21(9):1145–53.CrossRef
3.
Nuesch E, Dieppe P, Reichenbach S, Williams S, Iff S, Juni P. All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. BMJ. 2011;342:d1165.PubMedPubMedCentralCrossRef
4.
Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthr Cartil. 2019;27(11):1578–89.CrossRef
5.
Fernandes L, Hagen KB, Bijlsma JW, Andreassen O, Christensen P, Conaghan PG, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013;72(7):1125–35.PubMedCrossRef
6.
Thorstensson CA, Garellick G, Rystedt H, Dahlberg LE. Better Management of Patients with osteoarthritis: development and Nationwide implementation of an evidence-based supported osteoarthritis self-management Programme. Musculoskeletal care. 2015;13(2):67–75.PubMedCrossRef
7.
Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;1:Cd004376.PubMed
8.
Hernandez-Molina G, Reichenbach S, Zhang B, Lavalley M, Felson DT. Effect of therapeutic exercise for hip osteoarthritis pain: results of a meta-analysis. Arthritis Rheumatol. 2008;59(9):1221–8.CrossRef
9.
Skou ST, Bricca A, Roos EM. The impact of physical activity level on the short- and long-term pain relief from supervised exercise therapy and education: a study of 12,796 Danish patients with knee osteoarthritis. Osteoarthr Cartil. 2018;26(11):1474–8.CrossRef
10.
Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthr Cartil. 2010;18(4):476–99.CrossRef
11.
12.
Peeters G, Edwards KL, Brown WJ, Barker AL, Arden N, Redmond AC, et al. Potential effect modifiers of the association between physical activity patterns and joint symptoms in middle-aged women. Arthritis Care Res. 2018;70(7):1012–21.CrossRef
13.
Roos EM, Arden NK. Strategies for the prevention of knee osteoarthritis. Nat Rev Rheumatol. 2016;12(2):92–101.PubMedCrossRef
14.
Abell JE, Hootman JM, Zack MM, Moriarty D, Helmick CG. Physical activity and health related quality of life among people with arthritis. J Epidemiol Community Health. 2005;59(5):380–5.PubMedPubMedCentralCrossRef
15.
Thorstensson CA, Roos EM, Petersson IF, Arvidsson B. How do middle-aged patients conceive exercise as a form of treatment for knee osteoarthritis? Disabil Rehabil. 2006;28(1):51–9.PubMedCrossRef
16.
Wallis JA, Webster KE, Levinger P, Taylor NF. What proportion of people with hip and knee osteoarthritis meet physical activity guidelines? A systematic review and meta-analysis. Osteoarthr Cartil. 2013;21(11):1648–59.CrossRef
17.
Kanavaki AM, Rushton A, Efstathiou N, Alrushud A, Klocke R, Abhishek A, et al. Barriers and facilitators of physical activity in knee and hip osteoarthritis: a systematic review of qualitative evidence. BMJ Open. 2017;7(12):e017042.PubMedPubMedCentralCrossRef
18.
Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJ, Martin BW. Correlates of physical activity: why are some people physically active and others not? Lancet. 2012;380(9838):258–71.PubMedCrossRef
19.
Choi J, Lee M, Lee JK, Kang D, Choi JY. Correlates associated with participation in physical activity among adults: a systematic review of reviews and update. BMC Public Health. 2017;17(1):356.PubMedPubMedCentralCrossRef
20.
Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215.PubMedCrossRef
21.
Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs, NJ: Prentice Hall; 1986.
22.
Brisson NM, Gatti AA, Stratford PW, Maly MR. Self-efficacy, pain, and quadriceps capacity at baseline predict changes in mobility performance over 2 years in women with knee osteoarthritis. Clin Rheumatol. 2018;37(2):495–504.PubMedCrossRef
23.
Quicke JG, Foster NE, Ogollah RO, Croft PR, Holden MA. The relationship between attitudes, beliefs and physical activity in older adults with knee pain: secondary analysis of a randomised controlled trial. Arthritis Care Res. 2016;69(8):1192–200.CrossRef
24.
Rayahin JE, Chmiel JS, Hayes KW, Almagor O, Belisle L, Chang AH, et al. Factors associated with pain experience outcome in knee osteoarthritis. Arthritis Care Res. 2014;66(12):1828–35.CrossRef
25.
The National Board of Health and Welfare. The National guidelines for Musculoskeletal Diseases – summary: The National Board of Health and Welfare in Sweden; 2012.
26.
Weir CB, Jan A. BMI Classification Percentile And Cut Off Points. In: StatPearls [internet]. Treasure Island (FL): StatPearls Publishing LLC.; 2020.
27.
Lomi C, Nordholm LA. Validation of a Swedish version of the arthritis self-efficacy scale. Scand J Rheumatol. 1992;21(5):231–7.PubMedCrossRef
28.
Lorig K, Chastain RL, Ung E, Shoor S, Holman HR. Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheumatol. 1989;32(1):37–44.CrossRef
29.
Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short Form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res. 2011;63(Suppl 11):240–52.CrossRef
30.
Littell RC, Milliken GA, Stroup WW, Wolfinger RD, Schabenberber Oliver. SAS for Mixed Models. 2nd ed. Cary, NC: SAS Institute Inc.; 2006.
31.
Belsley DA, Kuh E, Welsch RE. Regression diagnostics : identifying influential data and sources of collinearity. New York: Wiley; 1980.CrossRef
32.
Raudenbush SW, Bryk AS. Hierarchical Linear Models, Application and data analysis methods. 2nd ed: Thousand Oaks (United States): Sage Publications, Inc; 2002.
33.
Verbeke G, Molenberghs G. Linear mixed models for longitudinal data. New York: Springer Verlag; 2000.
34.
Winer BJ. Principles in experimental Design. 2nd ed. New Ypork: McGraw-Hill Publishing Co; 1971.
35.
Cohen J. Statistical power analysis for the behavior sciences. 2nd ed: Hillsdale, N.J. : L. Erlbaum Associates; 1988.
36.
Selya AS, Rose JS, Dierker LC, Hedeker D, Mermelstein RJ. A practical guide to calculating Cohen’s f(2), a measure of local effect size, from PROC MIXED. Front Psychol. 2012;3:111.PubMedPubMedCentralCrossRef
37.
Baruth M, Wilcox S. Predictors of physical activity 6 months postintervention in the active for life initiative. J Phys Act Health. 2014;11(2):256–65.PubMedCrossRef
38.
39.
Hammer NM, Bieler T, Beyer N, Midtgaard J. The impact of self-efficacy on physical activity maintenance in patients with hip osteoarthritis - a mixed methods study. Disabil Rehabil. 2016;38(17):1691–704.PubMedCrossRef
40.
Marks R, Allegrante JP, Lorig K. A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice (part II). Health Promot Pract. 2005;6(2):148–56.PubMedCrossRef
41.
Krauss I, Katzmarek U, Rieger MA, Sudeck G. Motives for physical exercise participation as a basis for the development of patient-oriented exercise interventions in osteoarthritis: a cross-sectional study. Eur J Phys Rehabil Med 2017.
42.
Jensen MP, Nielson WR, Kerns RD. Toward the development of a motivational model of pain self-management. J Pain. 2003;4(9):477–92.PubMedCrossRef
43.
Knowles SR, Nelson EA, Castle DJ, Salzberg MR, Choong PF, Dowsey MM. Using the common sense model of illness to examine interrelationships between symptom severity and health outcomes in end-stage osteoarthritis patients. Rheumatology (Oxford). 2016;55(6):1066–73.CrossRef
44.
Brand E, Nyland J, Henzman C, McGinnis M. Arthritis self-efficacy scale scores in knee osteoarthritis: a systematic review and meta-analysis comparing arthritis self-management education with or without exercise. J Orthop Sports Phys Ther. 2013;43(12):895–910.PubMedCrossRef
45.
Stubbs B, Hurley M, Smith T. What are the factors that influence physical activity participation in adults with knee and hip osteoarthritis? A systematic review of physical activity correlates. Clin Rehabil. 2015;29(1):80–94.PubMedCrossRef
46.
Marks R. Knee obesity and exercise therapy-a complex issue. Obes Eat Disord. 2016;2(1):17.
47.
Lee PH, Macfarlane DJ, Lam TH, Stewart SM. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review. Int J Behav Nut Phys Act. 2011;8:115.CrossRef
48.
Brady TJ. Measures of self-efficacy, helplessness, mastery, and control: The Arthritis Helplessness Index (AHI)/Rheumatology Attitudes Index (RAI), Arthritis Self-Efficacy Scale (ASES), Children's Arthritis Self-Efficacy Scale (CASE), Generalized Self-Efficacy Scale (GSES), Mastery Scale, Multi-Dimensional Health Locus of Control Scale (MHLC), Parent's Arthritis Self-Efficacy Scale (PASE), Rheumatoid Arthritis Self-Efficacy Scale (RASE), and Self-Efficacy Scale (SES). Arthritis Care Res. 2003;49(Suppl 5):147–64.CrossRef
49.
Brady TJ. Measures of self-efficacy: arthritis self-efficacy scale (ASES), arthritis self-efficacy Scale-8 item (ASES-8), Children's arthritis self-efficacy scale (CASE), chronic disease self-efficacy scale (CDSES), Parent's arthritis self-efficacy scale (PASE), and rheumatoid arthritis self-efficacy scale (RASE). Arthritis Care Res. 2011;63(Suppl 11):473–85.CrossRef
50.
Garratt AM, Lochting I, Smedslund G, Hagen KB. Measurement properties of instruments assessing self-efficacy in patients with rheumatic diseases. Rheumatology (Oxford). 2014;53(7):1161–71.CrossRef
Metadata
Title
High self-efficacy – a predictor of reduced pain and higher levels of physical activity among patients with osteoarthritis: an observational study
Authors
Åsa Degerstedt
Hassan Alinaghizadeh
Carina A. Thorstensson
Christina B. Olsson
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03407-x

Other articles of this Issue 1/2020

BMC Musculoskeletal Disorders 1/2020 Go to the issue

Technical advance

A new lever reduction technique for the surgical treatment of elderly patients with lumbar degenerative Spondylolisthesis

Correction

Correction to: Routine versus on demand removal of the syndesmotic screw; a protocol for an international randomised controlled trial (RODEO-trial)

Research article

Bone transport versus acute shortening for the management of infected tibial bone defects: a meta-analysis

Study protocol

In vivo assessment of the elastic properties of women’s pelvic floor during pregnancy using shear wave elastography: design and protocol of the ELASTOPELV study

Case report

The serious full-length forearm injury - a case report and literature review

Research article

Risk factors for non-specific neck pain in young adults. A systematic review