Article

Persons with knee osteoarthritis (OA) are at risk of having
sensations of instability and sometimes 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 positively
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 OA. DESIGN: Descriptive,
cross-sectional study. SETTING: Four primary health care centers. SUBJECTS:
Eighty 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 following aspects: pain catastrophizing (Pain
Catastrophizing Scale), fear-avoidance beliefs (Tampa Scale for Kinesiophobia
[TSK-11] and the Fear-Avoidance Beliefs Questionnaire), pain (visual analog
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.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS