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Predictors and Outcome of Pain‐Related Avoidance of Activities in Persons With Early Symptomatic Knee Osteoarthritis: A Five‐Year Followup Study
Author(s) -
Holla Jasmijn F. M.,
Leeden Marike,
Knol Dirk L.,
Roorda Leo D.,
Hilberdink Wim K. H. A.,
Lems Willem F.,
Steultjens Martijn P. M.,
Dekker Joost
Publication year - 2015
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22381
Subject(s) - osteoarthritis , medicine , vitality , physical therapy , cohort , knee pain , cohort study , longitudinal study , cross sectional study , activities of daily living , physical medicine and rehabilitation , philosophy , alternative medicine , theology , pathology
Objective It has been hypothesized that pain and low vitality lead to an increase in avoidance of activities in persons with early symptomatic knee osteoarthritis (OA), and that avoidance of activities leads to an increase in activity limitations. The present study aimed to evaluate these hypotheses. Methods Baseline, 2‐year, and 5‐year followup data of 828 participants from the Cohort Hip and Cohort Knee Study with early symptomatic knee OA were used. Autoregressive generalized estimating equations and linear regression models were used to analyze the longitudinal and cross‐sectional associations between self‐reported knee pain, vitality, pain‐related avoidance of activities, and activity limitations. The models were adjusted for the covariates age, sex, education level, body mass index, comorbidity, radiographic severity, and hip pain. Results In longitudinal analyses, knee pain and vitality predicted a subsequent increase in avoidance of activities. Pain‐related avoidance of activities predicted a subsequent increase in activity limitations; however, this relationship lost statistical significance ( P = 0.089) after adjustment for covariates. Cross‐sectional analyses showed strong relationships between knee pain, low vitality, pain‐related avoidance of activities, and activity limitations at all time points. Conclusions In persons with early symptomatic knee OA, knee pain and low vitality lead to a subsequent increase in avoidance of activities. Pain‐related avoidance of activities is related to activity limitations at inception of symptoms, but also years later. Therefore, it can be recommended to monitor and target avoidance of activities at various stages of the disease.