• Knee osteoarthritis
• meta-analysis
• psychological intervention
• systematic review

• Humans
• Osteoarthritis, Knee/therapy
• Osteoarthritis, Knee/psychology
• Osteoarthritis, Knee/rehabilitation
• Psychosocial Intervention/methods
• Cognitive Behavioral Therapy/methods
• Self Efficacy
• Biofeedback, Psychology/methods
• Randomized Controlled Trials as Topic

• Arthroplasty, Replacement, Knee
• Exercise
• Patients
• Perioperative Care
• Self Efficacy

• Humans
• Arthroplasty, Replacement, Knee
• Self Efficacy
• Female
• Male
• Aged
• Middle Aged
• Exercise Therapy
• Muscle Strength
• Program Evaluation
• Walking
• Length of Stay
• Program Development
• Knee Joint

• CSP VA

• Astaxanthin
• Inflammation
• Osteoarthritis
• SIRT1

• Xanthophylls/pharmacology
• Xanthophylls/therapeutic use
• Sirtuin 1/metabolism
• Animals
• Mice
• Up-Regulation
• Inflammation/drug therapy
• Inflammation/metabolism
• Disease Models, Animal
• Osteoarthritis/drug therapy
• Osteoarthritis/metabolism
• Osteoarthritis/pathology
• Cartilage, Articular/drug effects
• Cartilage, Articular/metabolism
• Cartilage, Articular/pathology
• Chondrocytes/drug effects
• Chondrocytes/metabolism
• Chondrocytes/pathology
• Male
• Phenotype

• Exercise
• Kinesiophobia
• Knee
• Osteoarthritis
• Physical activity
• Quality of life
• Self-efficacy

• Humans
• Male
• Female
• Osteoarthritis, Knee/diagnosis
• Osteoarthritis, Knee/therapy
• Quality of Life
• Kinesiophobia
• Cross-Sectional Studies
• Self Report
• Self Efficacy
• Longitudinal Studies
• Exercise

• Digital health
• primary health care
• qualitative
• technology
• telerehabilitation

• National Research Foundation Chair Initiative

• Humans
• Cross-Sectional Studies
• East Asian People
• Osteoarthritis, Knee
• Psychometrics
• Reproducibility of Results
• Self Efficacy
• Surveys and Questionnaires

• Asian
• Cohort
• Healthcare Utilization
• Knee Osteoarthritis
• Outcomes
• Prognosis
• Psychosocial

• Humans
• Osteoarthritis, Knee/surgery
• Treatment Outcome
• Prospective Studies
• Quality of Life
• Singapore
• Multicenter Studies as Topic

• exercise outcome expectation
• knee osteoarthritis
• older adults

• Anterior cruciate ligament
• Knee injuries
• Knee pain
• Knee surgeries
• Trunk motion

• 2020/12257-0 Fundação de Amparo à Pesquisa do Estado de São Paulo

• health literacy
• knee
• learning
• opinions
• patient education
• self-management

• co-production
• facilitation
• learning theory
• patient education
• self-management

• Outcomes Measurement
• Patient Examination
• Patient Expectations
• Psychosocial

• Humans
• Knee Joint
• Osteoarthritis, Knee/therapy
• Pain Management/methods
• Randomized Controlled Trials as Topic
• Self-Management

Knee osteoarthritis (KOA) is the most common joint disorder in the United States and a leading cause of disability. Depression and obesity are highly comorbid with KOA and accelerate knee degeneration and disability through biopsychosocial mechanisms. Mind-body physical activity programs can engage biological, mechanical, and psychological mechanisms to improve outcomes in KOA, but such programs are not currently available.

This mixed methods study aims to adapt a mind-body activity program for the unique needs of patients with KOA, depression, and obesity (GetActive-OA) delivered via live video.

Participants were adults (aged ≥45 years) from rural Kentucky with obesity (BMI≥30 kg/m²), idiopathic KOA with mild to moderate radiographic changes, and elevated depressive symptoms (9-item Patient Health Questionnaire ≥10) recruited from 2 orthopedic centers. In phase 1, we developed GetActive-OA and the study protocol using qualitative focus group feedback from the study population (N=9; 2 focus groups, 90 minutes) and multidisciplinary expertise from clinical psychologists and orthopedic researchers. In phase 2, we explored the initial feasibility, credibility, and acceptability of GetActive-OA, live video delivery, and study procedures via an open pilot with exit interviews (N=5; 1 group). This research was guided by National Institutes of Health (NIH) model stage IA.

Phase 1 qualitative analyses revealed nuanced information about challenges with coping and increasing activity, high interest in a mind-body activity program, program participation facilitators (flexibility with technology) and barriers (amotivation and forgetfulness), and perceived challenges with data collection procedures (blood and urine samples and homework). Phase 2 quantitative analyses showed that GetActive-OA met most a priori feasibility markers: acceptability (80%), expectancy (100%), credibility (100%), clinician adherence (90%), homework adherence (80%), questionnaire data collection (100%), program satisfaction (100%), and safety (100%). Adherence to ActiGraph wear (80% baseline, 20% posttest) and collection of blood samples (60%) were low. Participation in GetActive-OA was associated with signals of improvements in general coping (Cohen d=2.41), pain catastrophizing (Cohen d=1.24), depression (Cohen d=0.88), anxiety (Cohen d=0.78), self-efficacy (Cohen d=0.73), pain (Cohen d=0.39), and KOA symptoms (Cohen d=0.36). Qualitative exit interviews confirmed quantitative findings and provided valuable information to optimize the program and protocol.

Patients with KOA, depression, and obesity from rural Kentucky were interested in a live video mind-body activity program. GetActive-OA shows promise; however, the program and protocol require further NIH stage I refinement before formal efficacy testing (NIH model stage II).

RR2-10.1016/j.conctc.2021.100720

• K23 AT010653 NCCIH NIH HHS
• R34 AT010370 NCCIH NIH HHS
• UL1 TR001998 NCATS NIH HHS

• Health literacy
• Knee
• Osteoarthritis
• Patient education
• Self-efficacy
• Self-management

• Aged
• Cohort Studies
• Exercise
• Female
• Humans
• Knee Joint
• Male
• Middle Aged
• Osteoarthritis, Knee/diagnosis
• Osteoarthritis, Knee/therapy
• Self Efficacy

• Patient education
• educational intervention
• health
• health education
• patient empowerment

Arthroscopic debridement is a mature treatment for knee osteoarthritis (KOA). Due to the differences in the research subjects, methods, and efficacy evaluation indexes, there are great differences in the surgical efficacy reported in the literature.

To compare the medium-term efficacy of arthroscopic debridement and conservative treatment for KOA of Kellgren-Lawrence grades I-III.

Patients with KOA of Kellgren-Lawrence grades I-III who were admitted to the orthopedic clinic of our hospital from July 2018 to December 2018 and agreed to undergo arthroscopic surgery were included in an arthroscopic debridement group, and those who refused surgical treatment were included in a conservative treatment group. Gender, age, body mass index (BMI), side of KOA, American hospital for special surgery knee score (HSS score) before treatment, visual analogue scale (VAS) score during walking and rest before treatment, conservative treatment content, and surgical procedure were recorded. Outpatient visits were conducted at the 1^st, 3^rd, 6^th, 12^th, and 24^th mo after treatment in the two groups. The changes of HSS score and VAS score in each group before and after treatment were statistically analyzed, and the differences of HSS score and VAS score in different treatment stages between the two groups were also compared.

In the conservative treatment group, there were 80 patients with complete follow-up data, including 20 males and 60 females, aged 58.75 ± 14.66 years old. And in the knee arthroscopic debridement group, there were 98 patients with complete follow-up data, including 24 males and 74 females, aged 59.27 ± 14.48 years old. There was no statistically significant difference in the general data (gender, age, BMI, side of KOA, Kellgren-Lawrence grade distribution, HSS score, and VAS score) between the two groups before treatment. The HSS scores of the conservative treatment group at the 1^st, 3^rd, 6^th, 12^th, and 24^th mo after treatment were significantly higher than that before treatment (P < 0.05). There was no statistical difference in HSS score of the conservative treatment group among the 1^st, 3^rd, 6^th, 12^th, and 24^th mo (P > 0.05). The HSS score of the knee arthroscopic debridement group at the 1^st mo after surgery was significantly higher than that before surgery (P < 0.05). HSS scores of the knee arthroscopic debridement group at the 3^rd, 6^th, 12^th, and 24^th mo were significantly higher than those before surgery and at the 1^st mo after surgery (P < 0.05). There were no statistically significant differences in HSS scores at the 3^rd, 6^th, 12^th, and 24^th mo after surgery (P > 0.05). HSS scores at the 3^rd, 6^th, 12^th, and 24^th mo were significantly higher in the arthroscopic debridement group than in the conservative treatment group (P < 0.05). There was no statistical difference in HSS scores between the two groups before treatment and at the 1^st mo of follow-up (P > 0.05). VAS scores during walking and rest were significantly decreased in both groups, and the VAS score during rest was significantly lower in the arthroscopic debridement group than in the conservative treatment group, but there was no significant difference in the VAS score during walking between the two groups after treatment.

Compared with conservative treatment, arthroscopic debridement can significantly improve the knee resting pain and knee functional status of patients with KOA of Kellgren-Lawrence grades I-III within 2 years after treatment.

• Knee joint
• Arthroscopy
• Osteoarthritis
• Arthroscopic debridement
• Conservative treatment
• Resting pain

• Knee
• Osteoarthritis
• Patient education
• Physical therapy
• Systematic review

• Knee
• Osteoarthritis
• Pain
• Patient education
• Self-efficacy

• Depression
• Mind-body
• Obesity
• Osteoarthritis
• Physical activity
• Resiliency

• R34 AT010370 NCCIH NIH HHS

• Administration, Topical
• Algorithms
• Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
• Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
• Exercise Therapy
• Female
• Humans
• Knee Joint/diagnostic imaging
• Knee Joint/pathology
• Knee Prosthesis
• Middle Aged
• Osteoarthritis, Knee/complications
• Osteoarthritis, Knee/diagnosis
• Osteoarthritis, Knee/surgery
• Osteoarthritis, Knee/therapy
• Patient Acuity
• Practice Guidelines as Topic
• Proton Pump Inhibitors/therapeutic use
• Radiography

• Osteoarthritis (OA)
• development and evaluation (GRADE)
• grading of recommendations assessment
• guideline

• exercise therapy
• implementation of guidelines
• osteoarthritis
• patient education
• patient-reported outcomes
• physical activity
• physiotherapy

• comorbidity
• function
• outcome expectancy
• pain
• self-efficacy

• Education
• Exercise
• Hip
• Knee
• Primary health care

The aim of this study was to examine the relationship between psychological characteristics and physical activity levels, measured as the average number of steps per day, in people with knee osteoarthritis (OA).

This study analysed baseline data from a randomized controlled trial (Australian New Zealand Clinical Trials Registry reference: ACTRN12612000308897). A total of 167 adults aged over 50 years, with knee pain rated as four or more on an 11-point numeric rating scale, and knee OA diagnosed using American College of Rheumatology clinical criteria, were recruited from the community (62 men and 105 women, mean age, 62.2 ± 7.5 years). The average number of steps per day over seven consecutive days was measured using an accelerometer-based device. Psychological characteristics evaluated were: depressive symptoms (Depression Anxiety Stress Scale), self-efficacy (Arthritis Self-Efficacy Scale for pain and other symptoms), fear of movement (Brief Fear of Movement Scale for Osteoarthritis), and pain catastrophizing (Pain Catastrophizing Scale). The association between the average number of steps per day and psychological characteristics was analyzed using a multiple linear regression analysis, with the average number of steps per day as the dependent variable, adjusting for each psychological characteristic separately, and age, sex, body mass index, and pain entered as covariates.

There was evidence that the amount of physical activity was associated with fear of movement (coefficient [B]: − 117, 95% confidence interval [95%CI]: − 227 to − 8) and with pain catastrophizing (B: -44, 95%CI: − 86 to − 1). The association with self-efficacy was similar (B:117, 95%CI: − 12 to 246). However, the direction of the association with depressive symptoms was less clear (B: -59, 95%CI: − 138 to 19).

The results of this study revealed that the relationship was such that lower fear of movement and lower pain catastrophizing may be associated with more steps per day. It may be hypothesized that fear of moving and pain catastrophizing lead to activity avoidance and that strategies to improve these disease-related psychological aspects may be useful in enhancing physical activity participation, although this hypothesis is highly speculative and needs further testing given the cross-sectional design of this study.

• Depression
• Fear of movement
• Knee
• Osteoarthritis
• Pain
• Pain catastrophizing
• Physical activity

We evaluated a structured education- and exercise-based self-management program for patients with knee or hip osteoarthritis (OA), using a registry-based study of data from 44,634 patients taken from the Swedish “Better Management of Patients with Osteoarthritis” registry. Outcome measures included a numeric rating scale (NRS), EuroQol five dimension scale (EQ-5D), Arthritis self-efficacy scale (ASES-pain and ASES-other symptoms), pain frequency, any use of OA medication, desire for surgery, fear–avoidance behavior, physical activity, and sick leave were reported at baseline, 3 and 12 month. Changes in scale variables were analyzed using general linear models for repeated measures and changes in binary variables by McNamara’s test. All analyses were stratified by joint. At the 3-month follow-up, patients with knee (n = 30686) and hip (n = 13948) OA reported significant improvements in the NRS-pain, the EQ-5D index, the ASES-other symptoms, and ASES-pain scores with standardized effect size (ES) ranges for patients with knee OA of 0.25–0.57 and hip OA of 0.15–0.39. Significantly fewer patients reported pain more than once weekly, took OA medication, desired surgery, showed fear–avoidance behavior, and were physically inactive. At the 12-month follow-up, patients with knee (n = 21647) and hip (n = 8898) OA reported significant improvements in NRS-pain, EQ-5D index, and a decrease in ASES-other symptoms and ASES-pain scores with an ES for patients with knee OA of –0.04 to 0.43 and hip OA of –0.18 to 0.22. Significantly fewer patients reported daily pain, desired surgery (for hip OA), reported fear–avoidance behavior, and reported sick leave. Following these interventions, patients with knee and hip OA experienced significant reductions in symptoms and decreased willingness to undergo surgery, while using less OA medication and taking less sick leave. The results indicate that offering this program as the first-line treatment for OA patients may reduce the burden of this disease.

• health education
• rheumatoid arthritis
• self-efficacy
• telephone follow-up

• adherence
• assessment
• patient barriers
• social cognitive theory

• Accelerometer
• Exercise
• Hip
• Knee
• Osteoarthritis
• Patient education
• Physical activity

• Accelerometry/methods
• Accelerometry/psychology
• Adult
• Aged
• Early Medical Intervention/methods
• Exercise/physiology
• Exercise/psychology
• Exercise Therapy/methods
• Exercise Therapy/psychology
• Exercise Therapy/trends
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Pain/psychology
• Pain Management/methods
• Pain Management/psychology
• Pain Measurement/methods
• Pain Measurement/psychology
• Patient Education as Topic/methods
• Quality of Life/psychology
• Self Efficacy
• Treatment Outcome

• The Academy of Caring Sciences, Skåne University Hospital
• The Swedish Rheumatism Association

• Beliefs
• Decision-making
• Hip
• Knee
• Osteoarthritis
• Treatment

• behaviour change
• osteoarthritis
• physiotherapy
• systematic review

• Cognitive Behavioral Therapy/methods
• Exercise
• Humans
• Osteoarthritis, Knee/psychology
• Osteoarthritis, Knee/rehabilitation
• Outcome Assessment, Health Care
• Patient Compliance
• Physical Therapy Modalities/psychology
• Randomized Controlled Trials as Topic
• Research Design
• Systematic Reviews as Topic

• MR/K00414X/1 Medical Research Council

• evidence
• osteoarthritis
• physiotherapy

• arthroplasty, knee
• mobility limitation
• neuropathic pain

Arthritis self-efficacy is important for successful disease management. This study examined psychometric properties of the 8-item English version of the Arthritis Self-Efficacy Scale (ASES-8) and differences in ASES-8 scores across sample subgroups. In 401 participants with self-reported doctor-diagnosed arthritis, exploratory factor analysis and tests of internal consistency were conducted. Concurrent validity was examined by associating ASES-8 scores with disease-specific, psychosocial, functional, and behavioral measures expected to be related to arthritis self-efficacy. All analyses were conducted for the full sample and within subgroups (gender, race, age, education, and weight status). Exploratory factor analysis for the entire sample and in all 12 subgroups demonstrated a one factor solution (factor loadings: 0.61 to 0.89). Internal consistency was high for measures of Cronbach's alpha (0.87 to 0.94), omega (0.87 to 0.93), and greatest lower bound (0.90 to 0.95). ASES-8 scores were significantly correlated with all measures assessed (P < 0.05), demonstrating concurrent validity. Those with a high school education or greater had higher ASES-8 scores than those with less than a high school education (P < .001); no other subgroup differences were found. The ASES-8 is a valid and reliable tool to measure arthritis self-efficacy efficiently and thereby reduce participant burden in research studies.