Adaptation to early knee osteoarthritis

Arthritis is currently the main cause of disability in this country. Specifically, knee osteoarthritis (KOA), is associated with significant mobility impairment and disability progression. Although radiographic joint changes are usually used to diagnose osteoarthritis and can contribute to how much pain and functional ability one has, these assessments do not predict the level of OA symptoms. Psychosocial factors have been shown to predict future pain and disability over and above disease or injury markers; however, these factors have rarely been studied in the prediction of progression of pain and disability for KOA patients, directly or in comparison to the impact of disease status.;Structural equation modeling was used to analyze data from a sample of 275 men and women with early KOA. This study examined psychological risk and resilience factors compared with a more objective indicator of disease severity (knee x-rays). Findings resulted in models that offered a fair to good fit of the data, suggesting that psychological risk and resilience are both important in the prediction of pain and physical functioning over and above disease severity. Resilience was shown to predict enhanced physical functioning and reduced pain, whereas risk was related to increased pain. Resilience's effect on pain was mediated through a common target in interventions, arthritis self-efficacy. In addition, results suggested that higher self-efficacy may reduce levels of pain as well as both subjective and objective physical functioning. Results of this study provide an integrative model of adjustment to early KOA and may be important to the prevention of disability in this population.