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Self-efficacy, pain, and quadriceps capacity at baseline predict changes in mobility performance over 2 years in women with knee osteoarthritis

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Abstract

This study examined the extent to which baseline measures of quadriceps strength, quadriceps power, knee pain and self-efficacy for functional tasks, and their interactions, predicted 2-year changes in mobility performance (walking, stair ascent, stair descent) in women with knee osteoarthritis. We hypothesized that lesser strength, power and self-efficacy, and higher pain at baseline would each be independently associated with reduced mobility over 2 years, and each of pain and self-efficacy would interact with strength and power in predicting 2-year change in stair-climbing performance. This was a longitudinal, observational study of women with clinical knee osteoarthritis. At baseline and follow-up, mobility was assessed with the Six-Minute Walk Test, and stair ascent and descent tasks. Quadriceps strength and power, knee pain, and self-efficacy for functional tasks were also collected at baseline. Multiple linear regression examined the extent to which 2-year changes in mobility performances were predicted by baseline strength, power, pain, and self-efficacy, after adjusting for covariates. Data were analyzed for 37 women with knee osteoarthritis over 2 years. Lower baseline self-efficacy predicted decreased walking (β = 1.783; p = 0.030) and stair ascent (β = −0.054; p < 0.001) performances over 2 years. Higher baseline pain intensity/frequency predicted decreased walking performance (β = 1.526; p = 0.002). Lower quadriceps strength (β = 0.051; p = 0.015) and power (β = 0.022; p = 0.022) interacted with lesser self-efficacy to predict worsening stair ascent performance. Strategies to sustain or improve mobility in women with knee osteoarthritis must focus on controlling pain and boosting self-efficacy. In those with worse self-efficacy, developing knee muscle capacity is an important target.

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Acknowledgements

The authors would like to thank Kristina Calder, Neha Arora, and Emily Wiebenga from the MacMobilize Laboratory at McMaster University, Canada, for their help with recruitment and data collection, as well as the study participants for making this study possible.

Funding

This work was supported by the Canadian Institutes of Health Research [Joint Motion Program (NMB), Operating Grant No. 102643 (MRM), New Investigator Award (MRM)]; the Ontario Ministry of Training, Colleges and Universities [Ontario Graduate Scholarships (NMB, AAG)]; the Arthritis Society (AAG); the Canadian Foundation for Innovation [No. 27501 (MRM)]; and the Ministry of Research and Innovation [Ontario Research Fund (MRM)].

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Authors and Affiliations

  1. School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada

    Nicholas M. Brisson, Anthony A. Gatti, Paul W. Stratford & Monica R. Maly

  2. Department of Kinesiology, University of Waterloo, Room 1052, Burt Matthews Hall, 200 University Ave, Waterloo, ON, N2L 3G1, Canada

    Monica R. Maly

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  1. Nicholas M. Brisson
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Correspondence to Monica R. Maly.

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This longitudinal, observational study was approved by the institutional human research ethics board. Participants provided written, informed consent prior to their inclusion in the study.

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Brisson, N.M., Gatti, A.A., Stratford, P.W. et al. Self-efficacy, pain, and quadriceps capacity at baseline predict changes in mobility performance over 2 years in women with knee osteoarthritis. Clin Rheumatol 37, 495–504 (2018). https://doi.org/10.1007/s10067-017-3903-3

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