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Avoidance of Activities in Early Symptomatic Knee Osteoarthritis: Results from the CHECK Cohort

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Pain-related avoidance of activities is hypothesized to lead to lower muscle strength and thereby activity limitations. Negative affect (e.g., low vitality, depression) is thought to strengthen the tendency to avoid activities.

Purpose

The aim of this study was to assess the validity of this “avoidance model” in patients with early symptomatic knee osteoarthritis (OA).

Methods

Cross-sectional data (n = 151) were used. The associations between pain, negative affect, avoidance, muscle strength, and activity limitations were modeled using structural equation modeling.

Results

Pain and negative affect were associated with lower muscle strength via avoidance (mediation by avoidance). Avoidance was associated with activity limitations via lower muscle strength (mediation by muscle strength). There were also direct associations between pain, negative affect, avoidance, muscle strength, and activity limitations.

Conclusions

The results support the validity of the avoidance model, which explains the associations between pain, negative affect, avoidance, muscle strength, and activity limitations in patients with early symptomatic knee OA.

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Acknowledgments

CHECK is funded by the Dutch Arthritis Association on the lead of a steering committee comprising 16 members with expertise in different fields of OA chaired by Prof. J.W.J. Bijlsma and coordinated by J. Wesseling, MSc. Involved are Erasmus Medical Center Rotterdam; Kennemer Gasthuis Haarlem; Leiden University Medical Center; Maastricht University Medical Center; Martini Hospital Groningen/Allied Health Care Center for Rheumatology and Rehabilitation Groningen; Medical Spectrum Twente Enschede/Ziekenhuisgroep Twente; Reade, Center for Rehabilitation and Rheumatology (formerly Jan van Breemen Institute)/VU Medical Center Amsterdam; St. Maartenskliniek Nijmegen; University Medical Center Utrecht; and Wilhelmina Hospital Assen.

Conflict of Interest Statement

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Amsterdam Rehabilitation Research Center | Reade, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands

    Jasmijn F. M. Holla MSc, Marike van der Leeden PT, PhD, Wilfred F. H. Peter PT, Leo D. Roorda MD, PhD & Joost Dekker PhD

  2. Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands

    Marike van der Leeden PT, PhD & Joost Dekker PhD

  3. EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

    Marike van der Leeden PT, PhD & Joost Dekker PhD

  4. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands

    Dirk L. Knol PhD

  5. Jan van Breemen Research Institute | Reade, Amsterdam, The Netherlands

    Willem F. Lems MD, PhD

  6. Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands

    Willem F. Lems MD, PhD

  7. Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands

    Janet Wesseling PT, MSc

  8. Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK

    Martijn P. M. Steultjens PhD

  9. Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands

    Joost Dekker PhD

Authors
  1. Jasmijn F. M. Holla MSc
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  2. Marike van der Leeden PT, PhD
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  5. Leo D. Roorda MD, PhD
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Corresponding author

Correspondence to Jasmijn F. M. Holla MSc.

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Holla, J.F.M., van der Leeden, M., Knol, D.L. et al. Avoidance of Activities in Early Symptomatic Knee Osteoarthritis: Results from the CHECK Cohort. ann. behav. med. 44, 33–42 (2012). https://doi.org/10.1007/s12160-012-9353-x

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  • DOI: https://doi.org/10.1007/s12160-012-9353-x

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