ASSOCIATION BETWEEN PAIN CATASTROPHIZATION, QUALITY OF LIFE AND KINESIOPHOBIA IN INDIVIDUALS WITH KNEE AND HIP OSTEOARTHRITIS: A CROSS-CROSS-SET STUDY
Osteoarthritis; Catastrophizing pain; Quality of life; Kinesiophobia; Physical Functional Performance.
Introduction: Knee and hip osteoarthritis has a high prevalence worldwide, especially in the elderly population. Pain is the main symptom, often resulting in impaired quality of life. Psychosocial factors, such as pain catastrophizing and kinesiophobia, may be associated with painful symptoms, influencing the impacts of the disease in different aspects. Objective: To investigate the association between pain catastrophizing, quality of life, kinesiophobia, physical performance, and level of physical activity in individuals with knee and hip osteoarthritis. Methodology: This is a cross-sectional study, carried out at the Learning and Motor Control Laboratory (LACOM) and at the Physiotherapy School Clinic of the Federal University of Pernambuco (UFPE). The sample was composed of individuals with a self-reported diagnosis of knee and/or hip osteoarthritis, of both sexes, aged 40 years and over. The following outcomes were evaluated: sociodemographic and clinical characteristics [sociodemographic and clinical assessment form]; pain catastrophizing [Pain catastrophizing scale]; quality of life [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)]; kinesiophobia [TAMPA Scale for Kinesiophobia]; level of physical activity [International Physical Activity Questionnaire (IPAQ) - short version]; physical performance [Short Physical Performance Battery (SPPB) and muscular flexibility by the Sit and Reach Test]. The collected data were stored and tabulated using the Statistical Package for Social Sciences (SPSS), version 28.0 software. The mean comparison test was used to compare groups with and without clinically relevant catastrophizing regarding the quality of life, kinesiophobia, physical performance, level of physical activity, and flexibility scores. The effect size was calculated using Cohen's d. The variables that were associated with pain catastrophizing in the mean comparison test were included in linear regression models, in which catastrophizing was tested as a predictive variable for the other outcomes evaluated. The results were expressed with 95% CI and considered statistically significant when p<0.05. Results: The sample consisted of 39 individuals, with a mean age of 67.08 (±10.25) years, with a predominance of women (92.3%), overweight (27.97 kg/m²), and time since diagnosis average osteoarthritis of 8 years. Clinically relevant pain catastrophizing (PCS>30) was present in 20% of the sample and was associated with worse general quality of life scores (d = 1.06), pain subitems (d = 0.82), stiffness (d = 1.24) and WOMAC physical function (d = 1.17) and even higher levels of kinesiophobia (d = 1.82). Linear regression models confirmed pain catastrophizing as a predictor variable of quality of life (general and by WOMAC sub-items) and kinesiophobia (p <0.05). Conclusion: Worse pain catastrophizing scores were associated with worse quality of life indices and a higher level of kinesiophobia. Catastrophizing did not influence the physical performance or level of physical activity of individuals with knee and hip osteoarthritis.