Journal CME, January 2023: Factors associated with self-rated difficulty to descend stairs in persons with knee osteoarthritis-Journal Article

Journal Article - Jan 23

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The study, titled "Factors associated with self-rated difficulty to descend stairs in persons with knee osteoarthritis," investigates the causes of self-reported difficulties in stair descent among individuals with knee osteoarthritis (OA). Conducted by Ann-Katrin Stensdotter and colleagues at the Norwegian University of Science and Technology, the study is based on a cross-sectional, case-control design involving 28 participants with knee OA and 31 controls.<br /><br />The main outcomes measured included lower extremity kinematics, stance time in stair descent, and muscle strength. Data were analyzed using multivariate statistics and linear regression to link self-reported difficulty in stair descent with variables such as pain, kinesiophobia (fear of movement), joint status, and muscle strength.<br /><br />Key findings indicate that patients with knee OA:<br />- Display altered lower extremity kinematics during stair descent.<br />- Have longer stance times and reduced muscle strength compared to controls.<br />- Report difficulties in stair descent predominantly due to kinesiophobia and pain rather than differences in stair-descent movement patterns or muscle strength.<br /><br />The analysis showed significant associations: Kinesiophobia (ß = 0.607, p = 0.001) along with pain and radiographic signs explained almost 100% of the variability in self-reported difficulties (ß = 0.972). Thus, psychological factors like fear of movement and recent pain were more predictive of perceived difficulty than biomechanical factors or muscle strength deficits.<br /><br />The study underscores the importance of addressing kinesiophobia and pain in clinical evaluations and interventions for knee OA, suggesting that these factors significantly impact a patient's perceived ability to descend stairs, more so than strength or kinematic deviations. This patient-centered approach could enhance treatment outcomes by focusing on psychological aspects alongside physical rehabilitation strategies.

Keywords

knee osteoarthritis

stair descent

kinesiophobia

pain

muscle strength

lower extremity kinematics

stance time

self-reported difficulty

psychological factors

clinical interventions