Outcome Expectations and Osteoarthritis: Perceived Benefits of Exercise Are Associated with Self-Efficacy and Depression.
Author: Marszalek J1, Price LL2,3, Harvey WF1, Driban JB1, Wang C1
Affiliation:
1Center for Integrative Medicine & Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, United States.
2The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, United States.
3Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts, United States.
Conference/Journal: Arthritis Care Res (Hoboken).
Date published: 2016 Jul 7
Other:
Special Notes: doi: 10.1002/acr.22969. [Epub ahead of print] , Word Count: 259
OBJECTIVE: Outcome expectancy is recognized as a determinant of exercise engagement and adherence. However, little is known about which factors influence outcome expectations for exercise among people with knee osteoarthritis. This is the first study to examine the association of outcome expectations for exercise with demographic, physical and psychosocial outcomes in individuals with knee osteoarthritis.
METHODS: We performed a cross-sectional analysis of the baseline data from a randomized trial of Tai Chi versus physical therapy in participants with symptomatic knee osteoarthritis. Knee pain was evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Outcome expectations for exercise, self-efficacy, depression, anxiety, stress, and social support were measured using standard instruments. Logistic regression models were utilized to determine associates of outcome expectations.
RESULTS: There were 262 participants with a mean age of 59.8 years, BMI 32.1 kg/m2 , 69.1% female, 51.5% white, mean disease duration 8.6 years, and mean WOMAC knee pain and function scores of 260.8 and 906.8, respectively. Higher outcome expectations for exercise were associated with greater self-efficacy (odds ratio [OR] 1.25, 95% confidence interval [95% CI] 1.11-1.41; P=0.0004) as well as with less depressive symptoms (OR 0.84 for each 5-point increase, 95% CI 0.73-0.97; P=0.01). Outcome expectancy was not significantly associated with gender, race, education, pain, function, radiographic severity, social support, anxiety, or stress.
CONCLUSIONS: Our results suggest significant associations between outcome expectations for exercise and self-efficacy and depression. Future studies should examine how these relationships longitudinally affect long-term clinical outcomes of exercise-based treatment for knee osteoarthritis. This article is protected by copyright. All rights reserved.
© 2016, American College of Rheumatology.
KEYWORDS: exercise; osteoarthritis; outcome expectations; self-efficacy
PMID: 27390257 DOI: 10.1002/acr.22969
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