新規理学療法ジャーナル

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Are Psychological Factors Associated with Pain Worsening in Individuals with Knee Osteoarthritis? A Systematic Review

Ryo Tanaka, Kurumi Minamiarita and Nobuhiro Kito

Objective: While some reviews have addressed prognostic factors for knee osteoarthritis, relatively few have addressed the worsening of pain with knee osteoarthritis. Moreover, prior reviews have focused on biological and clinical factors and have neglected psychological factors, which have been shown to be associated with pain in other conditions. The aim of this systematic review was to explore the relationship of psychological factors with pain worsening in people with knee osteoarthritis. Methods: Articles were selected following a comprehensive search of PubMed, the Cochrane Central Register of Controlled Trials, and the Cumulative Index to Nursing andAllied Health Literature from database inception to June 2015. Assessment of the risk of bias was performed using the Risk of Bias Assessment Tool for Nonrandomized Studies. The level of evidence was determined based on the National Health and Medical Research Council of Australia diagnostic levels of evidence. Results: Twenty articles met the inclusion criteria. Depression, pain catastrophizing, and self-efficacy have been addressed by relatively numerous studies and displayed a significantly positive relationship with pain intensity. However, most studies were cross-sectional studies, and there were only three cohort studies. Conclusion: There is currently insufficient evidence to support a significant relationship between psychological factors and pain worsening in patients with osteoarthritis of the knee.