A Pilot Investigation Of Psychosocial Factors And Self-directed Exercise In Patients With Symptomatic Posttraumatic Osteoarthritis

PURPOSE: There is limited information if patients with PTOA experience the same barriers to exercise as patients with idiopathic OA. The purpose of this pilot study was to investigate the relationship between patient oriented factors and self-directed exercise in patients with symptomatic PTOA. METHODS: Patients 18-65yrs with symptomatic PTOA, defined as patients seeking care from a physician, were enrolled in the study. Patients completed patient-reported outcomes (KOOS, VAS, PROMIS pain inf, OSPRO) and a medical history form containing questions about exercise consumption. Patients were categorized as participating in exercise (Ex) or not (No-Ex). Exercisers (Ex) and Non-Exercisers (No-Ex) were compared with an independent t-test or Fisher's exact test, p<0.05). RESULTS: 13 patients (9F, 47±9yrs, BMI: 27.72±5.35) were enrolled, 62% of patients (n=8) reported participating in exercise. Out of the 5 No-Ex patients, all patients reported the main reason was due to their knee. There was not statistical difference in pain between the groups. The average VAS score for patients was 4.3+1.8 (Ex: 4.4+1.5, No-Ex: 4.2+2.1; p=0.8) and the average PROMIS pain interference was 56.5+8.4 (Ex: 55.51+10.38, No-Ex: 58.12+4.26; p=0.6). However, over half of patient not engaging in exercise reported having fear avoidance and poor positive affect/coping, and 40% reported depressive symptoms (Table 1). CONCLUSIONS: Over a quarter of patients with symptomatic PTOA deny exercising. Interestingly, pain levels are similar between patients regardless of exercise consumption, indicating that pain alone does not influence the decision to engage in activity. Examining psychosocial factors, the majority of patients not engaging in exercise had scores indicative of negative mental health states. These preliminary results highlight how exercise consumption is multi-dimensional, and future exercise interventions need to examine multi-modal approaches.