Psychosocial Adaptation in a Sensor-Augmented Telerehabilitation Program for Knee Osteoarthritis: A Post Hoc Analysis of a Randomized Controlled Trial

Background: Psychosocial adaptation during telerehabilitation for knee osteoarthritis (OA) is not well understood. Objective: To explore associations among self-efficacy, anxiety, depressive symptoms, and kinesiophobia during sensor-augmented telerehabilitation. Methods: This exploratory post hoc secondary analysis included 21 participants from the telerehabilitation arm of the KneE-PAD randomized controlled trial. Psychosocial outcomes were assessed before and after intervention using the Arthritis Self-Efficacy Scale (ASES), Hospital Anxiety and Depression Scale (HADS), and Tampa Scale for Kinesiophobia (TSK). Within-group changes were assessed using paired analyses with Holm–Bonferroni adjustment, associations among change scores were examined using correlation analyses with multiplicity correction, and exploratory regression models were fitted without multiplicity adjustment. Results: Improvement in pain-related self-efficacy was associated with reduced anxiety (ρ = −0.71, adjusted p = 0.006). No other correlation remained statistically significant after Holm–Bonferroni correction, and the regression findings were interpreted as exploratory. Conclusions: Psychosocial changes during sensor-augmented telerehabilitation were characterized by a strong association between improvement in pain-related self-efficacy and reduction in anxiety. These exploratory findings require confirmation in larger, prospectively designed studies. Trial Registration: ClinicalTrials.gov Identifier: NCT06416332.