title: Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study.
abstract: Overweight and obese patients with osteoarthritis (OA) experience more OA pain and disability than patients who are not overweight. This study examined the long-term efficacy of a combined pain coping skills training (PCST) and lifestyle behavioral weight management (BWM) intervention in overweight and obese OA patients. Patients (n=232) were randomized to a 6-month program of: 1) PCST+BWM; 2) PCST-only; 3) BWM-only; or 4) standard care control. Assessments of pain, physical disability (Arthritis Impact Measurement Scales [AIMS] physical disability, stiffness, activity, and gait), psychological disability (AIMS psychological disability, pain catastrophizing, arthritis self-efficacy, weight self-efficacy), and body weight were collected at 4 time points (pretreatment, posttreatment, and 6 months and 12 months after the completion of treatment). Patients randomized to PCST+BWM demonstrated significantly better treatment outcomes (average of all 3 posttreatment values) in terms of pain, physical disability, stiffness, activity, weight self-efficacy, and weight when compared to the other 3 conditions (Ps<0.05). PCST+BWM also did significantly better than at least one of the other conditions (ie, PCST-only, BWM-only, or standard care) in terms of psychological disability, pain catastrophizing, and arthritis self-efficacy. Interventions teaching overweight and obese OA patients pain coping skills and weight management simultaneously may provide the more comprehensive long-term benefits.
authors.affiliation: Duke University Medical Center, Durham, NC, USA Emory University, Atlanta, GA, USA Wake Forest University, Winston-Salem, NC, USA.
authors.forename: Tamara J
authors.initials: TJ
authors.lastname: Somers
authors.forename: James A
authors.initials: JA
authors.lastname: Blumenthal
authors.forename: Farshid
authors.initials: F
authors.lastname: Guilak
authors.forename: Virginia B
authors.initials: VB
authors.lastname: Kraus
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Schmitt
authors.forename: Michael A
authors.initials: MA
authors.lastname: Babyak
authors.forename: Linda W
authors.initials: LW
authors.lastname: Craighead
authors.forename: David S
authors.initials: DS
authors.lastname: Caldwell
authors.forename: John R
authors.initials: JR
authors.lastname: Rice
authors.forename: Daphne C
authors.initials: DC
authors.lastname: McKee
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Shelby
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Campbell
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Pells
authors.forename: Ershela L
authors.initials: EL
authors.lastname: Sims
authors.forename: Robin
authors.initials: R
authors.lastname: Queen
authors.forename: James W
authors.initials: JW
authors.lastname: Carson
authors.forename: Mark
authors.initials: M
authors.lastname: Connelly
authors.forename: Kim E
authors.initials: KE
authors.lastname: Dixon
authors.forename: Lara J
authors.initials: LJ
authors.lastname: LaCaille
authors.forename: Janet L
authors.initials: JL
authors.lastname: Huebner
authors.forename: Jack W
authors.initials: JW
authors.lastname: Rejeski
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000523:psychology / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000150:complications / Q000523:psychology*; D050177:Overweight / Q000150:complications / Q000523:psychology / Q000628:therapy; D061217:Weight Reduction Programs / Q000379:methods*; D055815:Young Adult