title: Fear of Movement and Associated Factors Among Adults With Symptomatic Knee Osteoarthritis.
abstract: To examine the frequency of and factors associated with fear of movement (FOM) among patients with symptomatic knee osteoarthritis (KOA), using the new Brief Fear of Movement (BFOM) measure.
  
  
  
  Participants (n = 350) enrolled in a clinical trial completed the BFOM scale prior to randomization. The relationships of BFOM with the following characteristics were examined: age, sex, race, education, pain and activities of daily living (ADL) subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS), knee symptom duration, depressive symptoms (8-item Patient Health Questionnaire [PHQ-8]), history of falls and knee injury, family history of knee problems, self-efficacy for exercise (SEE), and unilateral balance test. A proportional odds logistic regression model examined multivariable associations of participant characteristics with a 3-level BFOM variable (agreement with 0, 1-2, or ≥3 items).
  
  
  
  The majority of participants (77%) agreed with at least 1 item on the BFOM scale, and 36% endorsed 3+ items, suggesting a high degree of FOM. In the multivariable model, the following remained significant after backward selection: age (odds ratio [OR] 0.79 per 10-point increase, 95% confidence interval [95% CI] 0.66-0.95), KOOS ADL (OR 0.86 per 10-point increase, 95% CI 0.76-0.97), PHQ-8 (OR 1.15, 95% CI 1.08-1.22), and SEE (OR 0.87 per 10-point increase, 95% CI 0.78-0.96).
  
  
  
  FOM was common among patients with symptomatic KOA, and this could negatively impact physical activity. Psychological variables were significantly associated with FOM, suggesting behavioral and psychological interventions may decrease FOM and improve outcomes among individuals with symptomatic KOA.
authors.affiliation: Duke University, Durham, North Carolina.
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Gunn
authors.affiliation: University of North Carolina, Chapel Hill.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Schwartz
authors.affiliation: University of North Carolina, Chapel Hill.
authors.forename: Liubov S
authors.initials: LS
authors.lastname: Arbeeva
authors.affiliation: University of North Carolina, Chapel Hill.
authors.forename: Leigh F
authors.initials: LF
authors.lastname: Callahan
authors.affiliation: University of North Carolina, Chapel Hill.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Golightly
authors.affiliation: Duke University, Durham, North Carolina.
authors.forename: Adam
authors.initials: A
authors.lastname: Goode
authors.affiliation: University of North Carolina, Chapel Hill.
authors.forename: Carla H
authors.initials: CH
authors.lastname: Hill
authors.affiliation: Duke University Medical Center and Durham VA Medical Center, Durham, North Carolina.
authors.forename: Kim
authors.initials: K
authors.lastname: Huffman
authors.affiliation: Northeastern University, and Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Maura D
authors.initials: MD
authors.lastname: Iversen
authors.affiliation: Comprehensive Physical Therapy Center, Chapel Hill, North Carolina.
authors.forename: Ami
authors.initials: A
authors.lastname: Pathak
authors.affiliation: Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina.
authors.forename: Shannon Stark
authors.initials: SS
authors.lastname: Taylor
authors.affiliation: University of North Carolina, Chapel Hill, and Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina.
authors.forename: Kelli D
authors.initials: KD
authors.lastname: Allen
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D016009:Chi-Square Distribution; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005239:Fear; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D016017:Odds Ratio; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D010147:Pain Measurement; D000073222:Patient Health Questionnaire; D012307:Risk Factors; D012720:Severity of Illness Index