Pain Coping Skills Training and Lifestyle Behavioral Weight Management in Patients with Knee Osteoarthritis: A Randomized Controlled Study

• Type of Material: Article
• Authors: Tamara J. Somers, Duke University Medical Center; James A. Blumenthal, Duke University Medical Center; Farshid Guilak, Duke University Medical Center; Virginia B. Kraus, Duke University Medical Center; Daniel O. Schmitt, Duke University Medical Center; Michael A. Babyak, Duke University Medical Center; Linda Craighead, Emory University; David S. Caldwell, Duke University Medical Center; John R. Rice, Duke University Medical Center; Daphne C. McKee, Duke University Medical Center; Rebecca A. Shelby, Duke University Medical Center; Lisa C. Campbell, Duke University Medical Center; Jennifer J. Pells, Duke University Medical Center; Ershela L. Sims, Duke University Medical Center; Robin Queen, Duke University Medical Center; James W. Carson, Duke University Medical Center; Mark Connelly Connelly, Duke University Medical Center; Kim E. Dixon, Duke University Medical Center; Lara J. LaCaille, Duke University Medical Center; Janet L. Huebner, Duke University Medical Center; W. Jack Rejeski, Duke University Medical Center; Francis J. Keefe, Duke University Medical Center
• Language: English
• Date: 2012-06
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved
• Final Published Version (URL): http://dx.doi.org/10.1016/j.pain.2012.02.023
• Title of Journal or Parent Work: PAIN
• ISSN: 0304-3959
• Volume: 153
• Issue: 6
• Start Page: 1199
• End Page: 1209
• Grant/Funding Information: This publication was made possible by grant number P01 AR50245 from the National Institutes of Health.
• Keywords: pain; overweight; obese; Physical disability; coping; osteoarthritis
• Research Categories: Health Sciences, General

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.