745: Beliefs about osteoarthritis are associated with pain and disability in Knee Osteoarthritis

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic secondary musculoskeletal pain, Assessment and Measurement of Pain/Nociception, Physiotherapy

Background and Aims: Knee osteoarthritis (OA) is the most prevalent form of OA and a leading cause of years lived with disability worldwide [1]. Clinical diagnosis is based on symptoms such as pain, stiffness, and functional limitations [2,3]. How an individual thinks about and interprets the condition can be crucial in explaining variations in pain and disability in patients with OA, since pain is a complex and subjective experience influenced by biological, psychological, and social factors [4-8]. Among these, psychosocial factors, such as beliefs about the condition, can influence how individuals interpret and respond to their symptoms, potentially affecting the experience of pain and disability and leading to avoidance of physical activity, which can limit physical function in the long term [6-8]. The Osteoarthritis Conceptualization Questionnaire (OACQ) assesses beliefs about the disease. This study aimed to investigate the association between beliefs about osteoarthritis and disability in individuals with knee osteoarthritis (OA).

Methods: This cross-sectional study included participants with OA recruited from the community. Disability was assessed using the domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): pain, function, and stiffness. Beliefs about the KOA were evaluated using the OACQ across the domains of Context, Physiology, Expectations, and Conceptual Change. Associations between variables were assessed using Spearman’s correlation coefficients. Multiple linear regression (ordinary least squares) was performed to examine whether OACQ domains were independently associated with WOMAC domains. Analyses were conducted using Jamovi (version 2.6), adopting a 5% significance level.

Results: A total of 144 participants (108 women; mean age=59 years, SD=9.79) were included. Mean pain was 9.45 (SD=3.67), stiffness was 4.00 (SD=1.76), and function was 33.30 (SD=11.80). There were moderate, negative, and significant correlations between the OACQ Physiology domain and WOMAC pain, rₛ(141)=−.37 (p<.001), stiffness, rₛ(142)=−.23 (p=.007), and function, rₛ(142) =−.30 (p<.001). A multiple regression analysis indicated that the model was a significant predictor of WOMAC function score, F(4,139)=6.30, p<.001, adjusted R²=.13. Specifically, the Physiology domain was an independent predictor of WOMAC function (B=−0.99, β=−.30, p<.001), explaining 15% of the variance.

Conclusions: Beliefs about osteoarthritis (OA) were associated with pain, stiffness, and function in individuals with KOA. In particular, beliefs related to the physiology of the disease showed consistent associations with pain and disability. Higher scores in this domain were associated with lower symptom severity and disability. These findings suggest that patients’ understanding of the disease mechanisms may play a key role in shaping disability and pain during activities. Overall, the results reinforce the importance of considering illness beliefs when interpreting the clinical presentation in this population.

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Presenting Author: Roger Berg
Submitting Author: Roger Berg

Senior Author: Thais Cristina Chaves

IASP 2026 Global Year theme of Neuropathic Pain: No

• Maria Gabriela Pereira Miranda: Master Degree in Physical Therapy in progress - Universidade Federal de São Carlos - UFSCar
• Roger Berg: Ph.D. in Physical Therapy in progress - Universidade Federal de São Carlos UFSCar
• Laís Braga Agostinho: Master Degree in Physical Therapy in progress - Universidade Federal de São Carlos - UFSCar
• Thais Cristina Chaves: Ph.D. in Rehabilitation - Universidade Federal de São Carlos - UFSCar