The effects of pain coping skills training among older outpatients with osteoarthritis

Aim: The present study examined the effects of individual pain coping-skills training (PCST) on knee pain, pain coping strategies, physical functions, and daily physical activity among older outpatients with osteoarthritis. Methods: Twenty-five older adults who suffered from knee pain and had been diagnosed to have knee osteoarthritis (men: n=4; 75.4±6.3 years) were assigned to either a PCST group (n=13) or a general health education group (n=12) according to their wishes. Both groups attended 20-minutes sessions once a week for 8 weeks. At the baseline, the basic attributes (e.g. gender, age, duration of knee pain, and medical history), BMI, and the severity of knee osteoarthritis were obtained. Additionally, knee pain and limitations in mobility, pain coping strategies, pain self-efficacy, exercise self-efficacy, lower muscle strength, mobility, accelerometer —based time spent in physical activity and sedentary behavior were assessed before and after the 8-week intervention period. Analyses were performed using an intention-to-treat principle. Differences in each variable between the groups were examined using an analysis of covariance. Each participant's baseline value was used as the covariate. Results: Even after controlling for the baseline attributes and values, only the PCST group exhibited a significant improvement in pain self-efficacy (p=0.005), exercise self-efficacy (p=0.042), lower muscle strength (p=0.004) and mobility (p=0.027). Furthermore, the PCST showed a significant increase in moderate-to vigorous-intensity physical activity (p=0.052) and a decrease in medical behaviors as one of pain coping strategies (p=0.073). Conclusion: The present study showed that PCST therefore appears to be a feasible and effective therapeutic strategy which improves self-efficacy for controlling knee pain, which may also result in increasing the self-efficacy for exercise, physical functions, and daily physical activities.