Network analysis of cognitive, physical/functional, sensory, and pain processing-related factors in individuals with knee osteoarthritis.

Background: Knee osteoarthritis (KOA) is a complex condition influenced by cognitive, physical, functional, sensory, and pain-processing-related factors, all of which contribute to pain and limitations in daily activities. Understanding how these factors are connected is vital for better disease management.

Objectives: To use network analysis to explore the relationships among cognitive (self-efficacy and catastrophizing), physical/functional (functionality and strength), sensory (central sensitization symptoms), and pain-processing-related factors (pain intensity) in individuals with KOA.

Methods: Two hundred and forty individuals with KOA participated in this cross-sectional study. The assessments included: Numeric Pain Rating Scale (NPRS), Central Sensitization Inventory (CSI), Pain Catastrophizing Scale (PCS), Pain Self-Efficacy Questionnaire (PSEQ), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), World Health Organization Disability Assessment Schedule (WHODAS), and quadriceps isometric strength (QIS). The network was estimated using the graphical LASSO method combined with a walktrap algorithm to identify clusters and connections between nodes (factors).

Results: The estimated network indicates that pain self-efficacy plays a key role in linking clinical and psychosocial factors, such as physical disability, pain during activities, and maladaptive pain thoughts. Its prominent position underscores its importance as a potential target for assessment and intervention in individuals with KOA.

Conclusion: Self-efficacy, as measured by the PSEQ, appears to be a central factor connected to physical/functional and sensory factors in individuals with KOA.