Modeling Relationships among Pain and Function in Individuals with Knee Osteoarthritis in the A2CPS Cohort

Giovanni Berardi; Laura Frey Law; Robert McCarthy; John Burns; Carol Vance; Dana L Dailey; Michael Charters; Andrew Urquhart; Elizabeth Dailey; Tor D Wager; Martin A Lindquist; Briha Ansari; Kathleen A Sluka

doi:10.1097/AJP.0000000000001405

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Modeling Relationships among Pain and Function in Individuals with Knee Osteoarthritis in the A2CPS Cohort

Journal article

Peer reviewed

Modeling Relationships among Pain and Function in Individuals with Knee Osteoarthritis in the A2CPS Cohort

Giovanni Berardi, Laura Frey Law, Robert McCarthy, John Burns, Carol Vance, Dana L Dailey, Michael Charters, Andrew Urquhart, Elizabeth Dailey, Tor D Wager, …

The Clinical journal of pain

07/09/2026

DOI: 10.1097/AJP.0000000000001405

PMID: 42421662

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Abstract

Individuals with knee osteoarthritis (OA) experience both pain and functional limitations which negatively impact quality of life and contribute to years lived with disability. Movement-evoked pain (MEP) is thought to act as a barrier to participation in daily activities, resulting in reduced function. The aim of this study was to examine the relationships between knee-specific measures of self-report pain interference, fear avoidance and performance-based MEP, and their associations with physical function among individuals with knee OA seeking joint arthroplasty. Using baseline data from the Acute to Chronic Pain Signatures Consortium (training data: release 1.0.0, n=603; validation data: release 2.0.0, n=441), this cross-sectional study employed structural equation modeling to examine associations among self-reported pain, movement-evoked pain, and physical function. We further evaluated whether these relationships differed by task specificity and biological sex. Greater self-reported knee pain interference and higher fear avoidance were associated with poorer physical function (β=-0.83, P<0.001). In contrast to expectations, MEP showed little association with physical function (β=-0.11, P=0.072) and was weakly associated with self-report knee pain interference and fear avoidance (β=0.36, P<0.001). These patterns were consistent in a validation dataset. These findings suggest knee-specific self-report measures (pain, pain interference, fear avoidance) and performance-based MEP are unique constructs. Self-report measures of knee pain interference and fear avoidance were more strongly related to the functional limitations in knee OA compared to performance-based MEP.

Pain

fear of movement

movement

knee osteoarthritis

function

Details

Title: Subtitle: Modeling Relationships among Pain and Function in Individuals with Knee Osteoarthritis in the A2CPS Cohort
Creators: Giovanni Berardi - University of Iowa
Laura Frey Law - University of Iowa, Physical Therapy and Rehabilitation Science
Robert McCarthy - Rush University Medical Center
John Burns - Rush University Medical Center
Carol Vance - University of Iowa, Physical Therapy and Rehabilitation Science
Dana L Dailey - Ambrose University
Michael Charters - Henry Ford Health System
Andrew Urquhart - University of Michigan
Elizabeth Dailey - University of Michigan
Tor D Wager - Dartmouth College
Martin A Lindquist - Johns Hopkins University
Briha Ansari - Johns Hopkins University
Kathleen A Sluka - University of Iowa
Resource Type: Journal article
Publication Details: The Clinical journal of pain
DOI: 10.1097/AJP.0000000000001405
PMID: 42421662
NLM abbreviation: Clin J Pain
ISSN: 1536-5409
eISSN: 1536-5409
Publisher: Wolters Kluwer
Grant note: U24NS112873-03S2 / NINDS NIH HHS UM1NS112874 / NIH HHS U54DA049116 / NIH HHS U24NS112873 / NIH HHS U54DA049113 / NIH HHS U54DA049115 / NIH HHS UM1NS118922 / NIH HHS U54DA049110 / NIH HHS
Language: English
Electronic publication date: 07/09/2026
Academic Unit: Iowa Neuroscience Institute; Nursing; Physical Therapy and Rehabilitation Science; Neuroscience and Pharmacology
Record Identifier: 9985182283102771

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