Evolving Associations between Psychosocial Factors and Knee Function across Chronicity in Knee Osteoarthritis
Applied/Translational Research
Care Continuum
Singapore Health Biomedical Congress
National Healthcare Group
Others
3 March 2026
This study aimed to examine how depression, anxiety, kinesiophobia, and life-space mobility (LSM) relate to knee function. Findings support a stage-specific rehabilitation approach.
Year Submitted: 2025
Published Date: 03 March 2026
Tags: Quantitative Research, Preventive Care, Primary Care, Care Continuum, Applied/Translational Research
About this Content
Aims
This study aimed to examine how depression, anxiety, kinesiophobia, and life-space mobility (LSM) relate to knee function across stages of KOA chronicity.
Background
Knee osteoarthritis (KOA) is a major contributor to disability and reduced mobility among older adults in Singapore. While its physical effects are well-established, the interaction between psychosocial factors and knee function over time remains underexplored.
Methods
This cross-sectional study recruited 186 participants over the age of 45 with knee OA from three public hospitals in Singapore Chronicity was defined by duration of KOA: 1 year (n=37), 13 years (n=43), and 3 years (n=79). The Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Brief Fear of Movement Scale (BFOM), University of Alabama at Birmingham Life-Space Assessment (UAB-LSA), and Knee Injury and Osteoarthritis Outcome Score-12 (KOOS-12) were administered. Spearmans correlation was used to assess associations between psychosocial variables and knee function.
Results
PHQ-9, GAD-7 and BFOM were found to be significantly negatively correlated with KOOS-12 among all stages of chronicity, with PHQ-9 and BFOM having the strongest associations in patients with a KOA duration of less than 1 year. Furthermore, UAB-LSA was significantly positively correlated with KOOS-12 only in the group with KOA duration less than 1 year.
Conclusion
Findings support a stage-specific rehabilitation approach. In early KOA, physicians and therapists should proactively address psychosocial factors, especially depression, kinesiophobia, and LSM, to improve knee function and participation. As chronicity increases, rehabilitation may shift toward biomechanical and structural management. A biopsychosocial model is essential for optimizing KOA care across its trajectory.
Lessons Learnt
Psychosocial factors seem to matter more in early KOA, highlighting the importance for interventions to enhance mobility and participation, mental health and kinesiophobia at this stage.
Additional Information
Singapore Health and Biomedical Congress 2025 Young Investigator's Award - Merit
Keywords
Knee Osteoarthritis, Kinesiophobia, Anxiety, Depression, Participation
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group, Others |
Organization(s) Involved | Rehabilitation Research Institute of Singapore, Nanyang Technological University, Woodlands Hospital |
Platform(s) | Singapore Health Biomedical Congress |
Healthcare Professional Group(s) | Allied Health, Medical, Academia |
Applicable Specialty or Discipline | Physiotherapy, Orthopaedics |
Project Lead(s) | Bryan Yijia Tan |
Project Member(s) | Neha Seayad |
Connect with this contributor!
Neha Seayad - neha.seayad@ntu.edu.sg