Análise de redes dos fatores cognitivos, sensoriais e físico-funcionais: o papel da autoeficácia nos fatores relacionados a osteoartrite de joelho

Abstract

Background: Knee osteoarthritis (KOA) is a complex condition influenced by cognitive, physical or functional, and sensory factors, all contributing to pain and limitations in daily activities. Understanding how these factors are interconnected is vital for improved disease management. Objectives: To use network analysis to explore the relationships among cognitive factors (self-efficacy and catastrophizing), physical/functional factors (functionality and strength), and sensory factors (central sensitization symptoms and 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 cognitive, physical/functional and sensorial factors, such as maladaptive pain thoughts, physical disability and pain during activities. Its prominent position underscores its importance as a potential target for assessment and intervention in individuals with KOA. Conclusion: Pain self-efficacy appears to be a central factor connected to physical/functional and sensory factors in individuals with KOA.