Objective: To evaluate the associations between psychological factors (pain self-efficacy, kinesiophobia, and pain catastrophizing), physical activity, and patient-reported hip function in patients presenting to physical therapy with chronic (>3 months) hip pain.
Design: Observational, cross-sectional.
Methods: Participants completed a survey including age, sex, height/weight, symptom duration, 11-item Tampa Scale for Kinesiophobia (TSK-11), Pain Catastrophizing Scale (PCS), Pain Self-Efficacy Questionnaire (PSEQ), and 12-item International Hip Outcome Tool (iHOT-12). Participants wore an accelerometer (60 Hz) for 7 days. Predictors of iHOT-12 scores were assessed using a linear regression with forward variable selection.
Results: Forty-one participants (29 females, 12 males; 40.5 ± 14.0 years; 26.7 ± 7.8 kg/m2) with intra-articular nonarthritic hip condition (53.7%), hip osteoarthritis (19.5%), other/multiple diagnoses (17.1%), and extra-articular hip condition (9.8%) were evaluated. Diagnosis groups did not differ in sex, body mass index, physical activity, psychological measures, or patient-reported function (P≥.09). Participants with hip osteoarthritis (59.8 ± 8.3 years) were older than those with intra-articular nonarthritic hip conditions (33.0 ± 9.7 years) and other/multiple diagnoses (37.4 ± 10.6) (P<.001). A model containing PSEQ scores, moderate-to-vigorous physical activity, and TSK-11 scores explained 38% of the variance in iHOT-12 scores (P<.001), with PSEQ explaining 20% of the variance in iHOT-12 scores alone.
Conclusion: Pain self-efficacy and kinesiophobia were associated with patient-reported function in people with chronic hip pain of multiple etiologies. Clinicians may consider screening for psychological factors in this patient population.