RESUMEN
Purpose: Previous evidence suggests that increased mindfulness is associated with lower levels of pain and less psychological stress among chronic musculoskeletal pain patients. However, the impact of the COVID-19 pandemic on knee osteoarthritis outcomes and its correlation to facets of mindfulness has not been clearly delineated. Therefore, we examined the impact of the COVID-19 pandemic on physical and psychological outcomes in knee osteoarthritis (OA) patients and tested whether this relationship is mediated by mindfulness. Method(s): Cross-sectional analysis was performed on baseline data from a randomized trial for knee OA. We measured COVID-19 impact (Epidemic-Pandemic Impacts Inventory [EPII]), mindfulness (Five Facet Mindfulness Questionnaire [FFMQ]), pain and physical function (Western Ontario and McMaster University Index [WOMAC]), and psychological symptoms (Hospital Anxiety and Depression Scale [HADS], Perceived Stress Scale). Pearson's correlation coefficients estimated associations between the COVID-19 pandemic's impact, mindfulness, and physical and psychological factors. We evaluated whether mindfulness mediated associations between the COVID-19 pandemic impacts and psychological health. Result(s): A total of 40 diverse knee OA patients were included in the analysis, age 66+/-8 years;60% women;43% non-white;body mass index 31+/-7 kg/m2. Table 1 summarizes correlations. Higher negative COVID-19 impact was associated with higher anxiety (p<0.05, r=0.41) and depressive symptoms (p<0.05, r=0.38). Mindfulness did not mediate the association, shown in Figure 1. However, higher total mindfulness was associated with lower WOMAC-pain (r=-0.36, p<0.05, r=-0.32, p<0.05), less depressive (p<0.01, r =-0.49) and anxiety symptoms (p<0.05, r = -0.38). Conclusion(s): Higher negative COVID-19 impact is associated with worse psychological wellbeing in knee OA patients. Consistent with our previous findings, higher levels of mindfulness are associated with less pain, depression, and anxiety. This cumulative evidence warrants longitudinal studies exploring how mind-body therapies aiming to cultivate mindfulness may impact the well-being of patients with knee OA. [Formula presented] [Formula presented]Copyright © 2023
RESUMEN
Purpose: The aims of this study were to explore the feasibility and perceived benefits of a remotely delivered Tai Chi mind-body Intervention compared with a wellness education intervention for Knee OA during the COVID-19 pandemic. Methods: In our randomized controlled trial, patients who met the ACR criteria for Knee OA were randomized to either a Tai Chi or Wellness Education group and attended 12 weeks of biweekly remote sessions. Semi-structured interviews were audio and videotaped via Zoom or telephone and ranged from 15-20 minutes in length. Interview questions were designed to ensure the exploration of key themes and were tailored for each intervention. Eleven key themes, including perceived benefits, social interaction and engagement, remote administration, and COVID-19 related experiences were identified and analyzed. Results: Thirty-two patients completed interviews. The mean participant age was 66 years, with 65% female. Consensus suggested remote delivery of the intervention was a well-adapted remedy for Knee OA. Specifically, the Tai Chi group reported pain reduction, improved walking ability;the Wellness group incorporated improved knowledge of healthy living skills into their daily routines. Both groups found therapeutic value in the interventions, such as direct benefits of Tai Chi, and indirect benefits of social interaction during an isolating time. Participants also reported enhanced ability to manage stress surrounding the pandemic. Most interviewees expressed general satisfaction. Several key barriers to treating Knee OA were identified, such as difficulty tailoring instructions to individual patients and providing direct feedback. Conclusions: This study confirmed the feasibility of a remote-delivered behavioral intervention for Knee OA during the pandemic. Despite the challenges of this novel experience, the perceived intervention benefits are comparable to those found in prior, in-person studies. Non-pharmacological methods of treating Knee OA, including remote delivery of education and mind-body approaches, are effective ways of managing Knee OA symptoms.