When it hurts, a positive attitude may help: association of positive affect with daily walking in knee osteoarthritis. Results from a multicenter longitudinal cohort study
Open accessAbstract
Objective: While depressive symptoms and knee pain are independently known to impede daily walking in older adults, it is unknown whether positive affect promotes daily walking. This study investigated this association among adults with knee osteoarthritis (OA) and examined whether knee pain modified this association. Methods: This study is a cross‐sectional analysis of the Multicenter Osteoarthritis Study. We included 1,018 participants (mean ± SD age 63.1 ± 7.8 years, 60% women) who had radiographic knee OA and had worn a StepWatch monitor to record their number of steps per day. High and low positive affect and depressive symptoms were based on the Center for Epidemiologic Studies Depression Scale. Knee pain was categorized as present in respondents who reported pain on most days at both a clinic visit and a telephone screening. Results: Compared to respondents with low positive affect (27% of all respondents), those with high positive affect (63%) walked a similar number of steps per day, while those with depressive symptoms (10%) walked less (adjusted β −32.6 [95% confidence interval (95% CI) −458.9, 393.8] and −579.1 [95% CI −1,274.9, 116.7], respectively). There was a statistically significant interaction of positive affect by knee pain (P = 0.0045). Among the respondents with knee pain (39%), those with high positive affect walked significantly more steps per day (adjusted β 711.0 [95% CI 55.1, 1,366.9]) than those with low positive affect. Conclusion: High positive affect was associated with more daily walking among adults with painful knee OA. Positive affect may be an important psychological factor to consider for promoting physical activity among people with painful knee OA.
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Positive Affect Moderates Walking's Impact on Depression in Fibromyalgia Patients
Écija, C., Catalá, P., Gutiérrez, L., & Peñacoba, C. (2025) · Pain Management Nursing · doi:10.1016/j.pmn.2025.02.002 · Cited by 1 · see citing works
Hilibrand, A. S., Farid, A. R., Desai, V. M., Lange, J. K., Shah, V. M., & Chen, A. F. (2025) · JAAOS Global Research and Reviews · doi:10.5435/jaaosglobal-d-24-00385 · Cited by 1 · see citing works
Positive Affect and Chronic Pain:A Preregistered Systematic Review and Meta-AnalysisPreprint
Ong, A. D., Thoemmes, F. J., Ratner, K., Ghezzi‐Kopel, K., & Reid, M. C. (2019) · doi:10.31234/osf.io/w4f6j · Cited by 4 · see citing works
New Perspectives on Activity/Disease Relationships Yielded by Objective Monitoring
Shephard, R. J. (2016) · Springer series on epidemiology and public health · doi:10.1007/978-3-319-29577-0_8
O’Brien, D., Bassett, S. F., Clair, V. W., & Siegert, R. J. (2020) · BMC Rheumatology · doi:10.1186/s41927-020-0116-1
Post-traumatic Arthritis of the Proximal Tibia
Hirsiger, S., Clerc, L., & Miozzari, H. H. (2020) · Springer eBooks · doi:10.1007/978-3-030-50413-7_11
Frequency of Self-Reported Hip and Knee Pain in Elderly Population
Bibi, A., Memon, A. G., Rahimoon, A. R., Zulqarnain, T., Soomro, M. K., & Memon, S. A. (2021) · Journal of Riphah College of Rehabilitation Sciences · doi:10.53389/jrcrs.2021090106
Pain and disability in patients with osteoarthritis: the key role of self-efficacy
Paredes, A. C., Almeida, A., & Pinto, P. R. (2023) · Revista Dor · doi:10.24875/dor.m23000022
Kloos, T., Elßner, A. C., Berlin, P., Rief, W., & Riecke, J. (2025) · Mindfulness · doi:10.1007/s12671-025-02621-9
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- Authors
- White, D. K., Keysor, J. J., Neogi, T., Felson, D. T., LaValley, M., Gross, K. D., Niu, J., Nevitt, M., Lewis, C. E., Torner, J., & Fredman, L.
- Affiliations
- Boston University (US)
- University of California, San Francisco (US)
- University of Alabama at Birmingham (US)
- University of Iowa (US)
- ORCID
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2012-08-27
- Volume
- 64
- Issue
- 9
- Pages
- 1312-1319
- ISSN
- 0893-7524 (ISSN-L)
- 2151-464X
- 2151-4658
- PMC
- PMC3410957
- OpenAlex
- W2048050567
- Cited by
- 52
- References
- 52
- Citations by year
- 2026: 1 · 2025: 4 · 2023: 1 · 2022: 4 · 2021: 6 · 2020: 5 · 2019: 3 · 2018: 1 · 2017: 7 · 2016: 7 · 2015: 3 · 2014: 4 · 2013: 5 · 2012: 1
- FWCI
- 3.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (5p30ag031679-15)
- National Institute on Aging (U01AG018832, R01AG018037, U01AG018947, U01AG019069, R01AG028556, R01AG028144, P30-AG031679, U01AG018820)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23AR055127, T32AR007598, P60AR047785)
- National Center for Complementary and Integrative Health (R21AT002959)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Keywords
- positive affect, knee osteoarthritis, knee pain, daily walking, depressive symptoms, physical activity, step count, psychological factors, older adults
- MeSH terms
- Affect, Aged, Alabama, Cross-Sectional Studies, Female, Humans, Iowa, Knee Joint, Health Knowledge, Attitudes, Practice, Longitudinal Studies, Male, Middle Aged, Pain Measurement, Radiography, Risk Factors, Multivariate Analysis, Linear Models, Walking, Risk Assessment, Arthralgia, Osteoarthritis, Knee, Actigraphy
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