2025/04/24 by Soyoung Lee, Ehyun Kim, Baekdong Cha +3 · 1 voice
Medicine · Psychology · #Osteoarthritis Treatment and Mechanisms #Musculoskeletal pain and rehabilitation #Sport Psychology and Performance
paper · pdf · doi:10.1016/j.ocarto.2025.100615
openalex publication_date 2025/04/24 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
Objective For people with knee osteoarthritis (OA), step-up is one of the most physically demanding and pain-evoking daily movements. Given the significant role of the prefrontal cortex (PFC) in executive function and pain modulation, our objectives were (1) to assess PFC activation during walking and step-up in people with knee OA and (2) to examine the association of pain and psychological outcomes with changes in PFC activation from walking to step-up. Design This cross-sectional study included 44 individuals with symptomatic knee OA. Participants completed Knee Injury and Osteoarthritis Outcome Score (KOOS), Pain, Enjoyment of Life, and General Activity (PEG) scale, Patient Health Questionnaire (PHQ-8) for mood, 3-item Pain Catastrophizing Scale (PCS), and Fear-Avoidance Beliefs Questionnaire (FABQ). Oxygenated hemoglobin concentration changes (HbO 2 ) in the bilateral PFC were assessed using functional Near-Infrared Spectroscopy. HbO 2 were compared between tasks using repeated measures ANCOVA. Multiple linear regression models tested the association between clinical outcomes and changes in HbO 2 from walking to step-up while adjusting for confounders. Results HbO 2 during step-up was higher compared to walking, with moderate effect size ( d = 0.3–0.5). Greater pain catastrophizing (R 2 = 0.10) was correlated with smaller changes in HbO 2 from walking to step-up. Conclusion People with knee OA utilized greater executive control during step-up compared to walking. Similar to stair climbing, step-up is more physically demanding and more frequently impaired than walking. Greater pain catastrophizing was related to smaller increases in PFC activation from walking to step-up, reflecting the availability of fewer executive resources to maintain task performance.