SynthesisJournal of behavioral medicine2014
The avoidance model in knee and hip osteoarthritis: a systematic review of the evidence.
Synthesis in Journal of behavioral medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Associations between biomarkers and skeletal muscle function in individuals with osteoarthritis: a systematic review and meta-analysis.Arthritis research & therapy · 2024Pooled it
- Experience of living with knee osteoarthritis: a systematic review of qualitative studies.BMJ open · 2019Pooled it
- Sleep and Pain: A Systematic Review of Studies of Mediation.The Clinical journal of pain · 2019Pooled it
- Barriers and facilitators of physical activity in knee and hip osteoarthritis: a systematic review of qualitative evidence.BMJ open · 2017Pooled it
- Relationship Between Attitudes and Beliefs and Physical Activity in Older Adults With Knee Pain: Secondary Analysis of a Randomized Controlled Trial.Arthritis care & research · 2017Trial
- Asymmetrical biomechanics in knee osteoarthritis: a review of contralateral risk from primary disease to post-arthroplasty progression.EFORT open reviews · 2026Review
- Depressive Symptoms and Physical Activity Mediate the Adverse Effect of Pain on Functional Dependence in Patients With Arthritis: Evidence From the Canadian Longitudinal Study on Aging.Physical therapy · 2025Article
- Article
- Outcomes Vary by Pre-Operative Physical Activity Levels in Total Knee Arthroplasty Patients.Journal of clinical medicine · 2023Article
- Article
- Understanding the Impact and Tackling the Burden of Osteoarthritis for Aboriginal and Torres Strait Islander People.Arthritis care & research · 2023Article
- Strength and physical activity in osteoarthritis: The mediating role of kinesiophobia.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2022Article
- A new integrated behavioural intervention for knee osteoarthritis: development and pilot study.BMC musculoskeletal disorders · 2021Review
- Walking energetics and abductor strength are associated with physical activity in older women with hip osteoarthritis.Gait & posture · 2021Observational
- The Impact of Self-Efficacy on Activity Limitations in Patients With Hip Osteoarthritis: Results From a Cross-Sectional Study.ACR open rheumatology · 2020Article
- Effects of interaction between varus thrust and ambulatory physical activity on knee pain in individuals with knee osteoarthritis: an exploratory study with 12-month follow-up.Clinical rheumatology · 2019Article
- Measurement properties of the OARSI core set of performance-based measures for hip osteoarthritis: a prospective cohort study on reliability, construct validity and responsiveness in 90 hip osteo-arthritis patients.Acta orthopaedica · 2019Article
- Article
- Psychological health is associated with knee pain and physical function in patients with knee osteoarthritis: an exploratory cross-sectional study.BMC psychology · 2018Article
- Does pain relate with activation of quadriceps and hamstrings muscles during strengthening exercise in people with knee osteoarthritis?SpringerPlus · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The avoidance model in patients with knee and hip osteoarthritis (OA) hypothesizes that pain and psychological distress lead to avoidance of activities, and thereby to muscle weakness and activity limitations. This paper systematically reviews the scientific evidence for the validity of this avoidance model. A qualitative data synthesis was used to identify levels of evidence. Sixty studies were included. In knee OA, strong evidence was found that avoidance of activities is associated with activity limitations via muscle weakness (mediation by muscle weakness), strong evidence was found for an association between muscle weakness and activity limitations, and weak evidence was found that pain and psychological distress are associated with muscle weakness via avoidance of activities (mediation by avoidance). In hip OA, weak evidence was found for mediation by muscle weakness; and strong evidence was found for an association between muscle weakness and activity limitations. More research is needed on the consecutive associations between pain or psychological distress, avoidance of activities and muscle weakness, and to confirm causal relationships.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.