Psychosocial Prognostic Factors in the Knee Osteoarthritis Rehabilitation: A Mixed Methods Longitudinal Study 

Project IDRRG4-2001
PartnerKhoo Teck Puat Hospital, St Luke Eldercare, Tan Tock Seng Hospital, Woodlands Health Campus
FocusPrecision Rehabilitation, Musculoskeletal, Knee Osteoarthritis
Clinical PIDr Bryan TAN Yijia
Consultant, Orthopaedic Surgery, Woodlands Health Campus
Technical PI
Assoc Prof Konstantina Griva
Associate Professor, Health Psychology/Behavioural Medicine,
Lee Kong Chian School of Medicine
ResearchersDr Yang Su-Yin, Principal Psychologist, Tan Tock Seng Hospital
A/Prof Jiang Nan, Assistant Professor, Department of Social Work,
National University of Singapore
Ms Denise Tan, Executive Architect, MOH Office of Healthcare Transformation (MOHT)


The challenge

Knee osteoarthritis (KOA) is one of the largest and fastest growing cause of pain and disability in the elderly. Limitations of the traditional biomedical approach (medication, surgery, physiotherapy) is increasingly evident with (1) dis-concordance between objective clinical parameters and patient-reported outcomes, and (2) limited treatment (including surgery) effectiveness. Holistic understanding of KOA through a biopsychosocial approach is needed.    


The proposed solution

Our study proposal aims to bridge this critical gap in the literature by, 1) Identifying and contextualizing the key psychosocial factors for OA knees in our local population; and 2) Identifying the prognostic ability of these key psychosocial factors in determining a patient’s outcome through a longitudinal prospective cohort study. Using a phased approach appropriate for the development of intervention, the research plan will be adopting a sequential exploratory mixed method (Qualitative + Quantitative) approach. WS1 (Qualitative) – Mapping the needs and scoping the key psychosocial factors in patients with knee OA through semi-structured interviews. WS2 (Quantitative) – Identify the key psychosocial factors that prognosticate clinical and functional outcomes and response to rehabilitation care in knee OA through a longitudinal prospective cohort study.

Results from this study will augment the biomechanical-based RRIS Ability dataset to allow for a more comprehensive and holistic understanding of OA knee through the biopsychosocial modal. Including these key prognostic psychosocial factors as part of the variables that Ability collects from all its participants will facilitate more accurate interpretation of the Ability data and its relationship with clinical outcomes. Looking forward towards clinical implementation, results of this study can be applied in 3 main areas. (1) Targeted Data Driven Rehabilitation at a Program Development (2) Impetus for larger Population-wide Musculoskeletal change studies (3) Influencing change at a System Level in collaboration with national bodies such as the Ministry of Healthcare Transformation.