The Role of Rumination and Worry in Pain and Functional Limitation in Knee Osteoarthritis

NCT07609056 | Active Not Recruiting

• 1 other identifier: W-RUM-OA-2026
• Study Type: observational
• Target: 103
• Locations: 1 country
• Sites: 1

Brief Summary

Knee osteoarthritis is a common degenerative joint disease in which pain severity often does not fully correspond with radiographic disease severity. Psychological processes such as rumination and worry may contribute to differences in pain perception and functional limitation among patients with similar structural disease burden. The purpose of this observational study is to investigate the relationships between radiographic osteoarthritis severity, pain severity, functional limitation, rumination, and worry in patients with knee osteoarthritis. Radiographic severity will be assessed using the Kellgren-Lawrence classification. Participants will complete the Penn State Worry Questionnaire, the Ruminative Thought Style Questionnaire, the Visual Analog Scale (VAS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The study aims to determine whether rumination and worry are associated with pain severity and functional impairment independently of radiographic osteoarthritis severity. Findings from this study may improve understanding of the biopsychosocial mechanisms underlying pain perception in knee osteoarthritis and may support the development of multidisciplinary treatment approaches that incorporate psychological factors into patient assessment and management.

Conditions

Osteo Arthritis Knee; Worries; Pain or Disability; Rumination

Keywords

Knee Osteoarthritis; Rumination; Worry; WOMAC; Pain; Kellgren-Lawrence

Outcome Measures

Primary Outcomes (1)

• Ruminative Thought Style Questionnaire Score in Patients with Knee Osteoarthritis

  Rumination severity will be assessed using the Ruminative Thought Style Questionnaire, a 20-item self-report scale evaluating repetitive and difficult-to-control negative thinking patterns. Each item is scored on a 1-7 Likert scale, with higher total scores indicating greater rumination severity.

  Baseline assessment at study enrollment

Secondary Outcomes (4)

• Visual Analog Scale (VAS) Pain Score

  Baseline assessment at study enrollment

• Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Total Score

  Baseline assessment at study enrollment

• Penn State Worry Questionnaire Score

  Baseline assessment at study enrollment

• Kellgren-Lawrence Radiographic Grade

  Baseline assessment at study enrollment

Study Arms (1)

Patients With Knee Osteoarthritis

Participants presenting with knee pain who are diagnosed with knee osteoarthritis based on radiographic evaluation will be included in this observational study. Radiographic severity will be classified according to the Kellgren-Lawrence grading system. Participants will complete questionnaires assessing worry, rumination, pain severity, and functional limitation, including the Penn State Worry Questionnaire, Ruminative Thought Style Questionnaire, Visual Analog Scale (VAS), and WOMAC.

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adults presenting with knee pain to the orthopedic and traumatology outpatient clinic who are diagnosed with knee osteoarthritis based on radiographic evaluation will be enrolled in this observational study. Participants will undergo assessment of radiographic osteoarthritis severity, pain severity, functional limitation, rumination, and worry using validated clinical and psychological questionnaires.

You may qualify if:

• Age 18 years or older
• Diagnosis of knee osteoarthritis confirmed by radiographic evaluation
• Ability and willingness to provide informed consent
• Ability to complete study questionnaires

You may not qualify if:

• Presence of comorbid conditions that may cause knee pain other than osteoarthritis
• Analgesic medication use within the previous week
• Cognitive impairment or psychiatric conditions that may interfere with questionnaire completion, including dementia, intellectual disability, or psychotic disorders

Sponsors & Collaborators

• Fatih Sultan Mehmet Training and Research Hospital: lead

Study Sites (1)

Fatih Sultan Mehmet Training and Research Hospital

Istanbul, Atasehir, 34752, Turkey (Türkiye)

Location

Related Publications (3)

• Meyer TJ, Miller ML, Metzger RL, Borkovec TD. Development and validation of the Penn State Worry Questionnaire. Behav Res Ther. 1990;28(6):487-95. doi: 10.1016/0005-7967(90)90135-6.

  PMID: 2076086 BACKGROUND

• Nwankwo VC, Jiranek WA, Green CL, Allen KD, George SZ, Bettger JP. Resilience and pain catastrophizing among patients with total knee arthroplasty: a cohort study to examine psychological constructs as predictors of post-operative outcomes. Health Qual Life Outcomes. 2021 May 1;19(1):136. doi: 10.1186/s12955-021-01772-2.

  PMID: 33933091 BACKGROUND

• Panwar P, Chaurasia S, Gangrade J, Bilandi A. Early diagnosis of knee osteoarthritis severity using vision transformer. BMC Musculoskelet Disord. 2025 Sep 30;26(1):884. doi: 10.1186/s12891-025-09137-2.

  PMID: 41029374 BACKGROUND

Related Links

• Karatepe HT, Yavuz FK, Turkcan A. Validity and reliability of the Turkish version of the Ruminative Thought Style Questionnaire. Psychiatry Clin Psychopharmacol. \[Internet\]. 2021 Feb. 22 \[cited 2026 May 20\];23(3):231-4.
• Boysan M, Keskin S, Beşiroğlu L. Assessment of hierarchical factor structure, reliability and validity of penn state worry questionnaire turkish version. Psychiatry Clin Psychopharmacol. \[Internet\]. 2021 Mar. 4 \[cited 2026 May 20\];18(3):174-82.

MeSH Terms

Conditions

Pain; Rumination Syndrome; Osteoarthritis, Knee

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Gastrointestinal Diseases; Digestive System Diseases; Feeding and Eating Disorders; Mental Disorders; Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Olcay Yavuz, MD, Principal Investigator

Study Record Dates

• First Submitted: May 19, 2026
• First Posted: May 27, 2026
• Study Start: March 1, 2026
• Primary Completion: May 20, 2026
• Study Completion: June 1, 2026
• Last Updated: May 29, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)