Psychosocial Adaptation in a Sensor-Augmented Telerehabilitation Program for Knee Osteoarthritis: A Post Hoc Analysis...

Background: Psychosocial adaptation during telerehabilitation for knee osteoarthritis (OA) is not well understood. Objective: To explore associations among self-efficacy, anxiety, depressive symptoms, and kinesiophobia during sensor-augmented telerehabilitation. Methods: This exploratory post hoc secondary analysis included 21 participants from the telerehabilitation arm of the KneE-PAD randomized controlled trial. Psychosocial outcomes were assessed before and after intervention using the Arthritis Self-Efficacy Scale (ASES), Hospital Anxiety and Depression Scale (HADS), and Tampa Scale for Kinesiophobia (TSK). Within-group changes were assessed using paired analyses with Holm-Bonferroni adjustment, associations among change scores were examined using correlation analyses with multiplicity correction, and exploratory regression models were fitted without multiplicity adjustment. Results: Improvement in pain-related self-efficacy was associated with reduced anxiety (ρ = -0.71, adjusted p = 0.006). No other correlation remained statistically significant after Holm-Bonferroni correction, and the regression findings were interpreted as exploratory. Conclusions: Psychosocial changes during sensor-augmented telerehabilitation were characterized by a strong association between improvement in pain-related self-efficacy and reduction in anxiety. These exploratory findings require confirmation in larger, prospectively designed studies. Trial Registration: ClinicalTrials.gov Identifier: NCT06416332.