Physical performance and movement-evoked pain profiles in community-dwelling individuals at risk for knee osteoarthritis
Physical performance and movement-evoked pain profiles in community-dwelling individuals at risk for knee osteoarthritis
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DOI：
10.1016/j.exger.2017.08.026
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发表时间：
2017-11-01
影响因子：
3.9
通讯作者：
Fillingim, Roger B.
中科院分区：
文献类型：
--
作者：
Cruz-Almeida, Yenisel;Cardoso, Josue;Fillingim, Roger B.
背景：与骨关节炎相关的膝盖疼痛是导致身体功能下降的重要原因。最近的证据支持与膝盖疼痛表现相关的个体间异质性，但这些个体之间的身体表现是否存在类似的异质性此前尚未得到检验。本研究的目的是表征身体表现特征的变异性以及其表现引起的疼痛（即运动引起的疼痛）。方法：在基于社区的研究“了解骨关节炎疾病的疼痛和限制”（UPLOAD）的二次分析中，个体（n = 270）完成了功能、疼痛、心理和体感评估。使用分层聚类分析得出身体功能概况，随后将其与几种临床、心理和实验疼痛测量进行比较。结果：我们的结果支持这样的假设：在膝关节骨关节炎疼痛患者中，存在三种不同的身体功能概况，并伴有不同程度的运动诱发疼痛。即使所有三组都经历了中度至重度的自发性膝关节疼痛，那些运动诱发疼痛最严重和身体功能表现最低的个体也具有最不利的心理特征，以及机械疼痛敏感性和时间总和的增加。结论：我们的研究结果支持在身体表现任务期间评估和考虑运动诱发疼痛的需要，因为这些有可能增加临床功能和疼痛评估的价值。识别同质个体群体中驱动疼痛负担的机制将最终允许有针对性地实施与疼痛的生物心理社会模型一致的治疗。
Background: Knee pain associated with osteoarthritis is a significant contributor to decreased physical function. Recent evidence supports the inter-individual heterogeneity associated with knee pain presentation, but whether there is similar heterogeneity in physical performance among these individuals has not been previously examined. The aim of the present study was to characterize the variability in physical performance profiles and the pain evoked by their performance (i.e., movement-evoked pain).Methods: In a secondary analysis of the community-based study Understanding Pain and Limitations in Osteoarthritic Disease (UPLOAD), individuals (n = 270) completed functional, pain, psychological, and somatosensory assessments. Hierarchical cluster analysis was used to derive physical function profiles that were subsequently compared across several clinical, psychological and experimental pain measures.Results: Our results support the hypothesis that among persons with knee OA pain, three different physical performance profiles exist with varying degrees of movement-evoked pain. Even as all three groups experienced moderate to severe levels of spontaneous knee pain, those individuals with the most severe movement-evoked pain and lowest physical functional performance also had the least favorable psychological characteristics along with increased mechanical pain sensitivity and temporal summation.Conclusions: Our findings support the need for the assessment and consideration of movement-evoked pain during physical performance tasks as these have the potential to increase the value of functional and pain assessments clinically. The identification of the mechanisms driving pain burden within homogeneous groups of individuals will ultimately allow for targeted implementation of treatments consistent with a biopsychosocial model of pain.