Lluch Girbés Enrique, Dueñas Lirios, Barbero Marco, Falla Deborah, Baert Isabel A C, Meeus Mira, Sánchez-Frutos José, Aguilella Luis, Nijs Jo
E. Lluch Girbés, PT, PhD, Department of Physical Therapy, University of Valencia, Gascó Oliag 5, 46010 Valencia, Spain; Departments of Human Physiology and Rehabilitation Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussels, Brussels, Belgium; and Pain in Motion International Research Group, Brussels, Belgium.
L. Dueñas, PT, PhD, Department of Physical Therapy, University of Valencia.
Phys Ther. 2016 Aug;96(8):1196-207. doi: 10.2522/ptj.20150492. Epub 2016 Mar 3.
Expanded distribution of pain is considered a sign of central sensitization (CS). The relationship between recording of symptoms and CS in people with knee osteoarthritis (OA) has been poorly investigated.
The aim of this study was to examine whether the area of pain assessed using pain drawings relates to CS and clinical symptoms in people with knee OA.
This was a cross-sectional study.
Fifty-three people with knee OA scheduled to undergo primary total knee arthroplasty were studied. All participants completed pain drawings using a novel digital device, completed self-administration questionnaires, and were assessed by quantitative sensory testing. Pain frequency maps were generated separately for women and men. Spearman correlation coefficients were computed to reveal possible correlations between the area of pain and quantitative sensory testing and clinical symptoms.
Pain frequency maps revealed enlarged areas of pain, especially in women. Enlarged areas of pain were associated with higher knee pain severity (rs=.325, P<.05) and stiffness (rs=.341, P<.05), lower pressure pain thresholds at the knee (rs=-.306, P<.05) and epicondyle (rs=-.308, P<.05), and higher scores with the Central Sensitization Inventory (rs=.456, P<.01). No significant associations were observed between the area of pain and the remaining clinical symptoms and measures of CS.
Firm conclusions about the predictive role of pain drawings cannot be drawn. Further evaluation of the reliability and validity of pain area extracted from pain drawings in people with knee OA is needed.
Expanded distribution of pain was correlated with some measures of CS in individuals with knee OA. Pain drawings may constitute an easy way for the early identification of CS in people with knee OA, but further research is needed.
疼痛分布范围扩大被认为是中枢敏化（CS）的一个标志。对于膝关节骨关节炎（OA）患者，症状记录与CS之间的关系尚未得到充分研究。
本研究旨在探讨使用疼痛图评估的疼痛区域是否与膝关节OA患者的CS及临床症状相关。
这是一项横断面研究。
对53例计划接受初次全膝关节置换术的膝关节OA患者进行研究。所有参与者使用一种新型数字设备完成疼痛图，完成自我管理问卷，并接受定量感觉测试。分别为女性和男性生成疼痛频率图。计算Spearman相关系数，以揭示疼痛区域与定量感觉测试及临床症状之间可能的相关性。
疼痛频率图显示疼痛区域扩大，尤其是在女性中。疼痛区域扩大与更高的膝关节疼痛严重程度（rs = 0.325，P < 0.05）和僵硬程度（rs = 0.341，P < 0.05）、更低的膝关节（rs = -0.306，P < 0.05）和上髁（rs = -0.308，P < 0.05）压痛阈值以及更高的中枢敏化量表得分（rs = 0.456，P < 0.01）相关。未观察到疼痛区域与其余临床症状及CS测量指标之间存在显著关联。
无法就疼痛图的预测作用得出确凿结论。需要进一步评估从膝关节OA患者疼痛图中提取的疼痛区域的可靠性和有效性。
在膝关节OA患者中，疼痛分布范围扩大与CS的一些测量指标相关。疼痛图可能是早期识别膝关节OA患者CS的一种简便方法，但仍需进一步研究。
