Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Pain Pract. 2021 Feb;21(2):226-261. doi: 10.1111/papr.12943. Epub 2020 Sep 5.
Alteration in somatosensory function has been linked to pain experience in individuals with joint pain. In this systematic review we aimed to establish the level of evidence of associations between psychological, social, physical activity, and sleep measures and somatosensory function that were assessed via quantitative sensory testing (QST) among individuals with joint pain.
A comprehensive literature search was conducted in 6 electronic databases from their inception to July 2019. Two reviewers independently assessed the methodological quality using a modified Quality in Prognostic Studies (QUIPS) tool and supplemented with recommendations from the Critical Appraisal and Data Extraction for Systematic Review of Prediction Modelling Studies (CHARMS) checklist and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The level of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. Data were pooled to evaluate the strength of the relationships of interest.
Seventeen studies related to joint pain were included. Pain catastrophizing, depression, anxiety, and physical activity level have been shown to have a significant (small to fair) association with several QST measures. Pressure pain threshold (PPT) is the only measure that was found to be consistently correlated with all the domains. The overall quality of evidence for all factors ranged from very low to moderate. Subgroup analysis revealed a stronger association for depression and pain catastrophizing and PPT and temporal pain summation in individuals with shoulder pain.
Psychological factors and physical activity levels are associated with somatosensory function in people with joint pain. These factors need to be adjusted when establishing predictive relationships between somatosensory function and pain outcomes in individuals with joint pain.
躯体感觉功能的改变与关节疼痛患者的疼痛体验有关。在本系统评价中，我们旨在确定关节疼痛患者通过定量感觉测试（QST）评估的心理、社会、身体活动和睡眠措施与躯体感觉功能之间关联的证据水平。
从成立到 2019 年 7 月，我们在 6 个电子数据库中进行了全面的文献检索。两位审查员使用改良的预后研究质量（QUIPS）工具独立评估方法学质量，并补充了预测模型研究的批判性评价和数据提取（CHARMS）清单以及诊断准确性研究的质量评估（QUADAS-2）工具的建议。使用推荐分级、评估、制定与评价（GRADE）系统评估证据水平。对数据进行汇总，以评估感兴趣的关系的强度。
纳入了 17 项与关节疼痛相关的研究。疼痛灾难化、抑郁、焦虑和身体活动水平已被证明与几种 QST 测量指标有显著（小到中等）关联。压力疼痛阈值（PPT）是唯一与所有领域都有一致相关性的测量指标。所有因素的总体证据质量均为低至高。亚组分析显示，在肩部疼痛患者中，抑郁和疼痛灾难化以及 PPT 和时间性疼痛总和与躯体感觉功能的相关性更强。
心理因素和身体活动水平与关节疼痛患者的躯体感觉功能有关。在建立关节疼痛患者躯体感觉功能与疼痛结果之间的预测关系时，需要调整这些因素。
