Pain Centre Versus Arthritis, University of Nottingham, UK; Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, UK.
Pain Centre Versus Arthritis, University of Nottingham, UK; School of Psychology, University of Nottingham, UK.
Osteoarthritis Cartilage. 2021 Jun;29(6):802-814. doi: 10.1016/j.joca.2021.02.562. Epub 2021 Feb 20.
Pain is the prevailing symptom of knee osteoarthritis. Central sensitisation creates discordance between pain and joint pathology. We previously reported a Central Pain Mechanisms trait derived from eight discrete characteristics: Neuropathic-like pain, Fatigue, Cognitive-impact, Catastrophising, Anxiety, Sleep disturbance, Depression, and Pain distribution. We here validate and show that an 8-item questionnaire, Central Aspects of Pain in the Knee (CAP-Knee) is associated both with sensory- and affective- components of knee pain severity.
Participants with knee pain were recruited from the Investigating Musculoskeletal Health and Wellbeing study in the East Midlands, UK. CAP-Knee items were refined following cognitive interviews. Psychometric properties were assessed in 250 participants using Rasch-, and factor-analysis, and Cronbach's alpha. Intra-class correlation coefficients tested repeatability. Associations between CAP-Knee and McGill Pain questionnaire pain severity scores were assessed using linear regression.
CAP-Knee targeted the knee pain sample well. Cognitive interviews indicated that participants interpreted CAP-Knee items in diverse ways, which aligned to their intended meanings. Fit to the Rasch model was optimised by rescoring each item, producing a summated score from 0 to 16. Internal consistency was acceptable (Cronbach's alpha = 0.74) and test-retest reliability was excellent (ICC = 0.91). Each CAP-Knee item contributed uniquely to one discrete 'Central Mechanisms trait' factor. High CAP-Knee scores associated with worse overall knee pain intensity, and with each of sensory- and affective- McGill Pain Questionnaire scores.
CAP-Knee is a simple and valid self-report questionnaire, which measures a single 'Central Mechanisms' trait, and may help identify and target centrally-acting treatments aiming to reduce the burden of knee pain.
疼痛是膝骨关节炎的主要症状。中枢敏化导致疼痛与关节病理之间存在差异。我们之前报道了一种源自 8 个离散特征的中枢疼痛机制特征：神经病理性疼痛、疲劳、认知影响、灾难化、焦虑、睡眠障碍、抑郁和疼痛分布。我们在此验证并表明，一个 8 项问卷，即膝关节中央疼痛特征（CAP-Knee）与膝关节疼痛严重程度的感觉和情感成分都相关。
在英国东米德兰兹的调查肌肉骨骼健康和幸福感研究中招募了膝关节疼痛的参与者。在进行认知访谈后，对 CAP-Knee 项目进行了改进。使用 Rasch 和因子分析以及 Cronbach's alpha 评估了 250 名参与者的心理测量特性。使用组内相关系数测试了重复性。使用线性回归评估了 CAP-Knee 与麦吉尔疼痛问卷疼痛严重程度评分之间的相关性。
CAP-Knee 很好地针对膝关节疼痛样本。认知访谈表明，参与者以不同的方式解释 CAP-Knee 项目，这与他们的预期含义相符。通过重新评分每个项目，将每个项目的分数从 0 到 16 进行优化，从而优化了 Rasch 模型的拟合度。内部一致性可接受（Cronbach's alpha=0.74），测试重测信度极佳（ICC=0.91）。每个 CAP-Knee 项目都对一个离散的“中枢机制特征”因素有独特的贡献。高 CAP-Knee 评分与总体膝关节疼痛强度增加有关，与感觉和情感 McGill 疼痛问卷评分均相关。
CAP-Knee 是一种简单而有效的自我报告问卷，可测量单一的“中枢机制”特征，可能有助于识别和针对旨在减轻膝关节疼痛负担的中枢作用治疗方法。
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