Hoteit Fatme, Feldman Debbie Ehrmann, Pollice Jasmine, Carlesso Lisa C
Physiotherapy Program, School of Rehabilitation.
Department of Social and Preventive Medicine, School of Public Health.
Physiother Can. 2021 Spring;73(2):118-128. doi: 10.3138/ptc-2019-0049.
We identified the pain and patient characteristics and physical function associated with intermittent and constant pain in people with knee osteoarthritis (OA). The search strategy was conducted in MEDLINE, CINAHL, Embase, SPORTDiscus, Cochrane, and the Physiotherapy Evidence Database for articles published up to October 2018. We included observational studies, randomized controlled trials, reviews, qualitative studies, and case reports in English and French of adults with knee OA. Articles were screened by two independent reviewers, and disagreements were resolved by a third researcher. Our search yielded 1,232 articles, and 4 articles were included in the review. Constant pain was related to limitations in daily activities, a higher Kellgren and Lawrence grade, a higher prevalence of comorbidities, and symptomatic knee OA and depressive symptoms. Intermittent pain was associated with limitations in high-impact activities, but greater time spent in moderate activities was reported. The evidence is contradictory as to whether intermittent or constant pain has a greater average severity. There was limited evidence available to determine the association of pain and patient characteristics and physical function with constant and intermittent pain in people with knee OA. Future research will help improve our understanding of these two pain patterns by examining their associations across a variety of pain and functional outcomes in people with knee OA.
我们确定了膝关节骨关节炎(OA)患者间歇性和持续性疼痛相关的疼痛、患者特征及身体功能。检索策略在MEDLINE、CINAHL、Embase、SPORTDiscus、Cochrane以及物理治疗证据数据库中进行,以查找截至2018年10月发表的文章。我们纳入了有关成年膝关节OA患者的英文和法文观察性研究、随机对照试验、综述、定性研究及病例报告。文章由两名独立评审员筛选,分歧由第三名研究人员解决。我们的检索共得到1232篇文章,其中4篇纳入本综述。持续性疼痛与日常活动受限、较高的凯尔格伦和劳伦斯分级、较高的合并症患病率、有症状的膝关节OA及抑郁症状有关。间歇性疼痛与高强度活动受限有关,但据报告在中等强度活动中花费的时间更多。关于间歇性疼痛还是持续性疼痛平均严重程度更高,证据存在矛盾。关于膝关节OA患者疼痛及患者特征和身体功能与持续性和间歇性疼痛之间的关联,现有证据有限。未来的研究将通过检查膝关节OA患者各种疼痛和功能结局之间的关联,有助于提高我们对这两种疼痛模式的理解。