进一步探讨膝骨关节炎患者压痛阈值与功能之间的关系。

Further exploring the relationship between pressure pain thresholds and function in knee osteoarthritis.

机构信息

Ipswich General Hospital, Queensland Health, Ipswich, QLD, 4305, Australia; University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, 4072, Australia.

Ipswich General Hospital, Queensland Health, Ipswich, QLD, 4305, Australia; The CJM Centre, Ipswich, QLD, 4305, Australia; The Mater Private Hospital, Springfield Lakes, QLD, 4300, Australia; St Andrew's Ipswich Private Hospital, Ipswich, QLD, 4305, Australia.

出版信息

Musculoskelet Sci Pract. 2022 Jun;59:102542. doi: 10.1016/j.msksp.2022.102542. Epub 2022 Mar 8.

DOI:10.1016/j.msksp.2022.102542

PMID:35287029

Abstract

BACKGROUND

Studies in Knee Osteoarthritis (KOA) have shown lowered Pressure Pain Threshold (PPT) values compared to healthy controls potentially signifying mechanical hypersensitivity, although the relevance of these findings to knee function remains unclear.

OBJECTIVE

This study further explores the relationship between PPT measures and knee function (self-reported, physical) in individuals undergoing total knee arthroplasty for advanced KOA.

DESIGN

Cross-sectional observational study.

METHODS

PPT's were recorded both local to the affected knee and at a remote site (deltoid) in 79 individuals with advanced KOA. Participants also completed self-report (Knee Society Score - functional sub-score) and physical (6-min walk test distance)) measures of knee function, as well as measures of pain-related psychological distress. Hierarchical linear regression models evaluated the relationship between the measures of function (self-report and physical measures modelled separately), PPT measures (local and remote), while accounting for demographic and psychological distress measures.

RESULTS

Higher knee PPT scores were independently associated with higher self-reported knee function (β 0.33, p < 0.02) and higher 6-min walk test distance (β 0.41, p < 0.01), although pain self-efficacy (β 0.33, p < 0.01) was also a significant variable in both models. Nearly identical findings were evident for PPT's measured at the deltoid. Overall PPT's could only explain a modest portion of variance (adjusted R = 0.15 to 0.17) in the functional measures.

CONCLUSIONS

PPT measures may be limited in their capacity to distinguish the impact of peripheral and central pain mechanisms on knee function in individuals undergoing total knee arthroplasty for advanced KOA.

摘要

背景

膝骨关节炎（KOA）的研究表明，与健康对照组相比，压力疼痛阈值（PPT）值降低，可能表明存在机械性超敏反应，尽管这些发现与膝关节功能的相关性尚不清楚。

目的

本研究进一步探讨了在接受全膝关节置换术治疗晚期 KOA 的个体中，PPT 测量值与膝关节功能（自我报告的、身体的）之间的关系。

设计

横断面观察性研究。

方法

在 79 名患有晚期 KOA 的患者中，记录了受影响膝关节局部和远处（三角肌）的 PPT。参与者还完成了膝关节功能的自我报告（膝关节协会评分-功能子评分）和身体（6 分钟步行测试距离）测量，以及与疼痛相关的心理困扰测量。分层线性回归模型评估了功能测量值（自我报告和身体测量值分别建模）、PPT 测量值（局部和远程）与疼痛自我效能感（β 0.33，p < 0.02）之间的关系，同时考虑了人口统计学和心理困扰测量值。

结果

膝关节 PPT 评分越高，与自我报告的膝关节功能越高（β 0.33，p < 0.02）和 6 分钟步行测试距离越高（β 0.41，p < 0.01）独立相关，尽管疼痛自我效能感（β 0.33，p < 0.01）也是两个模型中的一个重要变量。三角肌测量的 PPT 也有几乎相同的发现。总体而言，PPT 只能解释功能测量值中相当小的一部分方差（调整后的 R 2 = 0.15 至 0.17）。