Özgül Sinem, Öztürk Özgül, Gülkesen Arif
Fırat University Faculty of Medical Sciences, Department of Physical Medicine and Rehabilitation, Elazığ, Turkey; Okan University Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, İstanbul, Turkey.
Acıbadem Mehmet Ali Aydınlar University, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
Musculoskelet Sci Pract. 2023 Apr;64:102747. doi: 10.1016/j.msksp.2023.102747. Epub 2023 Mar 11.
Left/right judgment task (LRJT) performance and tactile acuity are impaired in chronic pain conditions, however, evidence is limited for knee osteoarthritis (OA).
To compare LRJT performance and the two-point discrimination threshold (TPDT) of chronic knee OA patients with asymptomatic knee and pain-free controls.
Cross-sectional study.
Fifty knee OA patients and 50 age and gender-matched pain-free controls were assessed using the Recognize® application by displaying knee images and a digital caliper for the TPDT of the medial and lateral knee joint line.
TPDTs over the lateral joint line in symptomatic (mean difference [MD]: 13.59 mm; 95% confidence interval [CI]: 8.72, 18.46; d = 1.40) and asymptomatic knee (MD: 10.15 mm; 95% CI: 5.08, 15.22; d = 0.99) were significantly increased compared to pain-free controls. Similarly, TPDTs of the medial joint line were significantly increased in symptomatic (MD: 12.19 mm; 95% CI: 7.59, 16.79; d = 1.31) and asymptomatic knee (MD: 7.64 mm; 95% CI: 3.64, 11.64; d = 1.31) compared to pain-free controls. Patients with knee OA were less accurate (MD: 7.80%; 95% CI: 15.32, -0.27; d = 0.52) recognizing images of their symptomatic knee. No correlation was found between pain severity, pain duration, LRJT performance, and TPDTs. Post-hoc analysis revealed no differences in LRJT and TPDTs between patients with and without clinically relevant symptoms of central sensitization.
Chronic knee OA is associated with increased TPDT for medial and lateral knee joint lines and decreased recognition accuracy performance which should be considered during treatment process.
在慢性疼痛状态下，左右判断任务（LRJT）的表现和触觉敏锐度会受损，然而，关于膝关节骨关节炎（OA）的证据有限。
比较慢性膝关节OA患者与无症状膝关节者及无疼痛对照组的LRJT表现和两点辨别阈值（TPDT）。
横断面研究。
使用Recognize®应用程序，通过展示膝关节图像和数字卡尺测量膝关节内外侧关节线的TPDT，对50例膝关节OA患者和50例年龄及性别匹配的无疼痛对照组进行评估。
与无疼痛对照组相比，有症状膝关节（平均差值[MD]：13.59毫米；95%置信区间[CI]：8.72，18.46；d = 1.40）和无症状膝关节（MD：10.15毫米；95% CI：5.08，15.22；d = 0.99）外侧关节线的TPDT显著增加。同样，与无疼痛对照组相比，有症状膝关节（MD：12.19毫米；95% CI：7.59，16.79；d = 1.31）和无症状膝关节（MD：7.64毫米；95% CI：3.64，11.64；d = 1.31）内侧关节线的TPDT也显著增加。膝关节OA患者识别其有症状膝关节图像的准确性较低（MD：7.80%；95% CI：15.32，-0.27；d = 0.52）。未发现疼痛严重程度、疼痛持续时间、LRJT表现和TPDT之间存在相关性。事后分析显示，有和无中枢敏化临床相关症状的患者在LRJT和TPDT方面无差异。
慢性膝关节OA与膝关节内外侧关节线的TPDT增加及识别准确性降低有关，在治疗过程中应予以考虑。
