Pain sensitivity profiles in patients with advanced knee osteoarthritis
The development of patient profiles to subgroup individuals on a variety of variables has gained attention as a potential means to better inform clinical decision making. Patterns of pain sensitivity response specific to quantitative sensory testing (QST) modality have been demonstrated in healthy s...
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Published in | Pain (Amsterdam) Vol. 157; no. 9; pp. 1988 - 1999 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
01.09.2016
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Subjects | |
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Abstract | The development of patient profiles to subgroup individuals on a variety of variables has gained attention as a potential means to better inform clinical decision making. Patterns of pain sensitivity response specific to quantitative sensory testing (QST) modality have been demonstrated in healthy subjects. It has not been determined whether these patterns persist in a knee osteoarthritis population. In a sample of 218 participants, 19 QST measures along with pain, psychological factors, self-reported function, and quality of life were assessed before total knee arthroplasty. Component analysis was used to identify commonalities across the 19 QST assessments to produce standardized pain sensitivity factors. Cluster analysis then grouped individuals who exhibited similar patterns of standardized pain sensitivity component scores. The QST resulted in 4 pain sensitivity components: heat, punctate, temporal summation, and pressure. Cluster analysis resulted in 5 pain sensitivity profiles: a "low pressure pain" group, an "average pain" group, and 3 "high pain" sensitivity groups who were sensitive to different modalities (punctate, heat, and temporal summation). Pain and function differed between pain sensitivity profiles, along with sex distribution; however, no differences in osteoarthritis grade, medication use, or psychological traits were found. Residualizing QST data by age and sex resulted in similar components and pain sensitivity profiles. Furthermore, these profiles are surprisingly similar to those reported in healthy populations, which suggests that individual differences in pain sensitivity are a robust finding even in an older population with significant disease. |
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AbstractList | The development of patient profiles to subgroup individuals on a variety of variables has gained attention as a potential means to better inform clinical decision making. Patterns of pain sensitivity response specific to quantitative sensory testing (QST) modality have been demonstrated in healthy subjects. It has not been determined whether these patterns persist in a knee osteoarthritis population. In a sample of 218 participants, 19 QST measures along with pain, psychological factors, self-reported function, and quality of life were assessed before total knee arthroplasty. Component analysis was used to identify commonalities across the 19 QST assessments to produce standardized pain sensitivity factors. Cluster analysis then grouped individuals who exhibited similar patterns of standardized pain sensitivity component scores. The QST resulted in 4 pain sensitivity components: heat, punctate, temporal summation, and pressure. Cluster analysis resulted in 5 pain sensitivity profiles: a "low pressure pain" group, an "average pain" group, and 3 "high pain" sensitivity groups who were sensitive to different modalities (punctate, heat, and temporal summation). Pain and function differed between pain sensitivity profiles, along with sex distribution; however, no differences in osteoarthritis grade, medication use, or psychological traits were found. Residualizing QST data by age and sex resulted in similar components and pain sensitivity profiles. Furthermore, these profiles are surprisingly similar to those reported in healthy populations, which suggests that individual differences in pain sensitivity are a robust finding even in an older population with significant disease. Abstract The development of patient profiles to subgroup individuals on a variety of variables has gained attention as a potential means to better inform clinical decision making. Patterns of pain sensitivity response specific to quantitative sensory testing (QST) modality have been demonstrated in healthy subjects. It has not been determined whether these patterns persist in a knee osteoarthritis population. In a sample of 218 participants, 19 QST measures along with pain, psychological factors, self-reported function, and quality of life were assessed before total knee arthroplasty. Component analysis was used to identify commonalities across the 19 QST assessments to produce standardized pain sensitivity factors. Cluster analysis then grouped individuals who exhibited similar patterns of standardized pain sensitivity component scores. The QST resulted in 4 pain sensitivity components: heat, punctate, temporal summation, and pressure. Cluster analysis resulted in 5 pain sensitivity profiles: a “low pressure pain” group, an “average pain” group, and 3 “high pain” sensitivity groups who were sensitive to different modalities (punctate, heat, and temporal summation). Pain and function differed between pain sensitivity profiles, along with sex distribution; however, no differences in osteoarthritis grade, medication use, or psychological traits were found. Residualizing QST data by age and sex resulted in similar components and pain sensitivity profiles. Furthermore, these profiles are surprisingly similar to those reported in healthy populations, which suggests that individual differences in pain sensitivity are a robust finding even in an older population with significant disease. The development of patient profiles to subgroup individuals on a variety of variables has gained attention as a potential means to better inform clinical decision-making. Patterns of pain sensitivity response specific to quantitative sensory testing (QST) modality have been demonstrated in healthy subjects. It has not been determined if these patterns persist in a knee osteoarthritis population. In a sample of 218 participants, 19 QST measures along with pain, psychological factors, self-reported function, and quality of life were assessed prior to total knee arthroplasty. Component analysis was used to identify commonalities across the 19 QST assessments to produce standardized pain sensitivity factors. Cluster analysis then grouped individuals that exhibited similar patterns of standardized pain sensitivity component scores. The QST resulted in four pain sensitivity components: heat, punctate, temporal summation, and pressure. Cluster analysis resulted in five pain sensitivity profiles: a “low pressure pain” group, an “average pain” group, and three “high pain” sensitivity groups who were sensitive to different modalities (punctate, heat, and temporal summation). Pain and function differed between pain sensitivity profiles, along with sex distribution; however no differences in OA grade, medication use, or psychological traits were found. Residualizing QST data by age and sex resulted in similar components and pain sensitivity profiles. Further, these profiles are surprisingly similar to those reported in healthy populations suggesting that individual differences in pain sensitivity are a robust finding even in an older population with significant disease. |
Author | Bohr, Nicole L Zimmerman, M Bridget Callaghan, John J Herr, Keela Clark, Charles R Rakel, Barbara A Sluka, Kathleen A Frey-Law, Laura A Noiseux, Nicolas O |
AuthorAffiliation | a Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa b College of Nursing, University of Iowa c Department of Orthopedics and Rehabilitation, College of Medicine, University of Iowa d Department of Biostatistics, College of Public Health, University of Iowa |
AuthorAffiliation_xml | – name: a Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa – name: c Department of Orthopedics and Rehabilitation, College of Medicine, University of Iowa – name: d Department of Biostatistics, College of Public Health, University of Iowa – name: b College of Nursing, University of Iowa |
Author_xml | – sequence: 1 givenname: Laura A surname: Frey-Law fullname: Frey-Law, Laura A organization: Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa, Iowa City, IA, USA – sequence: 2 givenname: Nicole L surname: Bohr fullname: Bohr, Nicole L organization: College of Nursing, University of Iowa, Iowa City, IA, USA – sequence: 3 givenname: Kathleen A surname: Sluka fullname: Sluka, Kathleen A organization: Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa, Iowa City, IA, USA – sequence: 4 givenname: Keela surname: Herr fullname: Herr, Keela organization: College of Nursing, University of Iowa, Iowa City, IA, USA – sequence: 5 givenname: Charles R surname: Clark fullname: Clark, Charles R organization: Department of Orthopedics and Rehabilitation, College of Medicine, University of Iowa, Iowa City, IA, USA – sequence: 6 givenname: Nicolas O surname: Noiseux fullname: Noiseux, Nicolas O organization: Department of Orthopedics and Rehabilitation, College of Medicine, University of Iowa, Iowa City, IA, USA – sequence: 7 givenname: John J surname: Callaghan fullname: Callaghan, John J organization: Department of Orthopedics and Rehabilitation, College of Medicine, University of Iowa, Iowa City, IA, USA – sequence: 8 givenname: M Bridget surname: Zimmerman fullname: Zimmerman, M Bridget organization: Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA – sequence: 9 givenname: Barbara A surname: Rakel fullname: Rakel, Barbara A organization: College of Nursing, University of Iowa, Iowa City, IA, USA |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27152688$$D View this record in MEDLINE/PubMed |
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SubjectTerms | Adult Aged Analgesics - therapeutic use Catastrophization - etiology Catastrophization - psychology Cluster Analysis Cross-Sectional Studies Female Hot Temperature - adverse effects Humans Male Middle Aged Mood Disorders - diagnosis Mood Disorders - etiology Osteoarthritis, Knee - complications Osteoarthritis, Knee - drug therapy Osteoarthritis, Knee - psychology Pain - drug therapy Pain - etiology Pain Measurement Pain Threshold - drug effects Pain Threshold - physiology Pressure - adverse effects Quality of Life Surveys and Questionnaires Transcutaneous Electric Nerve Stimulation - adverse effects |
Title | Pain sensitivity profiles in patients with advanced knee osteoarthritis |
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