Cross-cultural adaptation and validation of the Korean version of the Central Sensitization Inventory in patients undergoing total knee arthroplasty for knee osteoarthritis

Abstract

The purpose of this study was to establish a Korean version of the Central Sensitization Inventory (CSI-K) for Korean-speaking patients facing total knee arthroplasty (TKA) for knee osteoarthritis (OA) and to investigate the psychometric characteristics of the CSI-K. We recruited a total of 269 patients with knee OA who were scheduled to undergo TKA for the study. CSI-K and pain-related outcomes, including the pain visual analog scale (VAS) and the Western Ontario and McMaster Universities OA Index (WOMAC) pain sub-scores, were measured. Since central sensitization (CS) is closely related to the quality of life (QOL) and limited functionality as well as pain, the patient’s function was measured using the WOMAC function sub-scores, and QOL was measured using the EuroQol five-dimension test (EQ-5D). Reliability and validity were evaluated. Exploratory factor analysis (EFA) was conducted to begin the data reduction to validate the existing questionnaire translation. The internal consistency was excellent, with a Cronbach's alpha of 0.941. The test-retest reliability was acceptable-to-excellent with an ICC of 0.888. As expected, the CSI scores correlated strongly with the WOMAC pain scores (r = 0.524, p < 0.001) and moderately with the pain VAS (r = 0.496, p < 0.001), the WOMAC function (r = 0.408, p < 0.001), and the EQ-5D scores (r = 0.437, p < 0.001). EFA resulted in a six-factor model. The findings demonstrate that the CSI was successfully trans-culturally adapted into a simplified Korean version (CSI-K) that was reliable and valid for Korean-speaking patients who awaiting TKA for knee OA.

Central Sensitization and Neuropathic Pain Cumulatively Affect Patients Reporting Inferior Outcomes Following Total Knee Arthroplasty

“…In the present study, the prevalences of central sensitization and neuropathic pain were 38.9% and 28.5%, respectively. These results are similar to those in previous studies 11,13,16-21 .…”

“…Central sensitization was confirmed with use of the Central Sensitization Inventory (CSI) 30 , a newly developed and validated self-reported questionnaire for evaluating the severity of central sensitization 18 . This questionnaire consists of 25 items that assess somatic and emotional symptoms.…”

“…Each item is rated on a 5-point Likert scale ranging from 0 to 4 (0 = never, 1 = rarely, 2 = sometimes, 3 = often, 4 = always). The total score ranges from 0 to 100, with 0 being the least severe and 100 being the most severe 17,18 . The accepted cutoff value for confirming central sensitization is a CSI score of ‡40 as suggested by Neblett et al 31 .…”

Neuropathic-like symptoms and central sensitization related signs and symptoms negatively affect the functional performance of patients with knee osteoarthritis – a cross-sectional study

“…In the current study, participants with knee OA and CS had greater self-perception functional impairment, confirming prior research showing that CSI scores correlated strongly with the WOMAC pain scores and moderately with the WOMAC function in patients undergoing total knee arthroplasty for knee OA [ 44 ]. In agreement, many patients with knee OA continued to experience CS after knee arthroplasty [ 45 ].…”

Centrally sensitized patients undergoing total knee arthroplasty have higher expectations than do non-centrally sensitized patients

“…Fourth, although the HSS-KRES is a validated tool for the evaluation of expectations, the inclusion of psychological parameters such as the 36-item Short Form Health Survey (SF 36) may have yielded more meaningful results [26]. Fifth, although the Korean version of CSI was validated, [9] the Korean version of the HSS-KRES has yet to be validated. Among the Asian languages, the Chinese version of HSS-KRES was validated [33].…”