From acute to persistent low back pain: a longitudinal investigation of somatosensory changes using quantitative sensory testing—an exploratory study

Marcuzzi, A.; Wrigley, Paul J.; Dean, Catherine M.; Graham, Petra L.; Hush, Julia M.

doi:10.1097/pr9.0000000000000641

Cited by 45 publications

(37 citation statements)

References 59 publications

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“…At T2, NRS score ≤1 will be classified as recovered LBP and NRS score ≥2 will be classified as chronic LBP. Similar classification has been reported previously 45 46…”

Section: Methodssupporting

confidence: 92%

Do sensorimotor cortex activity, an individual’s capacity for neuroplasticity, and psychological features during an episode of acute low back pain predict outcome at 6 months: a protocol for an Australian, multisite prospective, longitudinal cohort study

et al. 2019

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IntroductionLow back pain (LBP) is the leading cause of disability worldwide, with prevalence doubling in the past 14 years. To date, prognostic screening tools display poor discrimination and offer no net benefit of screening over and above a ‘treat all’ approach. Characteristics of the primary sensory (S1) and motor (M1) cortices may predict the development of chronic LBP, yet the prognostic potential of these variables remains unknown. The Understanding persistent Pain Where it ResiDes (UPWaRD) study aims to determine whether sensorimotor cortex activity, an individual’s capacity for plasticity and psychosocial factors in the acute stage of pain, predict LBP outcome at 6 months. This paper describes the methods and analysis plan for the development of the prediction model.Methods and analysisThe study uses a multicentre prospective longitudinal cohort design with 6-month follow-up. 120 participants, aged 18 years or older, experiencing an acute episode of LBP (less than 6 weeks duration) will be included. Primary outcomes are pain and disability.Ethics and disseminationEthical approval has been obtained from Western Sydney University Human Research Ethics Committee (H10465) and from Neuroscience Research Australia (SSA: 16/002). Dissemination will occur through presentations at national and international conferences and publications in international peer-reviewed journals.Trial registration numberACTRN12619000002189; Pre-results.

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“…At T2, NRS score ≤1 will be classified as recovered LBP and NRS score ≥2 will be classified as chronic LBP. Similar classification has been reported previously 45 46…”

Section: Methodssupporting

confidence: 92%

Do sensorimotor cortex activity, an individual’s capacity for neuroplasticity, and psychological features during an episode of acute low back pain predict outcome at 6 months: a protocol for an Australian, multisite prospective, longitudinal cohort study

et al. 2019

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“…Different psychophysical measures of pain sensitivity have been linked to neurophysiological indicators of sensitization risk factors for pain‐related outcomes 18,24–31 . Specifically, pressure pain threshold (PPT) is a reliable, valid, and clinically convenient psychophysical measure for chronic musculoskeletal pain assessment and commonly regarded as a generalized measure of nervous system sensitivity aligned with pain‐related outcomes 24,28,32–38 …”

Section: Introductionmentioning

confidence: 99%

A Cumulative Impact of Psychological and Sensitization Risk Factors on Pain‐Related Outcomes

et al. 2021

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Objective Risk constructs based on psychological risk factors (eg, pain catastrophizing, PC) and sensitization risk factors (eg, pressure pain threshold, PPT) are important in research and clinical practice. Most research looks at individual constructs but does not consider how different constructs might interact within the same individual. An evaluation of the cumulative impact of psychological and sensitization risk factors on pain‐related outcomes may help guide us in the risk assessment of patients with pain conditions. The aim of this study is to evaluate the cumulative impact of these psychological (PC) and sensitization (PPT) risk factors on pain‐related outcomes (activity avoidance, pain severity, and disability) considering covariates. Methods We included 109 participants (70.60% women; mean ± SD age 53.6 ± 12.3 years) with chronic musculoskeletal pain for data analysis, who completed all measures of this study. Participants completed a single testing session that included measures of risk factors (PC and PPT) and pain‐related outcomes (self‐reported avoidance, functional avoidance, disability, and pain severity). Subgroups were constructed by dichotomizing of PC and PPT scores, resulting in four groups: (1) low catastrophizing and low sensitivity (N = 26), (2) high catastrophizing and low sensitivity (N = 27), (3) low catastrophizing and high sensitivity (N = 25), and (4) high catastrophizing and high sensitivity (N = 31). Results One‐way analysis of variance (ANOVA) revealed significant group differences (P < 0.05, η2 = 0.08 to 0.14) in all outcomes of this study (except functional avoidance), and post hoc analysis indicated the significant differences are between group 1 and 4. A cumulative impact is reflected by large effect sizes between group 1 and 4 (d = 0.8 to 1). The group 2 and 3 (one risk dimension groups: either high‐PC or high‐PPT) represent 47% of the total participants. Conclusions The study suggests both higher level of PC and pressure sensitivity have a cumulative impact on risk screening for pain‐related outcomes, considering gender in functional avoidance (task‐related outcome). A clinical presentation with high‐PC (one dimension of risk) is not associated with high‐PPT (another dimension of risk). This finding has important clinical and theoretical implications.

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“…This includes quantitative sensory testing (QST), which quantifies individual pain perception in response to controlled noxious stimuli [ 13 ]. Such experimental tests can differentiate LBP patients from healthy controls, and perturbations in pain modulation (sensitization of the somatosensory system e.g., leading to decreases of pain thresholds) appear to manifest in the sub-acute stage as pain turns persistent [ 14 ]. It is of interest that these perturbations, in a commonly noted mechanical syndrome such as LBP, extend beyond deep muscle mechanical pain sensitivity, i.e., pressure pain, to superficial skin measures, e.g., heat pain.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional analysis of persistent low back pain, using correlations between lumbar stiffness, pressure pain threshold, and heat pain threshold

et al. 2021

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Introduction Little is known about the underlying biomechanical cause of low back pain (LBP). Recently, technological advances have made it possible to quantify biomechanical and neurophysiological measurements, potentially relevant factors in understanding LBP etiology. However, few studies have explored the relation between these factors. This study aims to quantify the correlation between biomechanical and neurophysiological outcomes in non-specific LBP and examine whether these correlations differ when considered regionally vs. segmentally. Methods This is a secondary cross-sectional analysis of 132 participants with persistent non-specific LBP. Biomechanical data included spinal stiffness (global stiffness) measured by a rolling indenter. Neurophysiological data included pain sensitivity (pressure pain threshold and heat pain threshold) measured by a pressure algometer and a thermode. Correlations were tested using Pearson’s product-moment correlation or Spearman’s rank correlation as appropriate. The association between these outcomes and the segmental level was tested using ANOVA with post-hoc Tukey corrected comparisons. Results A moderate positive correlation was found between spinal stiffness and pressure pain threshold, i.e., high degrees of stiffness were associated with high pressure pain thresholds. The correlation between spinal stiffness and heat pain threshold was poor and not statistically significant. Aside from a statistically significant minor association between the lower and the upper lumbar segments and stiffness, no other segmental relation was shown. Conclusions The moderate correlation between spinal stiffness and mechanical pain sensitivity was the opposite of expected, meaning higher degrees of stiffness was associated with higher pressure pain thresholds. No clinically relevant segmental association existed.

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From acute to persistent low back pain: a longitudinal investigation of somatosensory changes using quantitative sensory testing—an exploratory study

Cited by 45 publications

References 59 publications

Do sensorimotor cortex activity, an individual’s capacity for neuroplasticity, and psychological features during an episode of acute low back pain predict outcome at 6 months: a protocol for an Australian, multisite prospective, longitudinal cohort study

Do sensorimotor cortex activity, an individual’s capacity for neuroplasticity, and psychological features during an episode of acute low back pain predict outcome at 6 months: a protocol for an Australian, multisite prospective, longitudinal cohort study

A Cumulative Impact of Psychological and Sensitization Risk Factors on Pain‐Related Outcomes

A cross-sectional analysis of persistent low back pain, using correlations between lumbar stiffness, pressure pain threshold, and heat pain threshold

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