Movement‐evoked pain is not associated with pain at rest or physical function in knee osteoarthritis

Abstract

IntroductionKnee Osteoarthritis (KOA) is mainly characterized by pain. The assessment of KOA‐related pain frequently focuses on different constructs subject to sources of bias or drawbacks, as the classical Pain at Rest (PAR). Movement‐evoked pain (MEP), recently defined as ‘pain during walking’, emerges as a differential concept, since PAR and MEP are driven by different underlying mechanisms. Given the novelty of the MEP approach, its association with PAR or with different performance‐based tests has not been studied in KOA yet.Materials and MethodsA cross sectional study was conducted. PAR was measured, alongside the performance of four mobility tests and their corresponding MEP: Timed Up and Go Test, 10‐metre Walk Test, 2‐Minute Walk Test, and 6‐Minute Walk Test. Association and agreement were explored for MEP versus PAR, while the correlation of the tests versus each corresponding MEP‐measure was assessed.ResultsNeither association nor agreement were found in the duality MEP versus PAR. Also, the lack of association between the performance of a mobility test and the perceived level of pain during the development of the test was stated.ConclusionMovement‐evoked pain is neither related to pain at rest nor to functional performance in subjects affected by knee osteoarthritis. The results from our study suggest that MEP and pain at rest measure and refer to different constructs in knee osteoarthritis. The implementation of MEP as an outcome in exercise‐therapy could enhance the tracking of results, as well as the development of tailored interventions under different conditions.SignificanceThis research elucidates the relevance of MEP, recently defined as ‘pain during walking’, through the analysis of its association with PAR and with functional performance (measured through four mobility tests) in knee osteoarthritis. The results from our study highlight the absence of either association or agreement between MEP and PAR, fact that supports and endorses the idea that both concepts measure and refer to different constructs in knee osteoarthritis.

Response to the commentary by Johnson et al. on ‘Movement‐evoked pain is not associated with pain at rest or physical function in knee osteoarthritis’

“…Dear Editor, As the authors of the manuscript entitled 'Movementevoked pain is not associated with pain at rest or physical function in knee osteoarthritis' (Lozano-Meca et al, 2024), recently published in the European Journal of Pain, we have read the recent publication of the commentary by the authors Johnson et al (2024), and we thank the authors for their wise and accurate comments on our manuscript. We hereby provide some comments and clarifications that will certainly help the potential readers and, in turn, will enhance the scientific conceptualization on movementevoked pain (MEP, hereinafter).…”