Nervous System Sensitization as a Predictor of Outcome in the Treatment of Peripheral Musculoskeletal Conditions: A Systematic Review

O’Leary, Helen; Smart, Keith; Moloney, Niamh; Doody, Catherine

doi:10.1111/papr.12484

Cited by 59 publications

(43 citation statements)

References 76 publications

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“…However, current results are also contrary to those previously observed in subjects with whiplash‐associated disorders, where patients exhibiting augmented central pain processing obtained worse clinical outcomes than those patients exhibiting localized mechanical hyperalgesia after participating in an exercise treatment program . In addition, the lack of a prognostic role of central sensitization is also contrary to what is seen in musculoskeletal pain conditions . It is possible that the role of central sensitization in neuropathic conditions would be different than in musculoskeletal pain conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Most trials investigating prognostic factors of outcomes following conservative treatments have focused on local treatments such as corticosteroid injections . A recent review found preliminary evidence suggesting that central sensitization in musculoskeletal pain conditions is associated with poorer outcomes in response to either surgical or conservative treatment . Although there is evidence supporting the presence of central sensitization in CTS, studies addressing the relationship between sensitization and treatment outcomes are lacking.…”

Section: Introductionmentioning

confidence: 99%

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Influence of Clinical, Psychological, and Psychophysical Variables on Long‐term Treatment Outcomes in Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial

Fernández‐de‐las‐Peñas

de-la-Llave-Rincón

Cescon

et al. 2019

Pain Practice

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Objective To assess the influence of clinical, psychological, and psychophysical variables on long‐term clinical outcomes after the application of either physical therapy or surgery in women presenting with carpal tunnel syndrome (CTS). Methods A secondary analysis of a randomized trial investigating the efficacy of manual therapy including desensitization maneuvers of the central nervous system against surgery in 120 women with CTS was performed. Clinical outcomes including pain intensity, function, or symptom severity were assessed at 6 and 12 months post‐intervention. Participants completed at baseline several clinical (pain intensity, function, and symptom severity), psychological (depression), and psychophysical (pressure pain thresholds and pain extent) variables, which were included as predictors. Multiple regression analyses were conducted to assess the relationship between baseline variables and clinical outcomes at 6 and 12 months post‐intervention. Results The regression models indicated that higher scores of each clinical outcome (ie, intensity of pain or symptom severity) at baseline predicted better outcomes at 6 and 12 months post‐intervention (from 15% to 65% of variance) in both groups. Lower pressure pain thresholds over the carpal tunnel at baseline predicted poorer clinical outcomes at 6 and 12 months post‐intervention (from 5% to 20% of variance) in the physical therapy group, whereas higher depressive symptoms at baseline contributed to poorer outcomes at 6 and 12 months post‐intervention (from 5% to 15% of the variance) within the surgery group. Conclusion This study found that baseline localized pressure pain sensitivity and depression were predictive of long‐term clinical outcomes in women with CTS following physical therapy or surgery, respectively.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of Clinical, Psychological, and Psychophysical Variables on Long‐term Treatment Outcomes in Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial

Fernández‐de‐las‐Peñas

de-la-Llave-Rincón

Cescon

et al. 2019

Pain Practice

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“…PMPs of test procedures are specific to test sites and study populations . In PJP populations particularly, only 1 systematic review has surveyed the existing evidence of predictive validity of different QST procedures . This systematic review found that only cold pain threshold assessed using the thermotest system (Somedic AB, Frasta, Sweden) predicts pain and disability 1 year later in individuals with chronic lateral epicondylitis .…”

Section: Introductionmentioning

confidence: 99%

Test Procedures to Assess Somatosensory Abnormalities in Individuals with Peripheral Joint Pain: A Systematic Review of Psychometric Properties

et al. 2018

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“…Background: Ultrasonography can detect subclinical changes in anterior chest wall (ACW) joints of patients with ankylosing spondylitis (AS). 1 Pulmonary functions may be affected during the course of AS. 2 Up to the best of our knowledge, there are no previous studies of the relationship between ultrasound detected subclinical changes in ACW and the pulmonary functions in AS patients.…”

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confidence: 99%

THU0252 The rate of us verified hip involvement in patients with ankylosing spondylitis

Agafonova¹,

Dubinina

Dyomina

et al. 2018

Thursday, 14 June 2018

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BackgroundHip joint (HJ) involvement is one of the most common extra-axial manifestations of ankylosing spondylitis (AS).ObjectivesTo correlate clinical manifestations of coxitis with the ultra-sound findings in AS patients.Methods224 consecutive AS patients (mean age 33,2±14,2 y) meeting 1984 modified N-Y criteria and hospitalised in V.A. Nasonova Research Institute of Rheumatology with hip pain were evaluated. Patients’ mean age at the onset of the disease was 26,3±20,3 y., 93% of them were HLA-B27-positive. Median AS duration was 57 [12–444] months, the BASDAI score was 5,7±3,1. The diagnosis of coxitis was based on clinical signs and symptoms, such as inguinal pain and/or limitation in the range of hip motion (ROM) at the time of patients’ admission to the clinic. All patients (regardless current complaints) were subjected to ultrasound (US) examination of the HJ (Sono Diagnost 360 (Philips)) using linear (7,5 MHz) and convex (5,0 MHz) transducers. A neck capsular pattern (NCP – the distance between the signals from inner surface of the femoral neck and the joint capsule) more than 7 mm was used as the US criterion, verifying the clinical diagnosis of coxitis.ResultsThe US criterion of coxitis was found in 119 (53%) out of 224 patients, and two groups of pts were analysed based on NCP values with 7 mm threshold.ParametersP Group1 without US signs of coxitis (n=105)Group2 US confirmed coxitis (n=119) Gender(f/m), n79/2677/400,01AS duration, mo, Me[25%, 75%;]4319;8010224;1200,0006BASDAI, Me25;754,12,6; 5,55,24,2; 6,70,0001BASFI, Me25;752,42,0; 3,83,42,0; 5,40,0001HLA-B27, n (%)96 (91%)113 (95%)0,4ASDAS (?RP) ??[25;752,82,0; 3,83,52,6; 3,80002ESR, mm/h, Me [25%; 75%]105; 25258; 350001CRP, mg/mL, Me [25%; 75%]10,53,8; 28,523,04,9; 43,50,06Peripheral arthritis%38 (36%)28 (30%)0,06ConclusionsUS criterion of coxitis, i..e, increased NCP, was found in 53% of patients with clinical AS manifestations. Patients with US-confirmed coxitis demonstrate more active disease with greater functional impairment and longer history of AS, as compared to AS population without US signs of hip involvement.Disclosure of InterestNone declared

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Nervous System Sensitization as a Predictor of Outcome in the Treatment of Peripheral Musculoskeletal Conditions: A Systematic Review

Cited by 59 publications

References 76 publications

Influence of Clinical, Psychological, and Psychophysical Variables on Long‐term Treatment Outcomes in Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial

Influence of Clinical, Psychological, and Psychophysical Variables on Long‐term Treatment Outcomes in Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial

Test Procedures to Assess Somatosensory Abnormalities in Individuals with Peripheral Joint Pain: A Systematic Review of Psychometric Properties

THU0252 The rate of us verified hip involvement in patients with ankylosing spondylitis

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