Yenisel Cruz-Almeida1, Josue Cardoso2, Joseph L Riley2, Burel Goodin3, Christopher D King4, Megan Petrov5, Emily J Bartley2, Kimberly T Sibille6, Toni L Glover2, Matthew S Herbert3, Hailey W Bulls3, Adriana Addison3, Roland Staud7, David Redden8, Laurence A Bradley9, Roger B Fillingim10. 1. Pain Research & Intervention Center of Excellence, University of Florida, USA; Institute on Aging, University of Florida, USA; Cognitive Aging & Memory Clinical Translational Research Program, University of Florida, USA; Department of Aging & Geriatric Research, College of Medicine, University of Florida, USA; Department of Neuroscience, College of Medicine, University of Florida, USA; Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, USA. Electronic address: cryeni@ufl.edu. 2. Pain Research & Intervention Center of Excellence, University of Florida, USA; Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, USA. 3. Department of Psychology, University of Alabama at Birmingham, USA. 4. Pain Research Center, Cincinnati Children's Hospital Medical Center, USA. 5. College of Nursing & Health Innovation, Arizona State University, USA. 6. Pain Research & Intervention Center of Excellence, University of Florida, USA; Institute on Aging, University of Florida, USA; Department of Aging & Geriatric Research, College of Medicine, University of Florida, USA; Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, USA. 7. Department of Medicine, University of Florida, Gainesville, FL, USA. 8. Departments of Biostatistics and Medicine and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA. 9. Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA. 10. Pain Research & Intervention Center of Excellence, University of Florida, USA; Institute on Aging, University of Florida, USA; Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, USA.
Abstract
BACKGROUND: Knee pain associated with osteoarthritis is a significant contributor to decreased physical function. Recent evidence supports the inter-individual heterogeneity associated with knee pain presentation, but whether there is similar heterogeneity in physical performance among these individuals has not been previously examined. The aim of the present study was to characterize the variability in physical performance profiles and the pain evoked by their performance (i.e., movement-evoked pain). METHODS: In a secondary analysis of the community-based study Understanding Pain and Limitations in Osteoarthritic Disease (UPLOAD), individuals (n=270) completed functional, pain, psychological, and somatosensory assessments. Hierarchical cluster analysis was used to derive physical function profiles that were subsequently compared across several clinical, psychological and experimental pain measures. RESULTS: Our results support the hypothesis that among persons with knee OA pain, three different physical performance profiles exist with varying degrees of movement-evoked pain. Even as all three groups experienced moderate to severe levels of spontaneous knee pain, those individuals with the most severe movement-evoked pain and lowest physical functional performance also had the least favorable psychological characteristics along with increased mechanical pain sensitivity and temporal summation. CONCLUSIONS: Our findings support the need for the assessment and consideration of movement-evoked pain during physical performance tasks as these have the potential to increase the value of functional and pain assessments clinically. The identification of the mechanisms driving pain burden within homogeneous groups of individuals will ultimately allow for targeted implementation of treatments consistent with a biopsychosocial model of pain.
BACKGROUND:Knee pain associated with osteoarthritis is a significant contributor to decreased physical function. Recent evidence supports the inter-individual heterogeneity associated with knee pain presentation, but whether there is similar heterogeneity in physical performance among these individuals has not been previously examined. The aim of the present study was to characterize the variability in physical performance profiles and the pain evoked by their performance (i.e., movement-evoked pain). METHODS: In a secondary analysis of the community-based study Understanding Pain and Limitations in Osteoarthritic Disease (UPLOAD), individuals (n=270) completed functional, pain, psychological, and somatosensory assessments. Hierarchical cluster analysis was used to derive physical function profiles that were subsequently compared across several clinical, psychological and experimental pain measures. RESULTS: Our results support the hypothesis that among persons with knee OA pain, three different physical performance profiles exist with varying degrees of movement-evoked pain. Even as all three groups experienced moderate to severe levels of spontaneous knee pain, those individuals with the most severe movement-evoked pain and lowest physical functional performance also had the least favorable psychological characteristics along with increased mechanical pain sensitivity and temporal summation. CONCLUSIONS: Our findings support the need for the assessment and consideration of movement-evoked pain during physical performance tasks as these have the potential to increase the value of functional and pain assessments clinically. The identification of the mechanisms driving pain burden within homogeneous groups of individuals will ultimately allow for targeted implementation of treatments consistent with a biopsychosocial model of pain.
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