Katsuyoshi Tanaka1,2, Shunsuke Murata1,3,4, Tomohiko Nishigami5, Akira Mibu5, Masahiro Manfuku6, Yoshikazu Shinohara2, Akihito Tanabe2, Rei Ono1. 1. Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan. 2. Department of Rehabilitation, Tanabe Orthopaedics, Osaka, Japan. 3. Japan Society for the Promotion of Science, Chiyoda, Japan. 4. Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan. 5. Department of Nursing and Physical Therapy, Konan Women's University, Kobe, Japan. 6. Breast Care Sensyu Clinic, Osaka, Japan.
Abstract
BACKGROUND: Central sensitization (CS) is found in patients with musculoskeletal disorders and is related to clinical symptoms, including pain-related disability. The Central Sensitization Inventory (CSI) has been developed for patients who are at risk of symptoms related to CS, and CSI severity levels are suggested for clinical interpretation of the CSI score. However, the longitudinal relationship between CSI severity and pain-related disability is unclear in primary care. In this study, we investigated the association between CSI severity levels and the profiles of patients with musculoskeletal disorders as well as the longitudinal relationship between CSI severity levels and pain-related disability in primary care settings. METHODS: A total of 553 patients were assessed using CSI, EuroQol-5 dimension (EQ5D), and Brief Pain Inventory (BPI). Of the 553 patients, 150 patients were reassessed at the 3-month follow-up. Patients were grouped into three severity levels according to baseline CSI score: subclinical, mild, and moderate to higher level. RESULTS: As the CSI severity levels increased, the clinical symptoms tended to worsen on cross-sectional analysis (p < 0.05). Pain-related disability at the 3-month follow-up was significantly higher for patients with moderate to high baseline CSI severity levels than for patients with subclinical baseline CSI levels (p < 0.001). Furthermore, pain-related disability increased according to the CSI severity level, with a medium to large effect size. However, there were no differences in pain duration across the CSI severity levels. CONCLUSIONS: CSI has clinical utility as a prediction tool regardless of pain duration in patients with musculoskeletal disorders in primary care settings. SIGNIFICANCE: Higher CSI severity levels predicted higher pain-related disability for patients with musculoskeletal disorders in a primary care setting. CSI is a clinically useful prediction tool in patients with musculoskeletal disorders.
BACKGROUND: Central sensitization (CS) is found in patients with musculoskeletal disorders and is related to clinical symptoms, including pain-related disability. The Central Sensitization Inventory (CSI) has been developed for patients who are at risk of symptoms related to CS, and CSI severity levels are suggested for clinical interpretation of the CSI score. However, the longitudinal relationship between CSI severity and pain-related disability is unclear in primary care. In this study, we investigated the association between CSI severity levels and the profiles of patients with musculoskeletal disorders as well as the longitudinal relationship between CSI severity levels and pain-related disability in primary care settings. METHODS: A total of 553 patients were assessed using CSI, EuroQol-5 dimension (EQ5D), and Brief Pain Inventory (BPI). Of the 553 patients, 150 patients were reassessed at the 3-month follow-up. Patients were grouped into three severity levels according to baseline CSI score: subclinical, mild, and moderate to higher level. RESULTS: As the CSI severity levels increased, the clinical symptoms tended to worsen on cross-sectional analysis (p < 0.05). Pain-related disability at the 3-month follow-up was significantly higher for patients with moderate to high baseline CSI severity levels than for patients with subclinical baseline CSI levels (p < 0.001). Furthermore, pain-related disability increased according to the CSI severity level, with a medium to large effect size. However, there were no differences in pain duration across the CSI severity levels. CONCLUSIONS: CSI has clinical utility as a prediction tool regardless of pain duration in patients with musculoskeletal disorders in primary care settings. SIGNIFICANCE: Higher CSI severity levels predicted higher pain-related disability for patients with musculoskeletal disorders in a primary care setting. CSI is a clinically useful prediction tool in patients with musculoskeletal disorders.
Authors: Juliana Valentim Bittencourt; Márcia Cliton Bezerra; Mônica Rotondo Pina; Felipe José Jandre Reis; Arthur de Sá Ferreira; Leandro Alberto Calazans Nogueira Journal: Arch Physiother Date: 2022-02-17
Authors: Jone Ansuategui Echeita; Henrica R Schiphorst Preuper; Rienk Dekker; Ilse Stuive; Hans Timmerman; Andre P Wolff; Michiel F Reneman Journal: BMJ Open Date: 2020-03-08 Impact factor: 2.692