Relationship Between Central Sensitization and Kinesiophobia in Knee Osteoarthritis

The Relationship Between Central Sensitization and Kinesiophobia in Patients With Knee Osteoarthritis

Objective: The knee joint is one of most common locations in OA. In recent years, it has been accepted that there are different pain phenotypes and patient subgroups in knee OA and that central sensitization (CS) mechanisms are at the forefront in some patients. It is also known that fear of movement, known as kinesiophobia, develops in patients with chronic pain. The aim of this study is to investigate CS and kinesiophobia in patients with knee OA, their relationships with each other, and their effects on pain intensity, functional status, pain catastrophizing and depression.

Materials and Methods: Forty-two patients with knee OA and 42 healthy subjects participated in our study. Demographic data, body mass index, habits, comorbidities, medications of participants and disease duration and radiographic grade of knee OA patients were recorded. VAS was used to assess the severity of pain and WOMAC was used to assess pain and functional status in patients with OA. Algometer (pressure pain threshold measurement) and Central Sensitization Inventory were used to evaluate central sensitization in all participants. Pressure pain threshold (PPT) was measured at 3 different points: knee joint, cruris and forearm. The presence of kinesiophobia was assessed with the Tampa Scale af Kinesiophobia (TSK). Pain Catastrophizing Scale (PCS) and Beck Depression Inventory (BDI) were used to assess chronic pain related symptoms.

Study Overview

• Status: Completed
• Conditions: Knee Osteoarthritis; Central Sensitisation; Kinesiophobia
• Intervention / Treatment: Diagnostic test: Pressure Algometer

Detailed Description

Forty-two patients with knee OA and 42 healthy subjects participated in our study. Demographic data, body mass index, habits, comorbidities, medications of participants and disease duration and radiographic grade of knee OA patients were recorded. VAS was used to assess the severity of pain and WOMAC was used to assess pain and functional status in patients with OA. Algometer (pressure pain threshold measurement) and Central Sensitization Inventory were used to evaluate central sensitization in all participants. Pressure pain threshold (PPT) was measured at 3 different points: knee joint, cruris and forearm. The presence of kinesiophobia was assessed with the Tampa Scale af Kinesiophobia (TSK). Pain Catastrophizing Scale (PCS) and Beck Depression Inventory (BDI) were used to assess chronic pain related symptoms.

• Study Type: Observational
• Enrollment (Actual): 84

Contacts and Locations

Study Locations

• Turkey
  • Zonguldak, Turkey, 67100
    • Zonguldak Bulent Ecevit Universitiy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

Inclusion Criteria for control group:

• Being a healthy volunteer between the ages of 45-75
• No pain in the knee and forearm
• No mechanical, inflammatory, endocrine, degenerative, degenerative, systemic comorbidities that may affect the knee joint
• Body mass index below 35

Exclusion Criteria for control group:

• Diagnosed with knee osteoarthritis
• Presence of uncontrolled systemic disease
• Cooperation limitation or cognitive impairment
• Presence of chronic painful disease, rheumatologic disease, peripheral neuropathy
• Body mass index of 35 and above

Description

Inclusion Criteria for knee osteoarthritis group:

• Being a healthy volunteer between the ages of 45-75
• Being diagnosed with knee osteoarthritis according to ACR diagnostic criteria
• Knee pain for at least 6 months
• Kellgren-Lawrence 1, 2 or 3 radiologic grade of knee OA
• Body mass index below 35

Exclusion Criteria for knee osteoarthritis group:

• Presence of chronic widespread painful diseases other than osteoarthritis (fibromyalgia syndrome etc.), rheumatologic disease, peripheral neuropathy
• Presence of uncontrolled systemic disease
• Cooperation limitation or cognitive impairment
• Active arthritis in the knee joint to be evaluated
• Presence of prosthesis in the knees
• Pain in the forearm
• Body mass index of 35 and above

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Knee Osteoarthritis; Patients who have knee pain at least 6 months, 45-75 years old, kellgren-lawrence grade 1-3	Diagnostic test: Pressure Algometer; Pressure algometer is used to detect pain pressure treshold.
Control; Subjects who have not knee pain, 45-75 years old	Diagnostic test: Pressure Algometer; Pressure algometer is used to detect pain pressure treshold.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Pressure Treshold	Algometer was used to detect pressure pain threshold. Higher scores mean better outcomes.	Day 1
Central Sensitization	Central Sensitization Inventory was used to evaluate central sensitization. Minimum value is 0 , maximum value is 100. Higher values means worse outcomes.	Day 1
Kinesiophobia	The presence of kinesiophobia was assessed with Tampa Scale af Kinesiophobia. Minimum value is 17 , maximum value is 68. Higher values means worse outcomes.	Day 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Catastrophizing	Pain Catastrophizing Scale was used to assess chronic pain related symptoms. Minimum value is 0 , maximum value is 52. Higher values means worse outcomes.	Day 1
Depression	Beck Depression Inventory was used to assess depression. Minimum value is 0 , maximum value is 63. Higher values means worse outcomes.	Day 1
Visuel Analog Scala	Visuel Analog Scala was used to assess pain intensity. Patients' pain (0=no pain, 10=intolerable pain) on a 100 mm horizontal line. The marked value was recorded in millimeters.	Day 1
Western Ontario and McMaster Universitesies Osteoarthritis Index	Pain and functional status of the patients included in our study assessment was performed using this index, consists of a total of three subscales and 24 questions, each question is scored between 0 and 4 (0=none, 4=very severe). Minimum value is 0, maximum value is 100. Higher scores indicate an increase in pain and stiffness and a decline in physical function.	Day 1

Collaborators and Investigators

• Sponsor: Selda Sarıkaya

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2022
• Primary Completion (Actual): October 1, 2023
• Study Completion (Actual): December 1, 2023

Study Registration Dates

• First Submitted: March 19, 2024
• First Submitted That Met QC Criteria: March 26, 2024
• First Posted (Actual): March 28, 2024

Study Record Updates

• Last Update Posted (Actual): April 22, 2024
• Last Update Submitted That Met QC Criteria: April 19, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Keywords: knee osteoarthritis; kinesiophobia; central sensitization; algometer; pain pressure treshold
• Additional Relevant MeSH Terms: Mental Disorders; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Arthritis; Anxiety Disorders; Phobic Disorders; Osteoarthritis; Osteoarthritis, Knee; Kinesiophobia
• Other Study ID Numbers: 19/03/2024

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No