The efficacy of non-surgical treatment on pain and sensitization in patients with knee osteoarthritis: a pre-defined ancillary analysis from a randomized controlled trial

Autor: Ole Simonsen, Mogens Berg Laursen, Søren Thorgaard Skou, Michael Skovdal Rathleff, Lars Arendt-Nielsen, Sten Rasmussen, Ewa M. Roos
Rok vydání: 2016
Předmět:
Male
Ibuprofen
Osteoarthritis
Ibuprofen/therapeutic use
law.invention
0302 clinical medicine
Randomized controlled trial
law
Single-Blind Method
Orthopedics and Sports Medicine
Pain Management/methods
Sensitization
Pain Measurement
Osteoarthritis
Knee/physiopathology
Anti-Inflammatory Agents
Non-Steroidal
Non surgical treatment
Analgesics
Non-Narcotic
Osteoarthritis
Knee
Middle Aged
Exercise Therapy
Clinical trial
medicine.anatomical_structure
Female
Anti-Inflammatory Agents
Non-Steroidal/therapeutic use
Acetaminophen/therapeutic use
Analgesics
Non-Narcotic/therapeutic use
Pain Threshold
medicine.medical_specialty
Diet
Reducing
Total knee replacement
Biomedical Engineering
Pain
Foot Orthoses
Therapeutics
03 medical and health sciences
Patient Education as Topic
Rheumatology
Forearm
medicine
Pain Management
Humans
Knee
In patient
Acetaminophen
Aged
030203 arthritis & rheumatology
business.industry
medicine.disease
Exercise Therapy/methods
Physical therapy
business
030217 neurology & neurosurgery
Zdroj: Skou, S T, Roos, E M, Simonsen, O, Laursen, M B, Rathleff, M S, Arendt-Nielsen, L & Rasmussen, S 2016, ' The efficacy of non-surgical treatment on pain and sensitization in patients with knee osteoarthritis : a pre-defined ancillary analysis from a randomized controlled trial ', Osteoarthritis and Cartilage, vol. 24, no. 1, pp. 108–116 . https://doi.org/10.1016/j.joca.2015.07.013
Skou, S T, Roos, E M, Simonsen, O, Laursen, M B, Rathleff, M S, Arendt-Nielsen, L & Rasmussen, S 2016, ' The efficacy of non-surgical treatment on pain and sensitization in patients with knee osteoarthritis : a pre-defined ancillary analysis from a randomized controlled trial ', Osteoarthritis and Cartilage, vol. 24, no. 1, pp. 108-116 . https://doi.org/10.1016/j.joca.2015.07.013
ISSN: 1063-4584
DOI: 10.1016/j.joca.2015.07.013
Popis: Objective: To report the efficacy of a 3-month treatment program consisting of neuromuscular exercise, education, diet, insoles and pain medication (MEDIC-treatment) compared to usual care (two leaflets with information and treatment advice) in reducing pain-related measures and sensitization in patients with knee osteoarthritis (OA) not eligible for total knee replacement (TKR). Method: A pre-defined ancillary analysis of the results at 3 months of a randomized controlled trial (RCT) of 100 patients randomized to MEDIC-treatment or usual care. Trial registration: ClinicalTrials.gov (NCT01535001). Outcomes were sensitization assessed at the knee, the lower leg and forearm using a handheld algometer, peak pain intensity in the previous 24 h, pain intensity after 30 min of walking, pain location and pattern, spreading of pain (a region-divided body chart) and the usage of pain medication. Results: The MEDIC group had larger improvements from baseline to 3 months in peak pain intensity (P = 0.02) and pain after 30 min of walking (P < 0.001) and in the number of body sites with pain (P = 0.04). There was no difference in the change in sensitization from baseline to 3 months between groups (P = 0.87), but sensitization decreased in both groups (P < 0.001). Conclusion: A non-surgical treatment program is more efficacious in reducing pain-related measures than usual care, while both are equally efficacious in reducing sensitization, indicating that mechanisms other than pain sensitization contribute to the perceived pain. The patients did not have severe symptomatic knee OA and hence pain sensitization may not yet have developed into a clinically relevant parameter or subgroups with less sensitization may exist.
Databáze: OpenAIRE
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