Impact of Therapeutic Interventions on Pain Intensity and Endogenous Pain Modulation in Knee Osteoarthritis: A Systematic Review and Meta-analysis
| Autor: | Mirret M. El-Hagrassy, Paula Sanchez, Gleysson Rosa, Anthony Terrence O'Brien, Sonia Conde, Swapnali Chaudhari, Felipe Fregni, Haley Rafferty, Rodrigo Huerta |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
business.industry Psychological intervention Chronic pain General Medicine Osteoarthritis Osteoarthritis Knee medicine.disease Summation MUSCULOSKELETAL SECTION Intensity (physics) law.invention Anesthesiology and Pain Medicine Physical medicine and rehabilitation Randomized controlled trial law Meta-analysis Humans Pain Management Medicine Observational study Neurology (clinical) Chronic Pain business |
| Zdroj: | Pain Med |
| ISSN: | 1526-4637 1526-2375 |
| DOI: | 10.1093/pm/pny261 |
| Popis: | OBJECTIVE: To study the impact of therapeutic interventions on pain analgesia and endogenous pain modulation in knee osteoarthritis (KOA). DESIGN: Systematic review and meta-analysis. METHODS: We searched for KOA randomized clinical trials and observational studies with data on therapeutic interventions comparing pain intensity, temporal summation (TS), and conditioned pain modulation (CPM) scores relative to control. These data were pooled as Hedge’s g. To study the relationship between pain intensity and TS/CPM, we performed metaregression with 10,000 Monte-Carlo permutations. RESULTS: We reviewed 11 studies (559 participants). On studying all the interventions together, we found no significant changes in pain modulation, TS, or CPM. Our findings show that this lack of difference is likely because surgical and nonsurgical interventions resulted in contrary effects. Metaregression significantly correlated pain reduction with normalization of TS and CPM. CONCLUSIONS: We demonstrate an association between pain reduction and TS/CPM normalization. Though we cannot directly compare these interventions, the results allow us to draw hypotheses on potential practice schemas. Recovering defective endogenous pain modulation mechanisms may help establish long-term analgesia. However, to validate these paradigms as robust clinical biomarkers, further investigation into their mechanisms would be necessary. The registration number for this review is CRD42017072066. |
| Databáze: | OpenAIRE |
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