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RESEARCH PRODUCT

Preoperative pain neuroscience education combined with knee joint mobilization for knee osteoarthritis : a randomized controlled trial

Mira MeeusMira MeeusIsabel BaertEnrique LluchEnrique LluchJosé Sánchez-frutosLirios DueñasDeborah FallaJo Nijs

subject

MaleKnee JointPsychological interventionOsteoarthritisKnee Jointlaw.inventionDisability Evaluation0302 clinical medicineRandomized controlled triallawOutcome Assessment Health CareMedicinephysical therapyPain MeasurementAged 80 and overMobilizationCatastrophizationMiddle AgedOsteoarthritis Kneemusculoskeletal systemPhobic DisordersManipulation OrthopedicFemalePain catastrophizingmedicine.symptomPsychosocialmusculoskeletal diseasesmedicine.medical_specialtyClinical NeurologyPaincentral sensitization syndromesknee osteoarthritisEducation03 medical and health sciencesDouble-Blind MethodPreoperative CareHumansPhysical Therapy ModalitiesAged030203 arthritis & rheumatologyAnalysis of Variancebusiness.industryNeurosciencesmedicine.diseaseAnesthesiology and Pain MedicineKnee painPhysical therapyNeurology (clinical)Human medicinebusinessNeuroscience030217 neurology & neurosurgery

description

Abstract: Objectives: This study aimed to first compare the effects of a preoperative treatment combining pain neuroscience education (PNE) with knee joint mobilization versus biomedical education with knee joint mobilization on central sensitization (CS) in patients with knee osteoarthritis, both before and after surgery. Second, we wanted to compare the effects of both interventions on knee pain, disability, and psychosocial variables. Materials and Methods: Forty-four patients with knee osteoarthritis were allocated to receive 4 sessions of either PNE combined with knee joint mobilization or biomedical education with knee joint mobilization before surgery. All participants completed self-administered questionnaires and quantitative sensory testing was performed at baseline, after treatment and at a 1 month follow-up (all before surgery), and at 3 months after surgery. Results: Significant and clinically relevant differences before and after surgery were found after treatments for both knee pain and disability, and some measures of CS (ie, widespread hyperalgesia, CS inventory), with no significant between-group differences. Other indicators of CS (ie, conditioned pain modulation, temporal summation) did not change over time following either treatment, and in some occasions the observed changes were not in the expected direction. Patients receiving PNE with knee joint mobilization achieved greater improvements in psychosocial variables (pain catastrophizing, kinesiophobia) both before and after surgery. Discussion: Preoperative PNE combined with knee joint mobilization did not produce any additional benefits over time for knee pain and disability, and CS measures compared with biomedical education with knee joint mobilization. Superior effects in the PNE with knee joint mobilization group were only observed for psychosocial variables related to pain catastrophizing and kinesiophobia.

yearjournalcountryeditionlanguage
2017-05-18The clinical journal of pain
10.1097/ajp.0000000000000511https://hdl.handle.net/10067/1438800151162165141