Central Sensitization in Patients Attending Physical Therapy for Musculoskeletal Disorders

L. A., H. D., W. B, S. D., O. C, Louw H, Farrell K
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Abstract

Study Design: Survey study. Objective: To determine what percentage of patients attending physical therapy with musculoskeletal pain present with central sensitization and which patient factors may be predictive of central sensitization. Background: Treating pain, especially chronic pain is clinically challenging. It has been suggested that pain be sub-classified as either nociceptive, peripheral neuropathic or central sensitization, to aid clinical decision-making to inform the treatment approach for specific pain conditions. Methods: A convenience sample of adult patients (18-65) attending PT for musculoskeletal pain were asked to complete a demographic questionnaire and the central sensitization inventory. Results: Two-hundred and forty-five patients completed the central sensitization inventory, resulting in a mean score of 26.88 ± 15.54. The majority of the patients were classified as “low” in regard to central sensitization scores and nearly one in five patients (n = 39; 17.3%) were classified as “high” in regard to central sensitization scores. The variables of ‘being disabled’ (β = 13.73), ‘currently experiencing feelings of depression’ (β = 9.35), and ‘identifying as female’ (β = 3.60), had the largest partial effects on central sensitization as individual variables. Conclusions: Approximately one in five patients attending PT for musculoskeletal pain present with a central sensitization inventory score of > 40, suggesting presence of central sensitization. Patients that reported feeling disabled, experiencing feelings of depression and ‘identifying as female’ were more likely to score > 40 on the central sensitization inventory. Central sensitization is relatively common in patients attending PT for musculoskeletal pain and various patient characteristics may suggest higher potential CSI scores at intake.
参加肌肉骨骼疾病物理治疗的患者的中枢致敏
研究设计:调查研究。目的:确定接受物理治疗的肌肉骨骼疼痛患者中枢性致敏的比例,以及哪些患者因素可以预测中枢性致敏。背景:治疗疼痛,特别是慢性疼痛在临床上具有挑战性。有人建议将疼痛分为伤害性、外周神经性或中枢致敏性,以帮助临床决策,为特定疼痛状况的治疗方法提供信息。方法:方便抽样的成年患者(18-65岁)参加PT肌肉骨骼疼痛被要求完成人口统计问卷和中心致敏性量表。结果:245例患者完成了中心致敏性量表,平均得分为26.88±15.54。大多数患者在中枢致敏评分方面被归类为“低”,近五分之一的患者(n = 39;17.3%)在中枢致敏评分方面被归为“高”。“残疾”(β = 13.73)、“目前感到抑郁”(β = 9.35)和“认为自己是女性”(β = 3.60)这些变量作为个体变量对中枢敏化的部分影响最大。结论:大约五分之一因肌肉骨骼疼痛接受PT治疗的患者存在中枢致敏性评分为bbbb40,表明存在中枢致敏性。报告感觉残疾、经历抑郁和“自我认同为女性”的患者更有可能在中枢致敏性量表上获得bb40分。中枢致敏在因肌肉骨骼疼痛而接受PT治疗的患者中相对常见,不同的患者特征可能表明在摄入时潜在的CSI评分更高。
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