膝关节骨关节炎患者中枢致敏与活动受限的关系：疼痛灾难化的中介作用

IF 2.2 3区医学 Q1 REHABILITATION

Musculoskeletal Science and Practice Pub Date : 2025-03-26 DOI:10.1016/j.msksp.2025.103318

Nanyan Li , Pingjuan Tan , Guangyuan Dong , Yun Lu , Jingchun Zhang , Qingzhao Liang , Lei Shi

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引用次数: 0

摘要

膝关节骨关节炎患者最痛苦的症状是活动受限，这加剧了疾病的全球负担。研究表明，中枢致敏对膝关节骨关节炎患者的活动能力有负面影响。然而，关于其潜在机制的知识有限。因此，本研究旨在探讨疼痛灾难化对膝关节骨关节炎患者中枢致敏和活动限制的中介作用。目的通过模拟膝关节骨关节炎患者疼痛灾难化的三维介质，探讨中枢致敏与活动限制之间的关系。这是一项横断面研究。方法采用一般人口学问卷、动画活动问卷、疼痛灾变量表和中枢致敏量表对392例患者进行调查。采用多元线性回归确定中介模型中包含的协变量。采用SPSS PROCESS对中介效应进行检验。结果年龄、KOA持续时间、K-L等级为协变量。中介模型显示，中枢致敏对活性限制有直接影响(c ' = - 0.166；95% ci = - 0.271, - 0.064)。中枢致敏与活动限制的关系主要通过两个间接途径介导：(1)反刍(a1b1 =−0.095；95% CI−0.176,−0.017)和(2)无助感(a2b2 =−0.074；95% ci = - 0.137, - 0.009)。放大维度对活动限制的间接影响无统计学意义(a3b3 = 0.002；95% ci−0.051,0.054)。结论疼痛灾难化的反刍和无助感在中枢敏化与活动限制的关系中起主要中介作用。

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The relationship between central sensitization and activity limitation in patients with knee osteoarthritis:The mediating role of pain catastrophizing

Background

In patients with knee osteoarthritis, the most distressing symptom is activity limitation which exacerbates the global burden of the disease. Studies have shown that central sensitization has a negative effect on activity capabilities in patients with knee osteoarthritis. However, limited knowledge exists regarding the underlying mechanisms. Therefore, this study aimed to explore the mediating effect of pain catastrophizing on central sensitization and activity limitation among knee osteoarthritis patients.

Objectives

To explore the association between central sensitization and activity limitation by modelling three dimensions of pain catastrophizing as mediators among patients with knee osteoarthritis.

Design

This is a cross-sectional study.

Methods

A total of 392 patients were surveyed using the general demographic questionnaire, Animated Activity Questionnaire, Pain Catastrophizing Scale, and Central Sensitization Inventory. Multiple linear regression was used to determine covariates included in the mediating model. The mediating effect was tested using the SPSS PROCESS.

Results

Age, duration of KOA, and K-L grade were included as covariates. The mediating model revealed that central sensitization had a direct effect on activity limitation (c′ = −0.166; 95 % CI −0.271, −0.064). The relationship between central sensitization and activity limitation was primarily mediated by two indirect pathways: (1) rumination (a1b1 = −0.095; 95 % CI −0.176, −0.017) and (2) helplessness (a2b2 = −0.074; 95 % CI −0.137, −0.009). The indirect effect of the magnification dimension on activity limitation was not statistically significant (a3b3 = 0.002; 95 % CI −0.051, 0.054).

Conclusions

The study reveals rumination and helplessness in pain catastrophizing mainly mediate the relationship between central sensitization and activity limitation.

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来源期刊

Musculoskeletal Science and Practice Health Professions-Physical Therapy, Sports Therapy and Rehabilitation

CiteScore

4.10

自引率

8.70%

发文量

152

审稿时长

48 days

期刊介绍： Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.