鉴别中枢致敏性疼痛患者肌肉骨骼疼痛的临床指标的诊断准确性。

IF 2.1 Q1 REHABILITATION
Juliana Valentim Bittencourt, Ana Carolina de Melo Magalhães Amaral, Pedro Vidinha Rodrigues, Leticia Amaral Corrêa, Bruno Moreira Silva, Felipe José Jandre Reis, Leandro Alberto Calazans Nogueira
{"title":"鉴别中枢致敏性疼痛患者肌肉骨骼疼痛的临床指标的诊断准确性。","authors":"Juliana Valentim Bittencourt,&nbsp;Ana Carolina de Melo Magalhães Amaral,&nbsp;Pedro Vidinha Rodrigues,&nbsp;Leticia Amaral Corrêa,&nbsp;Bruno Moreira Silva,&nbsp;Felipe José Jandre Reis,&nbsp;Leandro Alberto Calazans Nogueira","doi":"10.1186/s40945-020-00095-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The identification of central sensitization (CS) is an important aspect in the management of patients with chronic musculoskeletal pain. Several methods have been developed, including clinical indicators and psychophysical measures. However, whether clinical indicators coincide with the psychophysical test of CS-related sign and symptoms is still unknown. Therefore, the present study aimed to analyze the diagnostic accuracy of the clinical indicators in identifying CS-related sign and symptoms in patients with musculoskeletal pain.</p><p><strong>Methods: </strong>One-hundred consecutive patients with musculoskeletal pain were included. Clinical indicators (index method) based on a combination of patient self-report pain characteristics and physical examination were used to identify the phenotype of patients with musculoskeletal pain and the predominance of the CS-related sign and symptoms. Conditioned pain modulation (CPM) was assessed by the Cold Pressor Test (reference standard), which is a psychophysical test used to detect impairment of CPM. Measurements of the diagnostic accuracy were performed.</p><p><strong>Results: </strong>Twenty-seven patients presented predominance of CS-related sign and symptoms in the assessment of the clinical indicators, and 20 had impairment of CPM. Clinical indicators showed high accuracy (75.0%; 95% confidence interval = 65.3 to 83.1), high specificity (80.0%; 95% confidence interval = 69.6 to 88.1), high negative predictive value (87.7%; 95% confidence interval = 81.2 to 92.1), and a relevant positive likelihood ratio (2.8, 95% confidence interval = 1.5 to 5.0) when compared to the Cold Pressor Test.</p><p><strong>Conclusion: </strong>Clinical indicators demonstrated a valuable tool for detecting the impaired CPM, which is a remarkable feature of the CS-related sign and symptoms. Clinicians are encouraged to use the clinical indicators in the management of patients with musculoskeletal pain.</p>","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2021-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40945-020-00095-7","citationCount":"7","resultStr":"{\"title\":\"Diagnostic accuracy of the clinical indicators to identify central sensitization pain in patients with musculoskeletal pain.\",\"authors\":\"Juliana Valentim Bittencourt,&nbsp;Ana Carolina de Melo Magalhães Amaral,&nbsp;Pedro Vidinha Rodrigues,&nbsp;Leticia Amaral Corrêa,&nbsp;Bruno Moreira Silva,&nbsp;Felipe José Jandre Reis,&nbsp;Leandro Alberto Calazans Nogueira\",\"doi\":\"10.1186/s40945-020-00095-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The identification of central sensitization (CS) is an important aspect in the management of patients with chronic musculoskeletal pain. Several methods have been developed, including clinical indicators and psychophysical measures. However, whether clinical indicators coincide with the psychophysical test of CS-related sign and symptoms is still unknown. Therefore, the present study aimed to analyze the diagnostic accuracy of the clinical indicators in identifying CS-related sign and symptoms in patients with musculoskeletal pain.</p><p><strong>Methods: </strong>One-hundred consecutive patients with musculoskeletal pain were included. Clinical indicators (index method) based on a combination of patient self-report pain characteristics and physical examination were used to identify the phenotype of patients with musculoskeletal pain and the predominance of the CS-related sign and symptoms. Conditioned pain modulation (CPM) was assessed by the Cold Pressor Test (reference standard), which is a psychophysical test used to detect impairment of CPM. Measurements of the diagnostic accuracy were performed.</p><p><strong>Results: </strong>Twenty-seven patients presented predominance of CS-related sign and symptoms in the assessment of the clinical indicators, and 20 had impairment of CPM. Clinical indicators showed high accuracy (75.0%; 95% confidence interval = 65.3 to 83.1), high specificity (80.0%; 95% confidence interval = 69.6 to 88.1), high negative predictive value (87.7%; 95% confidence interval = 81.2 to 92.1), and a relevant positive likelihood ratio (2.8, 95% confidence interval = 1.5 to 5.0) when compared to the Cold Pressor Test.</p><p><strong>Conclusion: </strong>Clinical indicators demonstrated a valuable tool for detecting the impaired CPM, which is a remarkable feature of the CS-related sign and symptoms. Clinicians are encouraged to use the clinical indicators in the management of patients with musculoskeletal pain.</p>\",\"PeriodicalId\":72290,\"journal\":{\"name\":\"Archives of physiotherapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2021-01-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1186/s40945-020-00095-7\",\"citationCount\":\"7\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of physiotherapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s40945-020-00095-7\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physiotherapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40945-020-00095-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 7

摘要

背景:中枢致敏(CS)的识别是慢性肌肉骨骼疼痛患者管理的一个重要方面。已经开发了几种方法,包括临床指标和心理物理测量。然而,临床指标与cs相关体征和症状的心理物理测试是否吻合尚不清楚。因此,本研究旨在分析临床指标在识别肌肉骨骼疼痛患者cs相关体征和症状方面的诊断准确性。方法:连续100例肌肉骨骼疼痛患者。采用基于患者自述疼痛特征和体格检查相结合的临床指标(指数法),确定肌肉骨骼疼痛患者的表型以及cs相关体征和症状的优势。条件疼痛调节(CPM)通过冷压试验(参考标准)进行评估,冷压试验是一种用于检测CPM损伤的心理物理测试。对诊断的准确性进行了测量。结果:27例患者在临床指标评估中表现为cs相关体征和症状优势,20例患者存在CPM损伤。临床指标准确率高(75.0%;95%可信区间= 65.3 ~ 83.1),高特异性(80.0%;95%置信区间= 69.6 ~ 88.1),高阴性预测值(87.7%;95%置信区间= 81.2至92.1),与冷压试验相比,相关的正似然比(2.8,95%置信区间= 1.5至5.0)。结论:临床指标是检测CPM受损的重要工具,是cs相关体征和症状的显著特征。鼓励临床医生在管理肌肉骨骼疼痛患者时使用临床指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic accuracy of the clinical indicators to identify central sensitization pain in patients with musculoskeletal pain.

Background: The identification of central sensitization (CS) is an important aspect in the management of patients with chronic musculoskeletal pain. Several methods have been developed, including clinical indicators and psychophysical measures. However, whether clinical indicators coincide with the psychophysical test of CS-related sign and symptoms is still unknown. Therefore, the present study aimed to analyze the diagnostic accuracy of the clinical indicators in identifying CS-related sign and symptoms in patients with musculoskeletal pain.

Methods: One-hundred consecutive patients with musculoskeletal pain were included. Clinical indicators (index method) based on a combination of patient self-report pain characteristics and physical examination were used to identify the phenotype of patients with musculoskeletal pain and the predominance of the CS-related sign and symptoms. Conditioned pain modulation (CPM) was assessed by the Cold Pressor Test (reference standard), which is a psychophysical test used to detect impairment of CPM. Measurements of the diagnostic accuracy were performed.

Results: Twenty-seven patients presented predominance of CS-related sign and symptoms in the assessment of the clinical indicators, and 20 had impairment of CPM. Clinical indicators showed high accuracy (75.0%; 95% confidence interval = 65.3 to 83.1), high specificity (80.0%; 95% confidence interval = 69.6 to 88.1), high negative predictive value (87.7%; 95% confidence interval = 81.2 to 92.1), and a relevant positive likelihood ratio (2.8, 95% confidence interval = 1.5 to 5.0) when compared to the Cold Pressor Test.

Conclusion: Clinical indicators demonstrated a valuable tool for detecting the impaired CPM, which is a remarkable feature of the CS-related sign and symptoms. Clinicians are encouraged to use the clinical indicators in the management of patients with musculoskeletal pain.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.60
自引率
0.00%
发文量
0
审稿时长
10 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信