This is an observational study to examine presence of CS in patients with knee osteoarthritis (OA), chronic LBP (CLBP), and chronic neck pain (CNP) seeking outpatient physical therapy (PT) services. The study will also examine if outcomes differ between patients with CS and patients without CS symptoms with standard PT interventions.
Central Sensitization (CS), defined as augmented pain processing, is common in subgroup of nearly all chronic pain conditions, including fibromyalgia, CLBP, OA, and chronic tension headache. However, current studies of CS are primarily limited to research settings, lacking the knowledge about prevalence of CS and rehabilitation outcomes in usual clinical care. Practicing clinicians do not routinely assess for CS symptoms. Without proper screening for CS, and lack of knowledge of varying levels of nervous system involvement contributing to pain, clinicians are unable to fully identify the depth of the mechanisms and therefore unable to fully determine the best treatment strategies. This observational study addresses this gap in knowledge by screening patients for CS symptoms.
Study Type
OBSERVATIONAL
Enrollment
77
All therapy will be given as it would have routinely been administered in the clinic. Standard care for all patients includes physical therapy and chiropractic treatment at each visit. There is a nurse practitioner on site. If necessary, patients can receive trigger point injections to the musculature around the back and neck, platelet rich plasma, or headache injections by the nurse practitioner. These interventions vary on a case by case basis. Involvement in the study will not impact the patients plan of care. We will collect this information as confounders and factor into statistical analysis.
LifeWorks
Shawnee Mission, Kansas, United States
Percentage of patients with knee OA, CLBP, and CNP presenting with CS symptoms.
Percentage of patients with knee OA, CLBP, and CNP presenting with CS symptoms.
Time frame: Through study completion, up to 16 weeks
2011 Fibromyalgia (FM) survey
A standard questionnaire for centralized pain. Scores 3-6 in widespread pain index and 9 or greater in symptom severity suggest widespread pain
Time frame: Through study completion, up to 16 weeks
Beck Anxiety Inventory
A standard questionnaire with 21 questions. Scores 0-21=low anxiety, scores 22-35=moderate anxiety and scores 36 and above=potentially concerning level of anxiety
Time frame: Through study completion, up to 16 weeks
Pittsburg sleep scale
A standard questionnaire to examine sleep problems. A total of 5 scores or greater indicate poor sleep quality
Time frame: Through study completion, up to 16 weeks
Fear Avoidance Questionnaire
A standard questionnaire to examine fear related to work and physical activities.
Time frame: Through study completion, up to 16 weeks
Lower Extremity Functional Scale (LEFS) for patients with knee OA
LEFS is a 20-question survey about the participant's ability to perform everyday tasks.
Time frame: Through study completion, up to 16 weeks
Neck Disability Index (NDI) for patients with CNP
NDI is a 10-question survey in which participants check a box corresponding to how their neck pain impacts their activities of daily living.
Time frame: Through study completion, up to 16 weeks
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Oswestry Disability Index (ODI) for patients with CLBP
ODI is a 10-question survey in which participants check a box corresponding to how their low back pain impacts their activities of daily living.
Time frame: Through study completion, up to 16 weeks
Physical Therapy examination data
Routine PT subjective and objective examination data that includes history taking, range of motion, muscle testing, and neurological exam if necessary
Time frame: Through study completion, up to 16 weeks
Functional Exam as part of routine primary PT
Routine PT functional assessment includes gait, sit-to-stand, stair climbing, and squats
Time frame: Through study completion, up to 16 weeks
Neck flexor muscle performance
Strength and endurance. Strength will be tested manually with 0-5 MMT standard grading scale or with use of dynamometer for strength and endurance performance of individual muscles.
Time frame: Through study completion, up to 16 weeks