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González-de-la-Flor Á, Valera-Calero JA, García-Fernández P, López-de-Uralde-Villanueva I, Fernández-de-Las-Peñas C, Plaza-Manzano G. Clinical Presentation Differences Among Four Subtypes of Femoroacetabular Impingement: A Case-Control Study. Phys Ther 2024; 104:pzad179. [PMID: 38157293 DOI: 10.1093/ptj/pzad179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/21/2023] [Accepted: 11/07/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The aims of this study were to assess the psychological, functional, and physical differences between patients with femoroacetabular impingement (FAI) syndrome and individuals who were asymptomatic (controls) to analyze clinical differences among 4 subtypes of FAI (cam type, cam type with labral tear, pincer type, and pincer type with labral tear), to calculate the correlations among the variables described, and to identify risk factors contributing to the hip function variance. METHODS A case-control study was conducted at a hospital rehabilitation unit with a cohort of individuals who were asymptomatic (controls) and a cohort of patients with FAI. Sociodemographic characteristics, pain intensity, psychological health status, hip range of motion (RoM), hip isometric strength, and hip function were assessed. RESULTS A total of 69 controls and 69 patients with FAI were analyzed. Although sociodemographic characteristics were comparable between samples, poorer hip RoM, strength, and psychological health were found for the cases. FAI subtypes showed no significant pain intensity, psychological health, or RoM differences (except for hip adduction), but hip strength differed among FAI subtypes. Multiple significant correlations between psychological health, pain intensity, RoM, strength, and hip function were found. The variance values of the International Hip Outcome Tool, Hip Outcome Score (HOS) for daily living activities, and HOS for sports activities were partially explained (47.6%, 36.0%, and 21.6%, respectively) on the basis of kinesiophobia, hip strength, self-efficacy, and anxiety. CONCLUSION Patients with FAI showed poorer psychological health, hip RoM, and strength than individuals who were asymptomatic and had similar sociodemographic characteristics. FAI subtype influenced the patients' clinical presentations. Hip strength, kinesiophobia, anxiety, and self-efficacy should be targeted for improving hip function, as they have been demonstrated to be important contributors to hip disability. IMPACT This study demonstrated that pain catastrophizing, hip strength, and hip adduction differed among FAI subtypes. However, hip function and pain intensity were comparable between FAI subtypes.
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Affiliation(s)
- Ángel González-de-la-Flor
- Department of Physical Therapy and Sport Medicine, Hospital Universitario Quironsalud Madrid, Madrid, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Pablo García-Fernández
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Hoffmann AA, Frostell E, Hedman-Lagerlöf M, McCracken LM, Axelsson E. Psychometric evaluation of the Pain Vigilance and Awareness Questionnaire (PVAQ) in fibromyalgia: Confirmatory factor analysis and the development of a Swedish 8-item version. Eur J Pain 2024; 28:396-407. [PMID: 37759360 DOI: 10.1002/ejp.2188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Excessive attention to pain, or hypervigilance, is associated with negative outcomes in chronic pain conditions such as fibromyalgia. The Pain Vigilance and Awareness Questionnaire (PVAQ) is a self-report questionnaire to measure attention to pain. This study aimed to evaluate the psychometric properties of a Swedish version of the PVAQ. METHODS Psychometric evaluation on cross-sectional data derived from a clinical trial for fibromyalgia (N = 274). We evaluated item characteristics, factor structure in a confirmatory factor analytic framework, internal consistency, and construct validity in terms of correlations with other clinical variables. RESULTS Though confirmatory factor analysis did not result in a satisfactory solution for the full 16-item scale, acceptable two-factor solutions could be based on either nine or eight items (the PVAQ-9 and PVAQ-8). Internal consistency for both the PVAQ-9 and PVAQ-8 were good to excellent, and associations with pain catastrophizing, anxiety, depression, disability, and overall fibromyalgia impact were largely supportive of construct validity. An unexpected result was that, contrary to previous findings, no version of the PVAQ correlated consistently with pain intensity. CONCLUSIONS The Swedish PVAQ-9 and PVAQ-8 appear to have acceptable psychometric properties when administered online to individuals with fibromyalgia. The PVAQ-8 may be preferable due to being shorter and including an equal number of items per factor. Replication is warranted. SIGNIFICANCE This study evaluated the psychometric properties of a Swedish translation of the PVAQ in individuals with fibromyalgia. No convincing factor structure was found for the 16-item version. We could, however, confirm the factor structure of an established 9-item version (the PVAQ-9), and recommend further use of a new 8-item version (the PVAQ-8). In summary, the PVAQ exhibited more convincing psychometric properties when the number of items was roughly cut in half.
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Affiliation(s)
- Alice Ahnlund Hoffmann
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Elsa Frostell
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maria Hedman-Lagerlöf
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden
| | | | - Erland Axelsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Liljeholmen Primary Health Care Center, Region Stockholm, Stockholm, Sweden
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden
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Huang X, Yin J, Liu X, Tan W, Lao M, Wang X, Liu S, Ou Q, Tang D, Wu W. The overgeneralization of pain-related fear in individuals with higher pain sensitivity: A behavioral and event-related potential study. Brain Res 2023; 1818:148473. [PMID: 37414269 DOI: 10.1016/j.brainres.2023.148473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023]
Abstract
Fear generalization contributes to the development and maintenance of pain. Pain sensitivity has been proposed to predict the strength of fear responses to aversive stimuli. However, whether individual variation in pain sensitivity affects pain-related fear generalization and its underlying cognitive processing remains unclear. To address this gap, we recorded behavioral and event-related potential (ERP) data among 22 high pain sensitivity (HPS) and 22 low pain sensitivity (LPS) healthy adults when exposed to a fear generalization paradigm. The behavioral results indicate that the HPS group displayed higher unconditioned stimulus expectancy and greater fear, arousal, and anxiety ratings to conditioned stimulus and generalization stimulus than the LPS group (all p values < 0.05). The ERP results showed that the HPS group exhibited a larger late positive potential evoked by GS2, GS3 and CS- (all p < 0.005) but a smaller N1 evoked by all CS and GSs (all p values < 0.05) relative to the LPS group. These findings suggest that individuals with a high level of pain sensitivity allocate more attention resources to pain-related threatening stimuli, which contributes to an overgeneralization of pain-related fear.
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Affiliation(s)
- Xiaomin Huang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China
| | - Junxiao Yin
- Department of Clinical Medical College of Acupuncture and Rehabilitation, University of Traditional Chinese Medicine, Guangzhou, Guangdong 510006, China
| | - Xinli Liu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China
| | - Wenwei Tan
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China
| | - Mengting Lao
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China
| | - Xianglong Wang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China
| | - Sishi Liu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China
| | - Qiling Ou
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China
| | - Danzhe Tang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China
| | - Wen Wu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China.
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Valera-Calero JA, Arendt-Nielsen L, Cigarán-Méndez M, Fernández-de-las-Peñas C, Varol U. Network Analysis for Better Understanding the Complex Psycho-Biological Mechanisms behind Fibromyalgia Syndrome. Diagnostics (Basel) 2022; 12:diagnostics12081845. [PMID: 36010196 PMCID: PMC9406816 DOI: 10.3390/diagnostics12081845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 07/21/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess potential associations between sensory, cognitive, health-related, and physical variables in women with fibromyalgia syndrome (FMS) using a network analysis for better understanding the complexity of psycho-biological mechanisms. Demographic, clinical, pressure pain threshold (PPT), health-related, physical, and psychological/cognitive variables were collected in 126 women with FMS. A network analysis was conducted to quantify the adjusted correlations between the modeled variables and to assess the centrality indices (i.e., the degree of connection with other symptoms in the network and the importance in the system modeled as a network. This model showed several local associations between the variables. Multiple positive correlations between PPTs were observed, being the strongest weight between PPTs over the knee and tibialis anterior (ρ: 0.28). Catastrophism was associated with higher hypervigilance (ρ: 0.23) and lower health-related EuroQol-5D (ρ: −0.24). The most central variables were PPT over the tibialis anterior (the highest strength centrality), hand grip (the highest harmonic centrality) and Time Up and Go (the highest betweenness centrality). This study, applying network analysis to understand the complex mechanisms of women with FMS, supports a model where sensory-related, psychological/cognitive, health-related, and physical variables are connected. Implications of the current findings, e.g., developing treatments targeting these mechanisms, are discussed.
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Affiliation(s)
- Juan Antonio Valera-Calero
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Villanueva de la Cañada, Spain; (J.A.V.-C.); (U.V.)
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Villanueva de la Cañada, Spain
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Sanse-Motorisk Interaktion (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9220 Aalborg, Denmark;
- Department of Medical Gastroenterology, Mech-Sense, Aalborg University Hospital, 9000 Aalborg, Denmark
| | | | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcon, Spain
- Correspondence:
| | - Umut Varol
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, 28692 Villanueva de la Cañada, Spain; (J.A.V.-C.); (U.V.)
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García-Pérez-de-Sevilla G, Gónzalez-de-la-Flor Á, Martín-Vera D, Domínguez-Balmaseda D, del-Blanco-Muñiz JÁ. Deep Cervical Muscles and Functionality in Patients with Chronic Tension-Type Headache: An Observational Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58070917. [PMID: 35888636 PMCID: PMC9320185 DOI: 10.3390/medicina58070917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 12/26/2022]
Abstract
Background and objectives: Chronic tension-type headache (TTH) is the type of headache with the highest prevalence. The involvement of musculoskeletal structures in TTH is supported by evidence in the scientific literature. Among these, deep cervical muscle strength appears to be related to the function of the cervical spine and the clinical characteristics of TTH. This study aimed to correlate anatomical, functional, and psychological variables in patients with TTH. Materials and methods: An observational descriptive study was carried out with 22 participants diagnosed with TTH for at least six months. The characteristics of headaches, including ultrasound-based deep neck flexor and extensor muscle thickness, range of motion (ROM), and pressure pain threshold (PPT), were recorded. We also conducted the Pain Vigilance and Awareness Questionnaire (PVAQ) and the Craniocervical Flexion Test (CCFT). Results: Moderate–large negative correlations were found between the PVAQ and the muscle thickness of right deep flexors contracted (r = −0.52; p = 0.01), left multifidus contracted (r = −0.44; p = 0.04), right multifidus at rest (r = −0.48; p = 0.02), and right multifidus contracted (r = −0.45; p = 0.04). Moderate–large positive correlations were found between the CCFT score and the left cervical rotation ROM (r = 0.53; p = 0.01), right cervical rotation ROM (r = 0.48; p = 0.03), muscle thickness of left multifidus contracted (r = 0.50; p = 0.02), and muscle thickness of right multifidus at rest (r = 0.51; p = 0.02). The muscle thickness of the contracted right deep cervical flexors showed a moderate negative correlation with headache intensity (r = −0.464; p = 0.03). No correlations were found between PPT and the rest of the variables analyzed. Conclusions: In patients with TTH, a higher thickness of deep cervical muscles was associated with higher ROM and higher scores in the CCFT. In turn, the thickness of deep cervical muscles showed negative correlations with pain hypervigilance and headache intensity. These results contribute to a better understanding of the physical and psychosocial factors contributing to the development of TTH, which is useful for implementing appropriate prevention and treatment measures.
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Liew BXW, Valera-Calero JA, Varol U, Nijs J, Arendt-Nielsen L, Plaza-Manzano G, Fernández-de-las-Peñas C. Distress and Sensitization as Main Mediators of Severity in Women with Fibromyalgia: A Structural Equation Model. Biomedicines 2022; 10:1188. [PMID: 35625923 PMCID: PMC9138673 DOI: 10.3390/biomedicines10051188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/10/2022] [Accepted: 05/18/2022] [Indexed: 12/05/2022] Open
Abstract
We aimed to explore a path model identified using a structural equation model (SEM) which best explains the multivariate contributions of sensitization, sensitivity, and emotional variables to clinical severity in women with FMS. Pain features, the Central Sensitization Inventory (CSI), painDETECT, S-LANSS, the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), the Pain Catastrophizing Scale (PCS), the Pain Vigilance and Awareness Questionnaire (PVAQ), the 11-item Tampa Scale for Kinesiophobia (TSK-11), and pressure pain thresholds (PPTs) were collected from 113 women with FMS. Four latent variables were created: severity (clinical pain features), sensitivity (PPTs), sensitization (S-LANSS, CSI, painDETECT), and distress (HADS-A, HADS-D, PCS, PVAQ, TSK-11). Data fit for the measurement model were considered excellent (RMSEA = 0.043, CFI = 0.966, SRMR = 0.067, and NNFI = 0.960). Distress had a significant relationship with the mediators of sleep (β = 0.452, p = 0.031) and sensitization (β = 0.618, p = 0.001). The only mediator with a significant effect (β = 1.113, p < 0.001) on severity was sensitization. A significant indirect effect of sensitization (β = 0.687, p = 0.001) that explained the relationship between distress and severity was also identified. The proposed model suggests that distress and sensitization, together with poor sleep, have a complex mediating effect on severity in women with FMS. The identified path model can be leveraged in clinical trials investigating treatment approaches for FMS.
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Affiliation(s)
- Bernard X. W. Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3SQ, UK;
| | - Juan Antonio Valera-Calero
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain;
| | - Umut Varol
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain;
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium;
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1050 Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9220 Aalborg, Denmark;
- Department of Medical Gastroenterology, Mech-Sense, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain;
- Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain
| | - César Fernández-de-las-Peñas
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9220 Aalborg, Denmark;
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
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Bayesian Linear Regressions Applied to Fibromyalgia Syndrome for Understanding the Complexity of This Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084682. [PMID: 35457550 PMCID: PMC9025530 DOI: 10.3390/ijerph19084682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 02/01/2023]
Abstract
A better understanding of the connection between factors associated with pain sensitivity and related disability in people with fibromyalgia syndrome may assist therapists in optimizing therapeutic programs. The current study applied mathematical modeling to analyze relationships between pain-related, psychological, psychophysical, health-related, and cognitive variables with sensitization symptom and related disability by using Bayesian Linear Regressions (BLR) in women with fibromyalgia syndrome (FMS). The novelty of the present work was to transfer a mathematical background to a complex pain condition with widespread symptoms. Demographic, clinical, psychological, psychophysical, health-related, cognitive, sensory-related, and related-disability variables were collected in 126 women with FMS. The first BLR model revealed that age, pain intensity at rest (mean-worst pain), years with pain (history of pain), and anxiety levels have significant correlations with the presence of sensitization-associated symptoms. The second BLR showed that lower health-related quality of life and higher pain intensity at rest (mean-worst pain) and pain intensity with daily activities were significantly correlated with related disability. These results support an application of mathematical modeling for identifying different interactions between a sensory (i.e., Central Sensitization Score) and a functional (i.e., Fibromyalgia Impact Questionnaire) aspect in women with FMS.
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Cigarán-Méndez M, Úbeda-D'Ocasar E, Arias-Buría JL, Fernández-de-Las-Peñas C, Gallego-Sendarrubias GM, Valera-Calero JA. The hand grip force test as a measure of physical function in women with fibromyalgia. Sci Rep 2022; 12:3414. [PMID: 35233066 PMCID: PMC8888740 DOI: 10.1038/s41598-022-07480-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/17/2022] [Indexed: 11/09/2022] Open
Abstract
Previous studies have reported the presence of muscle weakness in women with fibromyalgia syndrome (FMS) which is considered a risk factor for developing earlier disability and dependence during activities of daily life (ADL). We aimed to assess the relationship between hand grip force with sociodemographic, clinical, disease-specific, cognitive, and physical function variables in women with FMS. One hundred twenty-six women with FMS completed demographic (age, gender, height, weight, body mass index), pain-related (pain history, pain intensity at rest and during ADL), disease-specific severity (Fibromyalgia Impact Questionnaire -FIQ-S-, Fibromyalgia Health Assessment Questionnaire -FHAQ-, EuroQol-5D, Pain Catastrophizing Scale -PCS-, Pittsburgh Sleep Quality Index-PSQI-, Pain Vigilance and Awareness Questionnaire -PVAQ-, and Central Sensitization Inventory -CSI-), psychological (Tampa Scale for Kinesiophobia, TKS-11; Pain Vigilance and Awareness Questionnaire, PVAQ; Pain Catastrophizing Scale, PCS), and physical function (hand grip force, and Timed Up and Go Test, TUG). Hand grip force was associated with height (r = −0.273), BMI (r = 0.265), worst pain at rest (r = −0.228), pain during ADL (r = −0.244), TUG (r = −0.406), FHAQ (r = −0.386), EuroQol-5D (r = 0.353), CSI (r = −0.321) and PSQI (r = −0.250). The stepwise regression analysis revealed that 34.4% of hand grip force was explained by weight (6.4%), TUG (22.2%), and FHAQ (5.8%) variables. This study found that hand grip force is associated with physical function indicators, but not with fear-avoidance behaviors nor pain-related features of FMS. Hand grip force could be considered as an easy tool for identifying the risk of fall and poorer physical health status.
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Affiliation(s)
| | - Edurne Úbeda-D'Ocasar
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Calle Castillo de Alarcón 49, 28692, Villanueva de la Cañada, Madrid, Spain
| | - José Luis Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Gracia María Gallego-Sendarrubias
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Calle Castillo de Alarcón 49, 28692, Villanueva de la Cañada, Madrid, Spain
| | - Juan Antonio Valera-Calero
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Calle Castillo de Alarcón 49, 28692, Villanueva de la Cañada, Madrid, Spain. .,VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, Spain.
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The Spatial Extent of Pain Is Associated with Pain Intensity, Catastrophizing and Some Measures of Central Sensitization in People with Frozen Shoulder. J Clin Med 2021; 11:jcm11010154. [PMID: 35011895 PMCID: PMC8745240 DOI: 10.3390/jcm11010154] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this cross-sectional study was to explore the spatial extent of pain and its association with clinical symptoms, psychological features, and pain sensitization in people with frozen shoulder (FS). Forty-eight individuals with FS completed pain drawings (PDs) and reported their clinical symptoms including pain intensity (Visual Analogue Scale) and shoulder disability (Shoulder Pain and Disability Index). Moreover, pain sensitization measurements (pressure pain thresholds, temporal summation, conditioned pain modulation, and Central Sensitization Inventory (CSI)) were assessed. Psychological features were assessed by Pain Catastrophizing Scale (PCS) and Pain Vigilance and Awareness Questionnaire. Pain frequency maps were generated, Margolis rating scale was used for pain location, and Spearman correlation coefficients were computed. The mean (SD) pain extent was 12.5% (6.7%) and the most common painful area was the anterolateral shoulder region (100%). Women presented a more widespread pain distribution compared with men. Significant positive associations were obtained between pain extent and current pain intensity (rs = 0.421, p < 0.01), PCS (rs = 0.307, p < 0.05) and CSI (rs = 0.358, p < 0.05). The anterolateral region of the shoulder was the most common painful area in people with FS. Women with FS presented more extended areas of pain; and a more widespread distribution of pain was correlated with higher levels of pain, pain catastrophizing and pain sensitization.
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Influence of Catechol-O-Methyltransferase Gene Polymorphism on the Correlation between Alexithymia and Hypervigilance to Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413265. [PMID: 34948872 PMCID: PMC8704340 DOI: 10.3390/ijerph182413265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022]
Abstract
The psychological characteristic of having difficulty expressing emotions, known as alexithymia, is associated with hypervigilance to pain and is considered one of the risk factors for chronic pain. The correlation between alexithymia and hypervigilance to pain can be observed even in healthy individuals. However, the factors influencing this correlation remain unknown. We explored the dopamine system, which is known to be involved in emotion and pain. The dopamine-degrading enzyme catechol-O-methyltransferase (COMT) has a genetic polymorphism known to influence dopamine metabolism in the prefrontal cortex. COMT polymorphism reportedly affects various aspects of pain and increases pain sensitivity in Met allele carriers. Therefore, we investigated whether the correlation between alexithymia and hypervigilance to pain is influenced by COMT polymorphism in healthy individuals. The results revealed a significant positive correlation between the "difficulty describing feelings" of the 20-item Toronto Alexithymia Scale and the "attention to changes in pain" of the pain vigilance and awareness questionnaire in COMT Met carriers but not in Val/Val individuals. This finding suggests that the correlation between alexithymia and hypervigilance to pain is influenced by COMT polymorphism.
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Mutlu P, Zateri C, Zohra A, Ozerdogan O, Mirici AN. Prevalence of obstructive sleep apnea in female patients with fibromyalgia. Saudi Med J 2020; 41:740-745. [PMID: 32601643 PMCID: PMC7502927 DOI: 10.15537/smj.2020.7.25165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives: To determine the prevalence of obstructive sleep apnea in female patients with fibromyalgia (FM) presenting to physical therapy outpatient clinics. Methods: The 36-item short form health survey (SF-36) questionnaire, Berlin test, and epworth sleepiness scale were administered, along with a polysomnography to 38 female patients. This cross-sectional study comprised diagnosed with FM according to the diagnostic criteria of the American College of Rheumatology, between March 2017 and August 2019, at the Faculty of Medicine Hospital, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. Results: Of the participants, 65.9% were found to have obstructive sleep apnea (OSA). Patients with OSA were older and had a higher disease activity score for FM. A strong positive correlation was identified between the apnea-hypopnea index (AHI) and the FA disease activity score. A negative correlation was found between AHI and the subscales of SF-36. Conclusion: A clinical assessment of female patients with FM requires a multidisciplinary approach, and patients with excessive daytime sleepiness in particular are recommended to undergo polysomnography. The authors believe that the early detection and treatment of accompanying OSA will contribute not only to the quality of life, but also to the survival of patients with FM.
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Affiliation(s)
- Pinar Mutlu
- Department of Chest Diseases, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. E-mail.
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Koca TT, Tugan CB, Koçyiğit BF, Nacitarhan V. Fibromyalgia awareness in women aged between 18 and 75 years: a current view to fibromyalgia. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-0970-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Expanded Distribution of Pain as a Sign of Central Sensitization in Individuals With Symptomatic Knee Osteoarthritis. Phys Ther 2016; 96:1196-207. [PMID: 26939604 DOI: 10.2522/ptj.20150492] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 02/24/2016] [Indexed: 02/09/2023]
Abstract
BACKGROUND Expanded distribution of pain is considered a sign of central sensitization (CS). The relationship between recording of symptoms and CS in people with knee osteoarthritis (OA) has been poorly investigated. OBJECTIVE The aim of this study was to examine whether the area of pain assessed using pain drawings relates to CS and clinical symptoms in people with knee OA. DESIGN This was a cross-sectional study. METHODS Fifty-three people with knee OA scheduled to undergo primary total knee arthroplasty were studied. All participants completed pain drawings using a novel digital device, completed self-administration questionnaires, and were assessed by quantitative sensory testing. Pain frequency maps were generated separately for women and men. Spearman correlation coefficients were computed to reveal possible correlations between the area of pain and quantitative sensory testing and clinical symptoms. RESULTS Pain frequency maps revealed enlarged areas of pain, especially in women. Enlarged areas of pain were associated with higher knee pain severity (rs=.325, P<.05) and stiffness (rs=.341, P<.05), lower pressure pain thresholds at the knee (rs=-.306, P<.05) and epicondyle (rs=-.308, P<.05), and higher scores with the Central Sensitization Inventory (rs=.456, P<.01). No significant associations were observed between the area of pain and the remaining clinical symptoms and measures of CS. LIMITATIONS Firm conclusions about the predictive role of pain drawings cannot be drawn. Further evaluation of the reliability and validity of pain area extracted from pain drawings in people with knee OA is needed. CONCLUSION Expanded distribution of pain was correlated with some measures of CS in individuals with knee OA. Pain drawings may constitute an easy way for the early identification of CS in people with knee OA, but further research is needed.
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