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The Pain Disability Questionnaire (PDQ): evaluation of its utility for presurgical and 1-year postsurgical physical and psychosocial outcomes for patients undergoing total knee arthroplasty. CURRENT ORTHOPAEDIC PRACTICE 2016. [DOI: 10.1097/bco.0000000000000384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Urquhart DM, Phyomaung PP, Dubowitz J, Fernando S, Wluka AE, Raajmaakers P, Wang Y, Cicuttini FM. Are cognitive and behavioural factors associated with knee pain? A systematic review. Semin Arthritis Rheum 2014; 44:445-55. [PMID: 25151034 DOI: 10.1016/j.semarthrit.2014.07.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/11/2014] [Accepted: 07/11/2014] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Although studies that have examined the relationship between cognitive and behavioural factors and knee pain report conflicting results, no systematic review has been performed to summarise the evidence. The aim of this systematic review was to examine the relationship between cognitive and behavioural factors and pain at the knee. METHODS Electronic searches of MEDLINE, EMBASE and PsycINFO were performed to identify relevant studies published up to April 2014 using MeSH terms and keywords. Studies that met a set of predefined criteria were included. Coping, self-efficacy, somatising, pain catastrophising and helplessness were grouped together as "cognitive factors," while kinesiophobia and pain-related fear-avoidance were considered "behavioural factors." Two independent reviewers extracted the data and assessed the methodological quality of the selected studies. Due to the heterogeneity of the studies, a best-evidence synthesis was performed. RESULTS A total of 14 studies were included in the review, of which nine examined cognitive factors, one investigated behavioural factors and four studied both cognitive and behavioural factors. Eight of 14 studies were of high quality. The best-evidence synthesis showed moderate evidence for a relationship between cognitive factors and knee pain and limited evidence for no association between the behavioural factors and knee pain. CONCLUSION This review found evidence for a relationship between cognitive factors, but not behavioural factors, and knee pain. These findings will need to be confirmed with high-quality longitudinal studies, but the data suggest that cognitive factors may be important to target in the management of knee pain.
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Affiliation(s)
- Donna M Urquhart
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Rd, Melbourne 3004, Victoria, Australia
| | - Pyae P Phyomaung
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Rd, Melbourne 3004, Victoria, Australia
| | - Julia Dubowitz
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Rd, Melbourne 3004, Victoria, Australia
| | - Sanduni Fernando
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Rd, Melbourne 3004, Victoria, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Rd, Melbourne 3004, Victoria, Australia
| | - Paul Raajmaakers
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Rd, Melbourne 3004, Victoria, Australia
| | - Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Rd, Melbourne 3004, Victoria, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Rd, Melbourne 3004, Victoria, Australia.
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Phyomaung PP, Dubowitz J, Cicuttini FM, Fernando S, Wluka AE, Raaijmaakers P, Wang Y, Urquhart DM. Are depression, anxiety and poor mental health risk factors for knee pain? A systematic review. BMC Musculoskelet Disord 2014; 15:10. [PMID: 24405725 PMCID: PMC3907141 DOI: 10.1186/1471-2474-15-10] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 11/25/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND While it is recognized that psychosocial factors are important in the development and progression of musculoskeletal pain and disability, no systematic review has specifically focused on examining the relationship between psychosocial factors and knee pain. We aimed to systematically review the evidence to determine whether psychosocial factors, specifically depression, anxiety and poor mental health, are risk factors for knee pain. METHODS Electronic searches of MEDLINE, EMBASE and PsycINFO were performed to identify relevant studies published up to August 2012 using MESH terms and keywords. We included studies that met a set of predefined criteria and two independent reviewers assessed the methodological quality of the selected studies. Due to the heterogeneity of the studies, a best evidence synthesis was performed. RESULTS Sixteen studies were included in the review, of which 9 were considered high quality. The study populations were heterogeneous in terms of diagnosis of knee pain. We found a strong level of evidence for a relationship between depression and knee pain, limited evidence for no relationship between anxiety and knee pain, and minimal evidence for no relationship between poor mental health and knee pain. CONCLUSIONS Despite the heterogeneity of the included studies, these data show that depression plays a significant role in knee pain, and that a biopsychosocial approach to the management of this condition is integral to optimising outcomes for knee pain.
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Affiliation(s)
| | | | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Commercial Rd, Melbourne 3004, Victoria, Australia.
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