Do sex and pain characteristics influence the effectiveness of pain neuroscience education in people scheduled for total knee arthroplasty?: secondary analysis of a randomized controlled trial

Eva Huysmans; Jean-Pierre Baeyens; Lirios Dueñas; Deborah Falla; Mira Meeus; Eva Roose; Jo Nijs; Enrique Lluch Girbés

doi:10.1093/ptj/pzab197

Do sex and pain characteristics influence the effectiveness of pain neuroscience education in people scheduled for total knee arthroplasty? secondary analysis of a randomized controlled trial

Eva Huysmans, Jean-Pierre Baeyens, Lirios Dueñas, Deborah Falla, Mira Meeus, Eva Roose, Jo Nijs, Enrique Lluch Girbés

Sport, Exercise and Rehabilitation Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: This explorative study investigates the moderating effect of sex and baseline pain characteristics on the effectiveness of preoperative pain neuroscience education (PNE) plus knee joint mobilization versus biomedical education plus knee joint mobilization in patients who have knee osteoarthritis and are scheduled to undergo total knee arthroplasty (TKA).

METHODS: After baseline assessment of self-reported questionnaires (pain intensity, disability, symptoms of central sensitization and pain cognitions) and quantitative sensory testing, 44 participants with knee osteoarthritis were randomized into the PNE plus knee joint mobilization or biomedical education plus knee joint mobilization group. The questionnaires were retaken directly after and 1 month after 4 sessions of treatment and at 3 months after surgery. Based on baseline quantitative sensory testing results, the sample was subdivided into a high (showing high experimental pain levels and low pressure pain thresholds) and low pain cluster using principal components analysis and cluster analysis. Therapy effects over time were evaluated using 3-way analysis of variance, with time as the within factor and treatment, sex, and baseline pain cluster as between factors.

RESULTS: Women benefited significantly more from the PNE intervention compared with the control intervention in terms of self-reported symptoms of central sensitization. For both pain clusters, differences in therapeutic effects concerning pain intensity and pain cognitions were found, with higher superiority of the PNE intervention in the high-pain cluster subgroup compared with the low-pain cluster.

CONCLUSION: Based on these explorative analyses, it can be concluded that sex and preoperative pain measures may influence the effectiveness of preoperative PNE for some specific outcome measures in people scheduled to undergo TKA.

IMPACT: Although further research on this topic is needed, the potential influence of sex and preoperative pain measures on the effectiveness of preoperative PNE should be considered when implementing this intervention in people undergoing TKA.

Original language	English
Article number	pzab197
Number of pages	11
Journal	Physical Therapy
Volume	101
Issue number	12
Early online date	25 Aug 2021
DOIs	https://doi.org/10.1093/ptj/pzab197
Publication status	Published - Dec 2021

Bibliographical note

Keywords

Pain
Osteoarthritis
Education: Clinical
Arthroplasty

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10.1093/ptj/pzab197

https://academic.oup.com/ptj/advance-article-abstract/doi/10.1093/ptj/pzab197/6352443Licence: None: All rights reserved

Cite this

Huysmans, E., Baeyens, J-P., Dueñas, L., Falla, D., Meeus, M., Roose, E., Nijs, J., & Girbés, E. L. (2021). Do sex and pain characteristics influence the effectiveness of pain neuroscience education in people scheduled for total knee arthroplasty? secondary analysis of a randomized controlled trial. Physical Therapy, 101(12), Article pzab197. Advance online publication. https://doi.org/10.1093/ptj/pzab197

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title = "Do sex and pain characteristics influence the effectiveness of pain neuroscience education in people scheduled for total knee arthroplasty?: secondary analysis of a randomized controlled trial",

abstract = "OBJECTIVE: This explorative study investigates the moderating effect of sex and baseline pain characteristics on the effectiveness of preoperative pain neuroscience education (PNE) plus knee joint mobilization versus biomedical education plus knee joint mobilization in patients who have knee osteoarthritis and are scheduled to undergo total knee arthroplasty (TKA).METHODS: After baseline assessment of self-reported questionnaires (pain intensity, disability, symptoms of central sensitization and pain cognitions) and quantitative sensory testing, 44 participants with knee osteoarthritis were randomized into the PNE plus knee joint mobilization or biomedical education plus knee joint mobilization group. The questionnaires were retaken directly after and 1 month after 4 sessions of treatment and at 3 months after surgery. Based on baseline quantitative sensory testing results, the sample was subdivided into a high (showing high experimental pain levels and low pressure pain thresholds) and low pain cluster using principal components analysis and cluster analysis. Therapy effects over time were evaluated using 3-way analysis of variance, with time as the within factor and treatment, sex, and baseline pain cluster as between factors.RESULTS: Women benefited significantly more from the PNE intervention compared with the control intervention in terms of self-reported symptoms of central sensitization. For both pain clusters, differences in therapeutic effects concerning pain intensity and pain cognitions were found, with higher superiority of the PNE intervention in the high-pain cluster subgroup compared with the low-pain cluster.CONCLUSION: Based on these explorative analyses, it can be concluded that sex and preoperative pain measures may influence the effectiveness of preoperative PNE for some specific outcome measures in people scheduled to undergo TKA.IMPACT: Although further research on this topic is needed, the potential influence of sex and preoperative pain measures on the effectiveness of preoperative PNE should be considered when implementing this intervention in people undergoing TKA.",

keywords = "Pain, Osteoarthritis, Education: Clinical, Arthroplasty",

author = "Eva Huysmans and Jean-Pierre Baeyens and Lirios Due{\~n}as and Deborah Falla and Mira Meeus and Eva Roose and Jo Nijs and Girb{\'e}s, {Enrique Lluch}",

note = "{\textcopyright} The Author(s) 2021. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.",

year = "2021",

month = dec,

doi = "10.1093/ptj/pzab197",

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Huysmans, E, Baeyens, J-P, Dueñas, L, Falla, D, Meeus, M, Roose, E, Nijs, J & Girbés, EL 2021, 'Do sex and pain characteristics influence the effectiveness of pain neuroscience education in people scheduled for total knee arthroplasty? secondary analysis of a randomized controlled trial', Physical Therapy, vol. 101, no. 12, pzab197. https://doi.org/10.1093/ptj/pzab197

Do sex and pain characteristics influence the effectiveness of pain neuroscience education in people scheduled for total knee arthroplasty? secondary analysis of a randomized controlled trial. / Huysmans, Eva; Baeyens, Jean-Pierre; Dueñas, Lirios et al.
In: Physical Therapy, Vol. 101, No. 12, pzab197, 12.2021.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Do sex and pain characteristics influence the effectiveness of pain neuroscience education in people scheduled for total knee arthroplasty?

T2 - secondary analysis of a randomized controlled trial

AU - Huysmans, Eva

AU - Baeyens, Jean-Pierre

AU - Dueñas, Lirios

AU - Falla, Deborah

AU - Meeus, Mira

AU - Roose, Eva

AU - Nijs, Jo

AU - Girbés, Enrique Lluch

N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.

PY - 2021/12

Y1 - 2021/12

N2 - OBJECTIVE: This explorative study investigates the moderating effect of sex and baseline pain characteristics on the effectiveness of preoperative pain neuroscience education (PNE) plus knee joint mobilization versus biomedical education plus knee joint mobilization in patients who have knee osteoarthritis and are scheduled to undergo total knee arthroplasty (TKA).METHODS: After baseline assessment of self-reported questionnaires (pain intensity, disability, symptoms of central sensitization and pain cognitions) and quantitative sensory testing, 44 participants with knee osteoarthritis were randomized into the PNE plus knee joint mobilization or biomedical education plus knee joint mobilization group. The questionnaires were retaken directly after and 1 month after 4 sessions of treatment and at 3 months after surgery. Based on baseline quantitative sensory testing results, the sample was subdivided into a high (showing high experimental pain levels and low pressure pain thresholds) and low pain cluster using principal components analysis and cluster analysis. Therapy effects over time were evaluated using 3-way analysis of variance, with time as the within factor and treatment, sex, and baseline pain cluster as between factors.RESULTS: Women benefited significantly more from the PNE intervention compared with the control intervention in terms of self-reported symptoms of central sensitization. For both pain clusters, differences in therapeutic effects concerning pain intensity and pain cognitions were found, with higher superiority of the PNE intervention in the high-pain cluster subgroup compared with the low-pain cluster.CONCLUSION: Based on these explorative analyses, it can be concluded that sex and preoperative pain measures may influence the effectiveness of preoperative PNE for some specific outcome measures in people scheduled to undergo TKA.IMPACT: Although further research on this topic is needed, the potential influence of sex and preoperative pain measures on the effectiveness of preoperative PNE should be considered when implementing this intervention in people undergoing TKA.

AB - OBJECTIVE: This explorative study investigates the moderating effect of sex and baseline pain characteristics on the effectiveness of preoperative pain neuroscience education (PNE) plus knee joint mobilization versus biomedical education plus knee joint mobilization in patients who have knee osteoarthritis and are scheduled to undergo total knee arthroplasty (TKA).METHODS: After baseline assessment of self-reported questionnaires (pain intensity, disability, symptoms of central sensitization and pain cognitions) and quantitative sensory testing, 44 participants with knee osteoarthritis were randomized into the PNE plus knee joint mobilization or biomedical education plus knee joint mobilization group. The questionnaires were retaken directly after and 1 month after 4 sessions of treatment and at 3 months after surgery. Based on baseline quantitative sensory testing results, the sample was subdivided into a high (showing high experimental pain levels and low pressure pain thresholds) and low pain cluster using principal components analysis and cluster analysis. Therapy effects over time were evaluated using 3-way analysis of variance, with time as the within factor and treatment, sex, and baseline pain cluster as between factors.RESULTS: Women benefited significantly more from the PNE intervention compared with the control intervention in terms of self-reported symptoms of central sensitization. For both pain clusters, differences in therapeutic effects concerning pain intensity and pain cognitions were found, with higher superiority of the PNE intervention in the high-pain cluster subgroup compared with the low-pain cluster.CONCLUSION: Based on these explorative analyses, it can be concluded that sex and preoperative pain measures may influence the effectiveness of preoperative PNE for some specific outcome measures in people scheduled to undergo TKA.IMPACT: Although further research on this topic is needed, the potential influence of sex and preoperative pain measures on the effectiveness of preoperative PNE should be considered when implementing this intervention in people undergoing TKA.

KW - Pain

KW - Osteoarthritis

KW - Education: Clinical

KW - Arthroplasty

U2 - 10.1093/ptj/pzab197

DO - 10.1093/ptj/pzab197

M3 - Article

C2 - 34459493

SN - 0031-9023

VL - 101

JO - Physical Therapy

JF - Physical Therapy

IS - 12

M1 - pzab197

ER -