title: Pain sensitivity profiles in patients with advanced knee osteoarthritis.
abstract: The development of patient profiles to subgroup individuals on a variety of variables has gained attention as a potential means to better inform clinical decision making. Patterns of pain sensitivity response specific to quantitative sensory testing (QST) modality have been demonstrated in healthy subjects. It has not been determined whether these patterns persist in a knee osteoarthritis population. In a sample of 218 participants, 19 QST measures along with pain, psychological factors, self-reported function, and quality of life were assessed before total knee arthroplasty. Component analysis was used to identify commonalities across the 19 QST assessments to produce standardized pain sensitivity factors. Cluster analysis then grouped individuals who exhibited similar patterns of standardized pain sensitivity component scores. The QST resulted in 4 pain sensitivity components: heat, punctate, temporal summation, and pressure. Cluster analysis resulted in 5 pain sensitivity profiles: a "low pressure pain" group, an "average pain" group, and 3 "high pain" sensitivity groups who were sensitive to different modalities (punctate, heat, and temporal summation). Pain and function differed between pain sensitivity profiles, along with sex distribution; however, no differences in osteoarthritis grade, medication use, or psychological traits were found. Residualizing QST data by age and sex resulted in similar components and pain sensitivity profiles. Furthermore, these profiles are surprisingly similar to those reported in healthy populations, which suggests that individual differences in pain sensitivity are a robust finding even in an older population with significant disease.
authors.affiliation: Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Frey-Law
authors.affiliation: College of Nursing, University of Iowa, Iowa City, IA, USA.
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Bohr
authors.affiliation: Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Sluka
authors.affiliation: College of Nursing, University of Iowa, Iowa City, IA, USA.
authors.forename: Keela
authors.initials: K
authors.lastname: Herr
authors.affiliation: Department of Orthopedics and Rehabilitation, College of Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Clark
authors.affiliation: Department of Orthopedics and Rehabilitation, College of Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Nicolas O
authors.initials: NO
authors.lastname: Noiseux
authors.affiliation: Department of Orthopedics and Rehabilitation, College of Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Callaghan
authors.affiliation: Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
authors.forename: M Bridget
authors.initials: MB
authors.lastname: Zimmerman
authors.affiliation: College of Nursing, University of Iowa, Iowa City, IA, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Rakel
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D058443:Catastrophization / Q000209:etiology / Q000523:psychology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000209:etiology; D020370:Osteoarthritis, Knee / Q000150:complications* / Q000188:drug therapy / Q000523:psychology*; D010146:Pain / Q000188:drug therapy / Q000209:etiology*; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects / Q000502:physiology*; D011312:Pressure / Q000009:adverse effects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects
chemical_list: D000700:Analgesics