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Baseline self-report ‘central mechanisms’ trait predicts persistent knee pain in the Knee Pain in the Community (KPIC) cohort

Akin-Akinyosoye, K.; Sarmanova, A.; Fernandes, G. S.; Frowd, N.; Swaithes, L.; Stocks, J.; Valdes, A.; McWilliams, D. F.; Zhang, W.; Doherty, M.; Ferguson, E.; Walsh, D. A.

Baseline self-report ‘central mechanisms’ trait predicts persistent knee pain in the Knee Pain in the Community (KPIC) cohort Thumbnail


Authors

K. Akin-Akinyosoye

A. Sarmanova

G. S. Fernandes

N. Frowd

L. Swaithes

Profile image of JOANNE STOCKS

Dr JOANNE STOCKS JOANNE.STOCKS@NOTTINGHAM.AC.UK
Assistant Professor in Rehabilitation Technology

M. Doherty

EAMONN FERGUSON eamonn.ferguson@nottingham.ac.uk
Professor of Health Psychology

DAVID WALSH david.walsh@nottingham.ac.uk
Professor of Rheumatology



Abstract

© 2019 The Authors Objectives: We investigated whether baseline scores for a self-report trait linked to central mechanisms predict 1 year pain outcomes in the Knee Pain in the Community cohort. METHOD: 1471 participants reported knee pain at baseline and responded to a 1-year follow-up questionnaire, of whom 204 underwent pressure pain detection thresholds (PPTs) and radiographic assessment at baseline. Logistic and linear regression models estimated the relative risks (RRs) and associations (β) between self-report traits, PPTs and pain outcomes. Discriminative performance for each predictor was compared using receiver-operator characteristics (ROC) curves. Results: Baseline Central Mechanisms trait scores predicted pain persistence (Relative Risk, RR = 2.10, P = 0.001) and persistent pain severity (β = 0.47, P < 0.001), even after adjustment for age, sex, BMI, radiographic scores and symptom duration. Baseline joint-line PPTs also associated with pain persistence (RR range = 0.65 to 0.68, P < 0.02), but only in univariate models. Lower baseline medial joint-line PPT was associated with persistent pain severity (β = −0.29, P = 0.013) in a fully adjusted model. The Central Mechanisms trait model showed good discrimination of pain persistence cases from resolved pain cases (Area Under the Curve, AUC = 0.70). The discrimination power of other predictors (PPTs (AUC range = 0.51 to 0.59), radiographic OA (AUC = 0.62), age, sex and BMI (AUC range = 0.51 to 0.64), improved significantly (P < 0.05) when the central mechanisms trait was included in each logistic regression model (AUC range = 0.69 to 0.74). Conclusion: A simple summary self-report Central Mechanisms trait score may indicate a contribution of central mechanisms to poor knee pain prognosis.

Citation

Akin-Akinyosoye, K., Sarmanova, A., Fernandes, G. S., Frowd, N., Swaithes, L., Stocks, J., …Walsh, D. A. (2020). Baseline self-report ‘central mechanisms’ trait predicts persistent knee pain in the Knee Pain in the Community (KPIC) cohort. Osteoarthritis and Cartilage, 28(2), 173-181. https://doi.org/10.1016/j.joca.2019.11.004

Journal Article Type Article
Acceptance Date Nov 18, 2019
Online Publication Date Dec 10, 2019
Publication Date 2020-02
Deposit Date Apr 7, 2020
Publicly Available Date Apr 8, 2020
Journal Osteoarthritis and Cartilage
Print ISSN 1063-4584
Electronic ISSN 1522-9653
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 28
Issue 2
Pages 173-181
DOI https://doi.org/10.1016/j.joca.2019.11.004
Keywords Orthopedics and Sports Medicine; Biomedical Engineering; Rheumatology
Public URL https://nottingham-repository.worktribe.com/output/3794577
Publisher URL https://www.sciencedirect.com/science/article/pii/S1063458419312701
Additional Information This article is maintained by: Elsevier; Article Title: Baseline self-report ‘central mechanisms’ trait predicts persistent knee pain in the Knee Pain in the Community (KPIC) cohort; Journal Title: Osteoarthritis and Cartilage; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.joca.2019.11.004; Content Type: article; Copyright: © 2020 The Authors. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.