Pain Mechanisms and Psychosocial Variables in Patients With Chronic Pain After Total Knee Arthroplasty: Secondary Analysis From a Randomised Controlled Trial.

この研究はインパクトが大きい可能性があると判断されました。 OEのAIによるハイインパクト指標は、論文が掲載されたジャーナルと論文自体の科学的内容の両方からのシグナルを統合することで、論文の影響力を推定します。 最先端の自然言語処理を用いて開発されたOEハイインパクトモデルは、ジャーナルのインパクトファクターのみよりも、研究の将来の引用実績をより正確に予測します。 これにより、臨床的に意義のある研究をより早く認識することができ、読者は将来の診療を形成する可能性が最も高い論文に焦点を当てることができます。

研究概要

Sixty-nine patients with chronic post-TKA pain were randomized to neuromuscular exercise+pain neuroscience education (PNE) (n=36) or PNE alone (n=33). The primary outcome of interest for this secondary analysis was temporal summation of pain (TSP) at the index knee. Secondary outcomes included TSP extra-segmentally, pressure pain thresholds (PPT) locally and extra-segmentally, conditioned pain modulation (CPM), PainDETECT, fear-avoidance beliefs (FABQ-PA), and pain catastrophizing (PCS). Outcomes were assessed at baseline, 3, 6, and 12 months. Overall, the results of the study revealed a significant between-group improvement favoring exercise+PNE for TSP at the index knee (mean difference −1.45, 95% CI −2.48 to −0.42; p=0.006), with no between-group differences for other mechanistic or psychosocial outcomes. In addition, both groups showed within-group improvements in PainDETECT, FABQ-PA, and PCS, and change in PCS was associated with better KOOS4. These findings suggest exercise+PNE can attenuate central pain amplification (TSP) whereas broader clinical gains may relate to reducing catastrophizing.