Pain phenotyping and investigation of outcomes in physical therapy: An exploratory study in patients with low back pain.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2023
2023
Historique:
received:
10
11
2022
accepted:
25
01
2023
entrez:
14
2
2023
pubmed:
15
2
2023
medline:
17
2
2023
Statut:
epublish
Résumé
Phenotypes have been proposed as a method of characterizing subgroups based on biopsychosocial factors to identify responders to analgesic treatments. This study aimed to, first, confirm phenotypes in patients with low back pain receiving physical therapy based on an a priori set of factors used to derive subgroups in other pain populations. Second, an exploratory analysis examined if phenotypes differentiated pain and disability outcomes at four weeks of physical therapy. Fifty-five participants completed psychological questionnaires and pressure pain threshold (PPT). Somatization, anxiety, and depression domains of the Symptom-Checklist-90-Revised, and PPT, were entered into a hierarchical agglomerative cluster analysis with Ward's method to identify phenotypes. Repeated measures ANOVAs assessed pain ratings and disability by phenotype at four weeks. Three clusters emerged: 1) high emotional distress and pain sensitivity (n = 10), 2) low emotional distress (n = 34), 3) low pain sensitivity (n = 11). As an exploratory study, clusters did not differentiate pain ratings or disability after four weeks of physical therapy (p's>0.05). However, trends were observed as magnitude of change for pain varied by phenotype. This supports the characterization of homogenous subgroups based on a protocol conducted in the clinical setting with varying effect sizes noted by phenotype for short-term changes in pain. As an exploratory study, future studies should aim to repeat this trial in a larger sample of patients.
Identifiants
pubmed: 36787322
doi: 10.1371/journal.pone.0281517
pii: PONE-D-22-31058
pmc: PMC9928110
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0281517Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR000064
Pays : United States
Informations de copyright
Copyright: © 2023 Wilson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Psychiatry Res. 1989 May;28(2):193-213
pubmed: 2748771
Spine J. 2019 Apr;19(4):645-654
pubmed: 30308254
Pain. 1990 Mar;40(3):293-301
pubmed: 2139204
Neurosci Biobehav Rev. 2021 Jan;120:100-108
pubmed: 33253748
Lancet. 2021 Dec 19;396(10267):2006-2017
pubmed: 33275908
Pain Pract. 2003 Dec;3(4):310-6
pubmed: 17166126
Phys Ther. 2011 May;91(5):722-32
pubmed: 21451094
J Behav Med. 2000 Aug;23(4):351-65
pubmed: 10984864
Pain. 2021 May 1;162(5):1528-1538
pubmed: 33259458
Pain. 1999 Nov;83(2):157-62
pubmed: 10534586
Anesth Analg. 1998 Jan;86(1):102-6
pubmed: 9428860
Spine (Phila Pa 1976). 2002 Mar 1;27(5):E109-20
pubmed: 11880847
J Orthop Sports Phys Ther. 2016 Jun;46(6):443-51
pubmed: 27011304
J Pain. 2010 Nov;11(11):1074-82
pubmed: 20466596
J Pain. 2017 Mar;18(3):295-307
pubmed: 27884689
Man Ther. 2003 Feb;8(1):29-36
pubmed: 12586559
Eur J Pain. 2020 May;24(5):921-932
pubmed: 32040225
Pain. 2005 Sep;117(1-2):137-44
pubmed: 16055269
Clin J Pain. 2016 Dec;32(12):1015-1027
pubmed: 26889613
Ann Transl Med. 2020 Mar;8(6):299
pubmed: 32355743
J Orthop Sports Phys Ther. 2017 Apr;47(4):261-267
pubmed: 28257616
Support Care Cancer. 2017 Oct;25(10):3059-3066
pubmed: 28455545
Eur J Pain. 2018 Feb;22(2):216-241
pubmed: 29105941
Pain. 1995 Apr;61(1):81-91
pubmed: 7644252
Phys Ther. 2018 May 1;98(5):398-407
pubmed: 29669084
Clin J Pain. 2019 Nov;35(11):869-879
pubmed: 31408011
Arch Phys Med Rehabil. 2020 May;101(5):781-788
pubmed: 31821801
Ann Behav Med. 2017 Jun;51(3):365-375
pubmed: 27844327
J Pain. 2003 Feb;4(1):2-21
pubmed: 14622723
BMC Musculoskelet Disord. 2021 May 19;22(1):455
pubmed: 34011349
Rheumatology (Oxford). 2010 Dec;49(12):2346-56
pubmed: 20713495
J Orthop Sports Phys Ther. 2016 May;46(5):317-9
pubmed: 27133941
Phys Ther. 2013 Mar;93(3):321-33
pubmed: 23125279
BMC Musculoskelet Disord. 2014 Mar 07;15:68
pubmed: 24607083
J Manipulative Physiol Ther. 1998 Jan;21(1):1-7
pubmed: 9467094
Eur Spine J. 2007 Nov;16(11):1776-88
pubmed: 17619914
Pain. 2005 Jun;115(3):410-418
pubmed: 15876494
Musculoskelet Sci Pract. 2019 Jun;41:36-42
pubmed: 30909109
Psychopharmacol Bull. 1973 Jan;9(1):13-28
pubmed: 4682398
Physiotherapy. 1980 Aug;66(8):271-3
pubmed: 6450426
Pain. 2016 Sep;157(9):1988-1999
pubmed: 27152688
Eur J Pain. 2007 Feb;11(2):153-63
pubmed: 16446108
Sleep Med Rev. 2016 Feb;25:52-73
pubmed: 26163057
BMC Bioinformatics. 2022 May 31;23(1):205
pubmed: 35641905
Spine (Phila Pa 1976). 1991 Aug;16(8):940-2
pubmed: 1835155
Int J Ther Massage Bodywork. 2015 Sep 01;8(3):16-33
pubmed: 26388962
Spine (Phila Pa 1976). 2013 Apr 20;38(9):762-9
pubmed: 23132535
J Orthop Sports Phys Ther. 2010 Apr;40(4):197-205
pubmed: 20357418
Asian J Sports Med. 2012 Mar;3(1):8-14
pubmed: 22461960
Pain. 2006 Aug;123(3):231-243
pubmed: 16697110
Clin J Pain. 2012 Oct;28(8):658-66
pubmed: 22510537
EClinicalMedicine. 2021 Mar 30;34:100795
pubmed: 33870150
Eur J Pain. 2017 Jul;21(6):955-964
pubmed: 28230292
Br J Psychiatry. 1976 Mar;128:280-9
pubmed: 1252693
J Clin Neurosci. 2010 Jun;17(6):722-6
pubmed: 20356747
PLoS One. 2016 Aug 11;11(8):e0160866
pubmed: 27513474
J Pain. 2012 Dec;13(12):1139-50
pubmed: 23141188
Pain. 2016 Jun;157(6):1266-1278
pubmed: 26928952
Pain. 2002 Apr;96(3):319-324
pubmed: 11973004
Pain. 1993 Feb;52(2):157-168
pubmed: 8455963
Pain. 2016 Sep;157(9):1851-1871
pubmed: 27152687
Pain Rep. 2020 Sep 23;5(5):e847
pubmed: 33490842