Psychological Factors Associated with Functional Disability in Patients with Hip and Knee Osteoarthritis.

Several studies have shown an association between psychosocial variables and functional capacity in chronic pain processes such as osteoarthritis. The aim of this study was to test a structural equations model that shows the predictive weight of certain variables such as catastrophizing, self-efficacy and kinesiophobia on functional pain and WOMAC subscales scores of pain and physical function of older patients diagnosed with hip and knee osteoarthritis. We also assessed the specific weight of age in terms of the factors. The study was conducted on a sample of 170 patients (142 women and 28 men mean age, 74.44 years range, 50-96 years). The main variables evaluated were WOMAC subscales scores of pain and physical function, self-efficacy, catastrophizing and kinesiophobia. To assess these variables, we used the Spanish validated version of the Western Ontario and McMaster Universities questionnaire, the Chronic Pain Self-Efficacy Scale, the Pain Catastrophizing Scale and the Tampa Scale for Kinesiophobia, respectively. We tested a structural equations model (IBM SPSS Amos version 22). The results showed the predominant predictive weight (both direct and indirect) of catastrophizing while simultaneously ruling out the relevance of age as a predictor of WOMAC subscales scores of pain and physical function. This study provides data of interest on the explanatory mechanisms that underlie the direct and inverse relationships between the studied psychological variables.

Effects of High-Intensity Interval Training (HIIT) on Patients with Musculoskeletal Disorders: A Systematic Review and Meta-Analysis with a Meta-Regression and Mapping Report.

The aim was to assess the impact of high-intensity interval training (HIIT) on patients with musculoskeletal disorders. We conducted a search of Medline, Embase, PEDro, and Google Scholar. We conducted a meta-analysis to determine the effectiveness of HIIT on pain intensity, maximal oxygen consumption (VO2 max), disability, and quality of life (QoL). We employed the GRADE and PEDro scales to rate the quality, certainty, and applicability of the evidence. Results showed significant differences in pain intensity, with a moderate clinical-effect (SMD = -0.73; 95% CI: -1.40--0.06), and in VO2 max, with a moderate clinical-effect (SMD = 0.69; 95% CI: 0.42-0.97). However, the meta-analysis showed no statistically significant results for disability (SMD = -0.34; 95% CI: -0.92-0.24) and QoL (SMD = 0.40; 95% CI: -0.80-1.60). We compared HIIT against other exercise models for reducing pain intensity and increasing VO2 max. The meta-analysis showed no significant differences in favour of HIIT. Meta-regression analysis revealed that pain intensity scores were negatively associated with VO2 max (R2 = 82.99%, p = 0.003). There is low-moderate evidence that the HIIT intervention for patients with musculoskeletal disorders can reduce pain intensity and increase VO2 max but has no effect on disability and QoL. Results also showed that HIIT was not superior to other exercise models in reducing pain intensity and increasing VO2 max.

Clinical features of patients with chronic non-specific neck pain per disability level: A novel observational study

BACKGROUND To date, there are no cross-sectional studies considering the influence of disability level in patients with non-specific chronic neck pain. Therefore, the main aim of this study was to determine kinesiophobia, active cervical range of movement (CROM), and pressure pain threshold (PPT) differences between different disability levels (mild, moderate, and severe) in subjects with non-specific chronic neck pain and asymptomatic subjects. METHODS A descriptive cross-sectional study. Subjects were recruited from a primary health care center and an outpatient department hospital. A total sample of 128 subjects, 96 of them with nonspecific chronic neck pain and 32 asymptomatic, were recruited. The NDI was used to divide the subjects with chronic neck pain into 3 groups (mild, moderate, and severe disability). The main outcome measurement was the Tampa Scale of kinesiophobia (TSK-11). The secondary outcome measurements were the Visual Analogue Scale (VAS), PPT (trapezius and tibialis anterior), CROM (flexion, extension, rotation, and lateral inclination) and pain duration. RESULTS The ANOVA results revealed, in the comparisons between groups, statistically significant differences for the VAS between the mild-severe (P < 0.01) and moderate-severe groups (P < 0.01), but not between the mild-moderate groups (P > 0.05); for the TSK, differences were not statistically significant (P > 0.05). CONCLUSION Kinesiophobia may not be influenced by disability level in patients with chronic non-specific neck pain. Nevertheless, pain intensity and chronicity of patients with severe neck disability are increased with respect to mild and moderate disability index.

RESUMO CONTEXTO Até a data, não há estudos transversais considerando a influência do nível de incapacidade em pacientes com dor de garganta crônica não específica. Portanto, o objetivo principal deste estudo foi determinar a diferença entre os níveis de diminuição do colesterol cervical (Crom) e o limiar por dor de pressão (PPT) entre diferentes níveis de incapacidade (leve, moderada e grave) em indivíduos com dor crônica não específica no pescoço e sujeitos assintomáticos. MÉTODOS Estudo descritivo transversal. Os indivíduos foram recrutados de um centro de saúde primário e de um hospital do departamento ambulatorial. Uma amostra total de 128 indivíduos, 96 indivíduos com dor no pescoço crônica não específica e 32 indivíduos assintomáticos, foi recrutada. O NDI foi usado para dividir os indivíduos com dor no pescoço crônica em três grupos (incapacidade leve, moderada e grave). A principal medida de resultados foi a Tampa Scale of Kinesiophobia (TSK-11). As medidas de resultado secundário foram a Escala Analógica Visual (VAS), PPT (trapézio e tibial anterior), Crom (flexão, extensão, rotação e inclinação lateral) e duração da dor. RESULTADOS Nos resultados da Anova revelados nas comparações entre os grupos, diferenças estatisticamente significativas para o VAS foram observadas entre os grupos leve-grave (P<0,01) e moderado-grave (P<0,01), mas não entre os grupos moderado-moderado (P>0,05). Para o TSK, as diferenças não foram estatisticamente significativas (P>0,05). CONCLUSÃO A cinesiofobia pode não ser influenciada pelo nível de incapacidade em pacientes com dor no pescoço crônica não específica. No entanto, a intensidade da dor e a cronicidade de pacientes com deficiência grave do pescoço são aumentadas em relação ao índice de incapacidade leve e moderada.