Increased postural stiffness during challenging postural tasks in patients with knee osteoarthritis with high pain sensitization

Postural stability is affected in knee osteoarthritis patients who present with pain but the link to pain sensitization is unclear. Patients with knee osteoarthritis completed the Knee Injury and Osteoarthritis Outcome Score and pressure pain thresholds were assessed bilaterally at the knee, lower l...

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Veröffentlicht in:Clinical biomechanics (Bristol) 2019-01, Vol.61, p.129-135
Hauptverfasser: Hirata, R.P., Skou, S.T., Simonsen, O., Rasmussen, S., Laursen, M., Graven-Nielsen, T.
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container_title Clinical biomechanics (Bristol)
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creator Hirata, R.P.
Skou, S.T.
Simonsen, O.
Rasmussen, S.
Laursen, M.
Graven-Nielsen, T.
description Postural stability is affected in knee osteoarthritis patients who present with pain but the link to pain sensitization is unclear. Patients with knee osteoarthritis completed the Knee Injury and Osteoarthritis Outcome Score and pressure pain thresholds were assessed bilaterally at the knee, lower leg and forearm prior to standing quietly (1 min) on a force platform in four conditions: Firm surface with open eyes, firm surface with closed eyes, soft surface with open eyes, and soft surface with closed eyes. Pain intensity during standing was assessed via numerical rating scale. Postural stability was assessed by the range, velocity, and standard deviation of the Center of Pressure (CoP) extracted from the force platform. The means of three repeated measures per standing condition were analysed. High-sensitization and low-sensitization groups were defined based on bilateral pressure pain thresholds from leg and arm. Fifty-six patients were included. Compared with the low-sensitization group, the high-sensitization group demonstrated 1) smaller pressure pain thresholds at the knee (P 
doi_str_mv 10.1016/j.clinbiomech.2018.12.004
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Patients with knee osteoarthritis completed the Knee Injury and Osteoarthritis Outcome Score and pressure pain thresholds were assessed bilaterally at the knee, lower leg and forearm prior to standing quietly (1 min) on a force platform in four conditions: Firm surface with open eyes, firm surface with closed eyes, soft surface with open eyes, and soft surface with closed eyes. Pain intensity during standing was assessed via numerical rating scale. Postural stability was assessed by the range, velocity, and standard deviation of the Center of Pressure (CoP) extracted from the force platform. The means of three repeated measures per standing condition were analysed. High-sensitization and low-sensitization groups were defined based on bilateral pressure pain thresholds from leg and arm. Fifty-six patients were included. Compared with the low-sensitization group, the high-sensitization group demonstrated 1) smaller pressure pain thresholds at the knee (P &lt; 0.05) although the Knee Injury and Osteoarthritis Outcome Score and pain intensity were not significantly different between groups, and 2) smaller range of the CoP in the anterior-posterior direction during the soft surface with closed eyes condition (P &lt; 0.05). Smaller CoP range suggest that patients with more widespread pain sensitivity have increased postural stiffness compared with the low-sensitization group. The greater stiffness found in high-sensitization patients under sensory restrictions (closed eyes and reduced proprioception) might relate to restricted integration of sensory information due to widespread pain sensitization. •Larger anterior-posterior postural sway compared with medial-lateral direction•Larger widespread pain sensitization relates to higher knee pain sensitivity.•Larger widespread pain sensitization relates to increased postural stiffness.</description><identifier>ISSN: 0268-0033</identifier><identifier>EISSN: 1879-1271</identifier><identifier>DOI: 10.1016/j.clinbiomech.2018.12.004</identifier><identifier>PMID: 30553079</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Accidental Falls - prevention &amp; control ; Aged ; Balance ; Center of Pressure ; Cross-Sectional Studies ; Female ; Foam ; Humans ; Knee - physiopathology ; Knee Joint ; Male ; Middle Aged ; Osteoarthritis, Knee - physiopathology ; Pain Measurement ; Pain pressure threshold ; Pain Threshold ; Postural Balance ; Posture ; Randomized Controlled Trials as Topic ; Severity of Illness Index ; Vision</subject><ispartof>Clinical biomechanics (Bristol), 2019-01, Vol.61, p.129-135</ispartof><rights>2018 Elsevier Ltd</rights><rights>Copyright © 2018 Elsevier Ltd. 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Patients with knee osteoarthritis completed the Knee Injury and Osteoarthritis Outcome Score and pressure pain thresholds were assessed bilaterally at the knee, lower leg and forearm prior to standing quietly (1 min) on a force platform in four conditions: Firm surface with open eyes, firm surface with closed eyes, soft surface with open eyes, and soft surface with closed eyes. Pain intensity during standing was assessed via numerical rating scale. Postural stability was assessed by the range, velocity, and standard deviation of the Center of Pressure (CoP) extracted from the force platform. The means of three repeated measures per standing condition were analysed. High-sensitization and low-sensitization groups were defined based on bilateral pressure pain thresholds from leg and arm. Fifty-six patients were included. 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The greater stiffness found in high-sensitization patients under sensory restrictions (closed eyes and reduced proprioception) might relate to restricted integration of sensory information due to widespread pain sensitization. •Larger anterior-posterior postural sway compared with medial-lateral direction•Larger widespread pain sensitization relates to higher knee pain sensitivity.•Larger widespread pain sensitization relates to increased postural stiffness.</description><subject>Accidental Falls - prevention &amp; control</subject><subject>Aged</subject><subject>Balance</subject><subject>Center of Pressure</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Foam</subject><subject>Humans</subject><subject>Knee - physiopathology</subject><subject>Knee Joint</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Osteoarthritis, Knee - physiopathology</subject><subject>Pain Measurement</subject><subject>Pain pressure threshold</subject><subject>Pain Threshold</subject><subject>Postural Balance</subject><subject>Posture</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Severity of Illness Index</subject><subject>Vision</subject><issn>0268-0033</issn><issn>1879-1271</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc2O0zAURi0EYkrhFZDZsUnwTxw7S1QxMNJIbGBtOc5N407qFF8HBCseHVctI5asbNnn8yefS8gbzmrOePvuUPs5xD4sR_BTLRg3NRc1Y80TsuFGdxUXmj8lGyZaUzEm5Q15gXhghRBKPyc3kiklme425Pdd9AkcwkBPC-Y1uZliDuMYAZEOawpxT_3k5hni_rx_pLLDB6Qh0pPLAWJG-iPkiT5EAFoYWFzKUwo5XC-msJ8KWwIIEcv5r5Jb4kvybHQzwqvruiVfbz982X2q7j9_vNu9v698I0yueu-UAq29Ad4Zp4RR2jfAfG-MbCUo0yhQZzuN5i0MLYxGdk65VgnZD4PckreXd09p-bYCZnsM6GGeXYRlRSu40q1Wqujaku6C-rQgJhjtKYWjSz8tZ_ZcYQ_2nwHY8wAsF7boLdnX15q1P8LwmPxrvAC7CwDls98DJIu-6PMwhAQ-22EJ_1HzB1JjoLQ</recordid><startdate>201901</startdate><enddate>201901</enddate><creator>Hirata, R.P.</creator><creator>Skou, S.T.</creator><creator>Simonsen, O.</creator><creator>Rasmussen, S.</creator><creator>Laursen, M.</creator><creator>Graven-Nielsen, T.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201901</creationdate><title>Increased postural stiffness during challenging postural tasks in patients with knee osteoarthritis with high pain sensitization</title><author>Hirata, R.P. ; 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Patients with knee osteoarthritis completed the Knee Injury and Osteoarthritis Outcome Score and pressure pain thresholds were assessed bilaterally at the knee, lower leg and forearm prior to standing quietly (1 min) on a force platform in four conditions: Firm surface with open eyes, firm surface with closed eyes, soft surface with open eyes, and soft surface with closed eyes. Pain intensity during standing was assessed via numerical rating scale. Postural stability was assessed by the range, velocity, and standard deviation of the Center of Pressure (CoP) extracted from the force platform. The means of three repeated measures per standing condition were analysed. High-sensitization and low-sensitization groups were defined based on bilateral pressure pain thresholds from leg and arm. Fifty-six patients were included. Compared with the low-sensitization group, the high-sensitization group demonstrated 1) smaller pressure pain thresholds at the knee (P &lt; 0.05) although the Knee Injury and Osteoarthritis Outcome Score and pain intensity were not significantly different between groups, and 2) smaller range of the CoP in the anterior-posterior direction during the soft surface with closed eyes condition (P &lt; 0.05). Smaller CoP range suggest that patients with more widespread pain sensitivity have increased postural stiffness compared with the low-sensitization group. The greater stiffness found in high-sensitization patients under sensory restrictions (closed eyes and reduced proprioception) might relate to restricted integration of sensory information due to widespread pain sensitization. •Larger anterior-posterior postural sway compared with medial-lateral direction•Larger widespread pain sensitization relates to higher knee pain sensitivity.•Larger widespread pain sensitization relates to increased postural stiffness.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30553079</pmid><doi>10.1016/j.clinbiomech.2018.12.004</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Accidental Falls - prevention & control
Aged
Balance
Center of Pressure
Cross-Sectional Studies
Female
Foam
Humans
Knee - physiopathology
Knee Joint
Male
Middle Aged
Osteoarthritis, Knee - physiopathology
Pain Measurement
Pain pressure threshold
Pain Threshold
Postural Balance
Posture
Randomized Controlled Trials as Topic
Severity of Illness Index
Vision
title Increased postural stiffness during challenging postural tasks in patients with knee osteoarthritis with high pain sensitization
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