Manifestations of Pain Sensitization Across Different Painful Knee Disorders: A Systematic Review Including Meta-analysis and Metaregression

Autor(es)

Silva, Danilo De Oliveira ^{[1, 2]} ; Rathleff, Michael Skovdal ^{[3, 4]} ; Petersen, Kristian ^[3] ; de Azevedo, Fabio Micolis ^[2] ; Barton, Christian John ^[1]

Afiliação do(s) autor(es)

^[1] La Trobe Univ, Coll Sci Hlth & Engn, Sch Allied Hlth, La Trobe Sport & Exercise Med Res Ctr LASEM, Bundoora, Vic - Australia

^[2] Sao Paulo State Univ UNESP, Lab Biomech & Motor Control LABCOM, Presidente Prudente - Brazil

^[3] Aalborg Univ, Fac Med, SMI, Aalborg - Denmark

^[4] Aalborg Univ, Dept Clin Med, Res Unit Gen Practice Aalborg, Aalborg - Denmark

• Tipo de documento: Artigo de Revisão
• Fonte: PAIN MEDICINE; v. 20, n. 2, p. 335-358, FEB 2019.
• Citações Web of Science: 7

Resumo

Objectives Previous reviews have reported that manifestations of pain sensitization may play an important role in the pain experienced by people with knee osteoarthritis. However, it is unknown if manifestations of pain sensitization are common features across other painful knee disorders or if sensitization requires targeted intervention. This review aims to synthesize the published research investigating manifestations of pain sensitization in painful knee disorders and to evaluate if the manifestations of pain sensitization change in response to treatment. Methods The systematic review protocol was registered with PROSPERO (CRD42015024211). We searched Medline, Embase, CINAHL, Web of Science, Sportsdiscus, and Cochrane Central for studies that investigated between-group differences (knee pain vs pain-free subjects) or the effect of treatment on manifestations of pain sensitization. Two reviewers independently assessed studies for inclusion and quality. Available data were synthesized via predetermined levels of evidence, meta-analysis, and metaregression where possible. Results Fifty-two studies investigating evidence related to pain sensitization distributed across four different painful knee disorders were identified. Conclusions Our meta-analysis provides evidence of pain sensitization in people with knee osteoarthritis (strong evidence), people with patellofemoral pain (moderate evidence), and postmeniscectomy patients (very limited evidence). However, conflicting evidence exists in patellar tendinopathy. Metaregression indicates that pain is associated with pressure pain thresholds in knee osteoarthritis. In people with knee osteoarthritis and patellofemoral pain, several interventions were found to reduce manifestations of pain sensitization. This review highlights that pain sensitization may be amenable to treatment through exercise therapy, mobilization, and pharmacological and surgical intervention. (AU)

• Processo FAPESP: 15/11534-1 - Influência da dor na análise de parâmetros cinemáticos das regiões proximais, locais e distais ao joelho em mulheres com dor femoropatelar durante subida e descida de escada
• Beneficiário: Danilo de Oliveira Silva
• Linha de fomento: Bolsas no Brasil - Doutorado