Cluster subgroups based on overall pressure pain sensitivity and psychosocial factors in chronic musculoskeletal pain: Differences in clinical outcomes

Autor(es)

Almeida, Suzana C. ^[1] ; George, Steven Z. ^{[2, 3]} ; Leite, V, Raquel D. ; Oliveira, Anamaria S. ^{[4, 5]} ; Chaves, Thais C. ^{[4, 6]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Phys Therapy, Sao Paulo - Brazil

^[2] Duke Univ, Duke Clin Res Inst, Durham, NC - USA

^[3] Duke Univ, Dept Orthopaed Surg, Durham, NC - USA

^[4] Leite, Raquel D., V, Univ Sao Paulo, Ribeirao Preto Med Sch, Post Grad Program Rehabil & Funct Performance, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Biomech Med & Rehabil Musculoskeletal Syst, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Dept Neurosci & Behav Sci, Ribeirao Preto Med Sch, Ave Bandeirantes 3900, BR-14055040 Ribeirao Preto, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: PHYSIOTHERAPY THEORY AND PRACTICE; v. 35, n. 12, p. 1218-1232, DEC 2 2019.
• Citações Web of Science: 1

Resumo

Objective: We aimed to empirically derive psychosocial and pain sensitivity subgroups using cluster analysis within a sample of individuals with chronic musculoskeletal pain (CMP) and to investigate derived subgroups for differences in pain and disability outcomes. Methods: Eighty female participants with CMP answered psychosocial and disability scales and were assessed for pressure pain sensitivity. A cluster analysis was used to derive subgroups, and analysis of variance (ANOVA) was used to investigate differences between subgroups. Results: Psychosocial factors (kinesiophobia, pain catastrophizing, anxiety, and depression) and overall pressure pain threshold (PPT) were entered into the cluster analysis. Three subgroups were empirically derived: cluster 1 (high pain sensitivity and high psychosocial distress; n = 12) characterized by low overall PPT and high psychosocial scores; cluster 2 (high pain sensitivity and intermediate psychosocial distress; n = 39) characterized by low overall PPT and intermediate psychosocial scores; and cluster 3 (low pain sensitivity and low psychosocial distress; n = 29) characterized by high overall PPT and low psychosocial scores compared to the other subgroups. Cluster 1 showed higher values for mean pain intensity (F-(2,F-77) = 10.58, p < 0.001) compared with cluster 3, and cluster 1 showed higher values for disability (F-(2,F-77) = 3.81, p = 0.03) compared with both clusters 2 and 3. Conclusions: Only cluster 1 was distinct from cluster 3 according to both pain and disability outcomes. Pain catastrophizing, depression, and anxiety were the psychosocial variables that best differentiated the subgroups. Overall, these results call attention to the importance of considering pain sensitivity and psychosocial variables to obtain a more comprehensive characterization of CMP patients' subtypes. (AU)

• Processo FAPESP: 13/10482-2 - Associação entre dor musculoesquelética crônica, incapacidade e aspectos emocionais
• Beneficiário: Suzana Cristina Almeida
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica