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- Title
Differences Between Women With Traumatic and Idiopathic Chronic Neck Pain and Women Without Neck Pain: Interrelationships Among Disability, Cognitive Deficits, and Central Sensitization.
- Authors
Coppieters, Iris; De Pauw, Robby; Kregel, Jeroen; Malfliet, Anneleen; Goubert, Dorien; Lenoir, Dorine; Cagnie, Barbara; Meeus, Mira
- Abstract
Background. To date, a clear differentiation of disability, cognitive deficits, and central sensitization between chronic neck pain of a traumatic nature and that of a nontraumatic nature is lacking. Objective. This study aimed to examine differences in disability, cognitive deficits, and central sensitization between women with traumatic and idiopathic (nontraumatic) chronic neck pain and women who were healthy. In addition, interrelationships among these variables were investigated. Design. This was a case-control study. Methods. Ninety-five women (28 women who were healthy [controls], 35 women with chronic idiopathic neck pain [CINP], and 32 women with chronic whiplash-associated disorders [CWAD] [traumatic]) were enrolled in the study. First, all participants completed standardized questionnaires to investigate pain-related disability and health-related quality of life. Next, cognitive performance was assessed. Finally, pressure pain thresholds and conditioned pain modulation were examined to investigate central sensitization. Results. Pain-related disability, reduced health-related quality of life, and cognitive defi- cits were present in participants with CWAD and, to a significantly lesser extent, in participants with CINP. Local hyperalgesia was demonstrated in participants with CWAD and CINP but not in women who were healthy. However, distant hyperalgesia and decreased conditioned pain modulation efficacy were shown only in participants with CWAD; this result is indicative of the presence of central sensitization. Moderate to strong Spearman correlations (ρ=.456--.701) among disability, cognitive deficits, and hyperalgesia (local and distant) were observed in participants with CWAD. In participants with CINP, only local hyperalgesia and subjective cognitive deficits were moderately (ρ=.463) correlated. Limitations. No conclusions about the causality of the observed correlations can be drawn. Conclusions. This innovative research revealed important differences between women with CWAD and women with CINP and thus provided evidence of the clinical importance of distinguishing the assessment and rehabilitation approaches for both pain conditions.
- Subjects
NETHERLANDS; CENTRAL nervous system; CHRONIC pain; COGNITION disorders; COMPARATIVE studies; FISHER exact test; HEALTH surveys; NEUROPSYCHOLOGICAL tests; NECK pain; PEOPLE with disabilities; PROBABILITY theory; QUALITY of life; QUESTIONNAIRES; SENSES; STATISTICS; WHIPLASH injuries; SAMPLE size (Statistics); DATA analysis; EFFECT sizes (Statistics); PAIN measurement; CROSS-sectional method; CASE-control method; DATA analysis software; MANN Whitney U Test; PAIN threshold; KRUSKAL-Wallis Test; ONE-way analysis of variance
- Publication
Physical Therapy, 2017, Vol 97, Issue 3, p338
- ISSN
0031-9023
- Publication type
Article
- DOI
10.2522/ptj.20160259