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5. Associations of the modified STarT back tool and Hospital Anxiety and Depression Scale (HADS) with gait speed and knee pain in knee osteoarthritis: a retrospective cohort study

Author

Poon, Cheryl Lian-Li, Cheong, Philip, Tan, John Wei-Ming, Thumboo, Julian, Woon, Ee-Lin, Clark, Ross Allan, Cheok, Gary, and Pua, Yong-Hao

Subjects
musculoskeletal diseases, human activities
Abstract

The association of the modified STarT Back Tool (mSBT) psychosocial measure with gait speed and knee pain in knee osteoarthritis is not well defined. This study aimed to, in patients with knee osteoarthritis, (i) examine the convergent validity of mSBT with the Hospital Anxiety and Depression Scale (HADS) and (ii) compare the predictive validity of mSBT and HADS with gait speed and knee pain. We performed a retrospective cohort analysis of mSBT, HADS, gait speed, and knee pain outcomes data collected from 119 patients who received outpatient physical therapy. Of these patients who were evaluated at their first (baseline) physical therapy visit, 55 had available data at the Week-16 follow-up visit. mSBT and HADS showed moderately strong pairwise correlations (Spearman correlation > 0.57; p < 0.001). After adjusting for age, sex, body weight, and knee impairment variables in multivariable linear mixed-effects analyses, mSBT was associated with gait speed (p < 0.001) and knee pain intensity (p < 0.001) and it had comparable strength of association as HADS. In within-patient regression analyses, change in mSBT was associated with changes in gait speed (p = 0.04) and knee pain (p = 0.01) over 16 weeks. The mSBT had convergent validity with HADS and it showed predictive validity with gait speed and knee pain in knee osteoarthritis. Although broader validation is required, the 5-item mSBT psychosocial measure may be applied as part of routine clinical care to assess psychological distress in patients with knee osteoarthritis.IMPLICATIONS FOR REHABILITATIONThe 5-item psychosocial subscale of the modified STarT Back tool (mSBT) showed good convergent validity with the 14-item Hospital Anxiety and Depression Scale in patients with knee osteoarthritis.The mSBT psychosocial subscale showed predictive validity, at both cross-sectional and longitudinal levels, with gait speed and knee pain in patients with knee osteoarthritis.The mSBT can potentially be used in the busy clinical setting to assess psychological distress in patients with knee osteoarthritis. The 5-item psychosocial subscale of the modified STarT Back tool (mSBT) showed good convergent validity with the 14-item Hospital Anxiety and Depression Scale in patients with knee osteoarthritis. The mSBT psychosocial subscale showed predictive validity, at both cross-sectional and longitudinal levels, with gait speed and knee pain in patients with knee osteoarthritis. The mSBT can potentially be used in the busy clinical setting to assess psychological distress in patients with knee osteoarthritis.

Published
2021
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6. Associations of the modified STarT back tool and Hospital Anxiety and Depression Scale (HADS) with gait speed and knee pain in knee osteoarthritis: a retrospective cohort study.

Author

Poon, Cheryl Lian-Li, Cheong, Philip, Tan, John Wei-Ming, Thumboo, Julian, Woon, Ee-Lin, Clark, Ross Allan, Cheok, Gary, and Pua, Yong-Hao

Subjects
*OSTEOARTHRITIS diagnosis, *WALKING speed, *STATISTICS, *KNEE pain, *GAIT in humans, *RESEARCH methodology evaluation, *PHYSICAL therapy, *MULTIVARIATE analysis, *RETROSPECTIVE studies, *REGRESSION analysis, *TREATMENT effectiveness, *PSYCHOMETRICS, *DESCRIPTIVE statistics, *DATA analysis, *LONGITUDINAL method, *SYMPTOMS
Abstract

The association of the modified STarT Back Tool (mSBT) psychosocial measure with gait speed and knee pain in knee osteoarthritis is not well defined. This study aimed to, in patients with knee osteoarthritis, (i) examine the convergent validity of mSBT with the Hospital Anxiety and Depression Scale (HADS) and (ii) compare the predictive validity of mSBT and HADS with gait speed and knee pain. We performed a retrospective cohort analysis of mSBT, HADS, gait speed, and knee pain outcomes data collected from 119 patients who received outpatient physical therapy. Of these patients who were evaluated at their first (baseline) physical therapy visit, 55 had available data at the Week-16 follow-up visit. mSBT and HADS showed moderately strong pairwise correlations (Spearman correlation > 0.57; p < 0.001). After adjusting for age, sex, body weight, and knee impairment variables in multivariable linear mixed-effects analyses, mSBT was associated with gait speed (p < 0.001) and knee pain intensity (p < 0.001) and it had comparable strength of association as HADS. In within-patient regression analyses, change in mSBT was associated with changes in gait speed (p = 0.04) and knee pain (p = 0.01) over 16 weeks. The mSBT had convergent validity with HADS and it showed predictive validity with gait speed and knee pain in knee osteoarthritis. Although broader validation is required, the 5-item mSBT psychosocial measure may be applied as part of routine clinical care to assess psychological distress in patients with knee osteoarthritis. The 5-item psychosocial subscale of the modified STarT Back tool (mSBT) showed good convergent validity with the 14-item Hospital Anxiety and Depression Scale in patients with knee osteoarthritis. The mSBT psychosocial subscale showed predictive validity, at both cross-sectional and longitudinal levels, with gait speed and knee pain in patients with knee osteoarthritis. The mSBT can potentially be used in the busy clinical setting to assess psychological distress in patients with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Published
2022
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9. Abnormal Quantitative Sensory Testing is Associated With Persistent Pain One Year After TKA

Author

Wright, Tony, Moss, Penny, Sloan, K., Beaver, R., Pedersen, Jarle, Vehof, Gerard, Borge, Henrik, Maestroni, Luca, Cheong, Philip, Wright, Tony, Moss, Penny, Sloan, K., Beaver, R., Pedersen, Jarle, Vehof, Gerard, Borge, Henrik, Maestroni, Luca, and Cheong, Philip

Abstract

Background - Up to 15% of patients report at least moderate persistent pain after TKA. Such pain may be associated with the presence of widespread hyperalgesia and neuropathic-type pain. Questions/purposes - We asked if there was a difference among patients who report moderate to severe pain or no pain at least 12 months after TKA regarding (1) pressure pain threshold, (2) thermal (cold/heat) pain and detection thresholds, and (3) self-reported neuropathic pain. Patients and Method - Fifty-three volunteers were recruited from patients reporting no pain or moderate to severe pain, according to the Knee Society Score©. Differences between the moderate-to-severe and no-pain groups regarding pressure pain, heat and cold thresholds, and self-reported neuropathic-type pain were analyzed using independent t-tests. Results - Patients in the moderate-to-severe pain group exhibited reduced pressure pain threshold in the knee with the TKA (p = 0.025) and at the elbow (p = 0.002). This group also showed greater pain sensitivity to cold at the knee (p = 0.008) and elbow (p = 0.010), and increased heat pain sensitivity at the elbow (p = 0.032). Cold and heat detection thresholds were impaired in this group at the elbow (cold, p = 0.034; heat, p = 0.010), although only heat detection was impaired at the knee (p = 0.009). The moderate-to-severe pain group also reported more neuropathic-type pain (p = 0.001). Conclusion - Persistent pain after TKA was associated with widespread pressure, cold hyperalgesia, and greater neuropathic-type pain. Level of Evidence - Level III, prognostic study.

Published
2015

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