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Titre : | Treatment for the central sensitization component of knee pain using systemic manual therapy (2024) |
Auteurs : | Adi Halili |
Type de document : | Article |
Dans : | Douleurs (Vol. 25, n° 2, Avril 2024) |
Article en page(s) : | p. 72-80 |
Note générale : | https://doi.org/10.1016/j.douler.2024.01.002 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Douleur ; Genou ; Gonalgie ; Techniques de physiothérapie |
Mots-clés: | Thérapie manuelle systémique ; Sensibilisation centrale |
Résumé : |
Background : The purpose of this study is to test the temporal model hypothesis for mechanism and treatment of central sensitization (CS) in patients with knee pain. The temporal model includes 5 stages: phasic activation of the locus coeruleus noradrenaline system, salient stimuli, threat coding of salient stimuli, central sensitization, and neuronal degeneration. The treatment model includes three elements: reducing afferent visceral input; shifting humoral inflammatory activity away from the brain and the body; and reducing oxidative stress. The use systemic manual therapy protocols (SMT) are proposed to address these components.
Design : Cohort retrospective multivariate analysis using a modified adaptive platform design. Methods : Improvement in knee pain and overall symptoms was measured in 467 patients after provision of 364 SMT protocols or protocol combinations, and across episode of care. The outcome tool used was the patient identified problem scale (PIP). Results : Knee pain was improved on average by 1.28/9 (P Conclusion : An effective treatment for knee pain is possible if in addition to direct intervention over the knee, regional contributors and CS are addressed. The four conditions specified to test the temporal model and treatment hypothesis were met. All three types of interventions to address CS were more effective than oSOC (optimal standard of care). |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.em-premium.com/article/1656942 |