Pain phenotyping and investigation of outcomes in physical therapy: An exploratory study in patients with low back pain

Phenotypes have been proposed as a method of characterizing subgroups based on biopsychosocial factors to identify responders to analgesic treatments. This study aimed to, first, confirm phenotypes in patients with low back pain receiving physical therapy based on an a priori set of factors used to...

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Published in:PloS one 2023-02, Vol.18 (2), p.e0281517-e0281517
Main Authors: Wilson, Abigail T, Riley, 3rd, Joseph L, Bishop, Mark D, Beneciuk, Jason M, Cruz-Almeida, Yenisel, Markut, Keri, Redd, Charlotte, LeBlond, Nicholas, Pham, Patrick H, Shirey, David, Bialosky, Joel E
Format: Article
Language:English
Subjects:
Analgesics
Analysis
Anxiety
Back pain
Backache
Biology and Life Sciences
Care and treatment
Chronic pain
Clinical outcomes
Cluster analysis
Complications and side effects
Depression, Mental
Disability Evaluation
Emotions
Humans
Identification methods
Low back pain
Low Back Pain - psychology
Medical prognosis
Medical research
Medicine and Health Sciences
Medicine, Experimental
Pain Measurement - methods
Pain sensitivity
Pain Threshold
Patient outcomes
Patients
Phenotype
Phenotypes
Phenotyping
Physical therapists
Physical therapy
Physical Therapy Modalities
Questionnaires
Ratings
Ratings & rankings
Rehabilitation
Sleep
Social Sciences
Subgroups
Surveys and Questionnaires
Therapeutics, Physiological
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creator Wilson, Abigail T
Riley, 3rd, Joseph L
Bishop, Mark D
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Cruz-Almeida, Yenisel
Markut, Keri
Redd, Charlotte
LeBlond, Nicholas
Pham, Patrick H
Shirey, David
Bialosky, Joel E
description Phenotypes have been proposed as a method of characterizing subgroups based on biopsychosocial factors to identify responders to analgesic treatments. This study aimed to, first, confirm phenotypes in patients with low back pain receiving physical therapy based on an a priori set of factors used to derive subgroups in other pain populations. Second, an exploratory analysis examined if phenotypes differentiated pain and disability outcomes at four weeks of physical therapy. Fifty-five participants completed psychological questionnaires and pressure pain threshold (PPT). Somatization, anxiety, and depression domains of the Symptom-Checklist-90-Revised, and PPT, were entered into a hierarchical agglomerative cluster analysis with Ward's method to identify phenotypes. Repeated measures ANOVAs assessed pain ratings and disability by phenotype at four weeks. Three clusters emerged: 1) high emotional distress and pain sensitivity (n = 10), 2) low emotional distress (n = 34), 3) low pain sensitivity (n = 11). As an exploratory study, clusters did not differentiate pain ratings or disability after four weeks of physical therapy (p's>0.05). However, trends were observed as magnitude of change for pain varied by phenotype. This supports the characterization of homogenous subgroups based on a protocol conducted in the clinical setting with varying effect sizes noted by phenotype for short-term changes in pain. As an exploratory study, future studies should aim to repeat this trial in a larger sample of patients.
doi_str_mv 10.1371/journal.pone.0281517
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subjects Analgesics
Analysis
Anxiety
Back pain
Backache
Biology and Life Sciences
Care and treatment
Chronic pain
Clinical outcomes
Cluster analysis
Complications and side effects
Depression, Mental
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Low Back Pain - psychology
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Pain Measurement - methods
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Phenotyping
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Physical therapy
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Therapeutics, Physiological
title Pain phenotyping and investigation of outcomes in physical therapy: An exploratory study in patients with low back pain
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