Abstract
s / Osteoarthritis and Cartilage 20 (2012) S54–S296 S255 assessment at baseline assessing pressure-pain sensitivity of the lower leg. During cuff inflation patients rated the pressure-pain intensity continuously on an electronic visual analogue scale (VAS), with 0 indicating “no pain” and 10 defined “worst pain imaginable”. The patients pressed a button, when the pressure-pain intensity was intolerable (pain tolerance threshold, PTT recorded in kPa) and the corresponding VAS score defined the pressure-pain limit (PTL). The PTT and PTL were measured before a 16-week intensive dietary intervention resulting in a significant weight loss. Treatment response was defined according to the Outcomes Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) responder criterion (yes/no). The associations between baseline PTT and PTL and lack of clinical response according to the OMERACT-OARSI criterion despite receiving intensive dietary therapy were assessed using logistic regression analysis; adjustments for potential confounding factors (gender, age, radiographic disease severity and baseline BMI) were performed. Results: Baseline PTT was associated with lack of response to weight loss according to the OMERACT-OARSI responder criteria, showing that patients with higher PTT had lower odds of non-response (odds ratio 1⁄4 0.966; 95% confidence interval (CI) 0.94 0.99, P1⁄4 0.0066) implying a better prognosis. There was no association between baseline PTL and treatment response (odds ratio 1⁄4 0.998; 95% confidence interval (CI) 0.85 1.17, P 1⁄4 0.9761). Conclusions: This study indicates that obese knee OA patients with low pressure pain tolerance (i.e. high sensitivity) at baseline have a reduced likelihood of symptomatic response to a weight loss intervention as compared to patients with high pressure pain tolerance (i.e. low sensitivity). Central sensitization of the nociceptive system may explain the relative high pressure pain sensitivity in the patients responding less efficient to the weight loss. Pain sensitivity assessment may aid clinical decision making as a prognostic tool. 504 EFFECT OF PROVIDER COMMUNICATION STYLE ON THE IMPROVEMENT OF PAIN AND FUNCTION IN PATIENTS WITH KNEE OSTEOARTHRITIS M.E. Suarez-Almazor , M.A. Kallen , V. Cox , R.L. Street, Jr. . UT MD Anderson Cancer Ctr., Houston, TX, USA; 2 Texas A & M Univ., College
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