{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:16:03Z","timestamp":1765700163781,"version":"3.48.0"},"reference-count":78,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,5,22]]},"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pain is the dominant symptom of knee osteoarthritis (OA), and recent evidence suggests factors outside of local joint pathology, such as pain sensitisation, can contribute significantly to the pain experience. It is unknown how pain sensitisation influences outcomes from commonly employed interventions such as physiotherapy. The aims of this study are, first, to provide a comprehensive description of the somatosensory characteristics of people with pain associated with knee OA. Second, we will investigate if indicators of pain sensitisation in patients with knee osteoarthritis are predictive of non-response to physiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a multicentre prospective cohort study with 140 participants. Eligible patients with moderate to severe symptomatic knee osteoarthritis will be identified at outpatient orthopaedic and rheumatology clinics. A baseline assessment will provide a comprehensive description of the somatosensory characteristics of each participant by means of clinical examination, quantitative sensory testing, and validated questionnaires measuring pain and functional capacity. Participants will then undergo physiotherapy treatment. The primary outcome will be non-response to physiotherapy on completion of the physiotherapy treatment programme as defined by the Osteoarthritis Research Society International treatment responder criteria. A principal component analysis will identify measures related to pain sensitisation to include in the predictive model. Regression analyses will explore the relationship between responder status and pain sensitisation while accounting for confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study has been approved by St James\u2019 Hospital\/AMNCH Research Ethics Committee and by the St Vincent's Healthcare Group Ethics and Medical Research Committee. The results will be presented at international conferences and published in a peer review journal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>NCT02310945.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-007430","type":"journal-article","created":{"date-parts":[[2015,6,10]],"date-time":"2015-06-10T16:06:43Z","timestamp":1433952403000},"page":"e007430","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Pain sensitisation and the risk of poor outcome following physiotherapy for patients with moderate to severe knee osteoarthritis: protocol for a prospective cohort study"],"prefix":"10.1136","volume":"5","author":[{"given":"Helen","family":"O'Leary","sequence":"first","affiliation":[{"name":"School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith M","family":"Smart","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, St Vincent's University Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niamh A","family":"Moloney","sequence":"additional","affiliation":[{"name":"Discipline of Physiotherapy, Department of Health Sciences, Macquarie University, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Blake","sequence":"additional","affiliation":[{"name":"School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine M","family":"Doody","sequence":"additional","affiliation":[{"name":"School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,6,9]]},"reference":[{"key":"2025121400142658000_5.6.e007430.1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket463"},{"key":"2025121400142658000_5.6.e007430.2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-154-4-201102150-00001"},{"key":"2025121400142658000_5.6.e007430.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2010.03.001"},{"key":"2025121400142658000_5.6.e007430.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2013.03.018"},{"key":"2025121400142658000_5.6.e007430.5","doi-asserted-by":"publisher","DOI":"10.1002\/art.34646"},{"key":"2025121400142658000_5.6.e007430.6","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204191"},{"key":"2025121400142658000_5.6.e007430.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2844"},{"key":"2025121400142658000_5.6.e007430.8","unstructured":"International Association for the Study of Pain Taxonomy Working Group. IASP Taxonomy. Pain terms\u20142011. 2011. http:\/\/www.iasp-pain.org\/Content\/NavigationMenu\/GeneralResourceLinks\/%250APainDefinitions"},{"key":"2025121400142658000_5.6.e007430.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.09.030"},{"key":"2025121400142658000_5.6.e007430.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2013.06.013"},{"key":"2025121400142658000_5.6.e007430.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.04.003"},{"key":"2025121400142658000_5.6.e007430.12","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.joca.2013.05.015","article-title":"Experimental pain sensitivity differs as a function of clinical pain severity in symptomatic knee osteoarthritis","volume":"21","author":"King","year":"2013","journal-title":"Osteoarthritis Cartilage"},{"key":"2025121400142658000_5.6.e007430.13","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1302\/0301-620X.93B4.25054","article-title":"Evidence that central sensitisation is present in patients with shoulder impingement syndrome and influences the outcome after surgery","volume":"93","author":"Gwilym","year":"2011","journal-title":"J Bone Joint Surg Br"},{"key":"2025121400142658000_5.6.e007430.14","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000078"},{"key":"2025121400142658000_5.6.e007430.15","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1016\/j.joca.2013.05.008","article-title":"The association between pre-operative pain sensitisation and chronic pain after knee replacement: an exploratory study","volume":"21","author":"Wylde","year":"2013","journal-title":"Osteoarthritis Cartilage"},{"key":"2025121400142658000_5.6.e007430.16","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B2.19640"},{"key":"2025121400142658000_5.6.e007430.17","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-157-9-201211060-00007"},{"key":"2025121400142658000_5.6.e007430.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2006.01.001"},{"key":"2025121400142658000_5.6.e007430.19","first-page":"205","article-title":"Factors associated with change in pain and disability over time: a community-based prospective observational study of hip and knee osteoarthritis","volume":"55","author":"Peters","year":"2005","journal-title":"Br J Gen Pract"},{"key":"2025121400142658000_5.6.e007430.20","doi-asserted-by":"publisher","DOI":"10.1002\/art.21581"},{"key":"2025121400142658000_5.6.e007430.21","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20130256"},{"key":"2025121400142658000_5.6.e007430.22","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(03)00078-2"},{"key":"2025121400142658000_5.6.e007430.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjpain.2012.07.001"},{"key":"2025121400142658000_5.6.e007430.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.11.005"},{"key":"2025121400142658000_5.6.e007430.25","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/pme.12230","article-title":"Can quantitative sensory testing move us closer to mechanism-based pain management?","volume":"15","author":"Cruz-Almeida","year":"2014","journal-title":"Pain Med"},{"key":"2025121400142658000_5.6.e007430.26","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780290816"},{"key":"2025121400142658000_5.6.e007430.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2014.01.003"},{"key":"2025121400142658000_5.6.e007430.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.05.047"},{"key":"2025121400142658000_5.6.e007430.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.01.041"},{"key":"2025121400142658000_5.6.e007430.30","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.jpain.2011.10.005","article-title":"Test order of quantitative sensory testing facilitates mechanical hyperalgesia in healthy volunteers","volume":"13","author":"Gr\u00f6ne","year":"2012","journal-title":"J Pain"},{"key":"2025121400142658000_5.6.e007430.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.06.029"},{"key":"2025121400142658000_5.6.e007430.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2004.02.001"},{"key":"2025121400142658000_5.6.e007430.33","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200110)45:5<453::AID-ART365>3.0.CO;2-W"},{"key":"2025121400142658000_5.6.e007430.34","doi-asserted-by":"publisher","DOI":"10.1053\/joca.1999.0262"},{"key":"2025121400142658000_5.6.e007430.35","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(02)00239-7"},{"key":"2025121400142658000_5.6.e007430.36","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1001\/jama.282.12.1157","article-title":"Capturing the patient's view of change as a clinical outcome measure","volume":"282","author":"Fischer","year":"1999","journal-title":"J American Med Assoc"},{"key":"2025121400142658000_5.6.e007430.37","first-page":"1022","article-title":"Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis","volume":"17","author":"Ferraz","year":"1990","journal-title":"J Rheumatol"},{"key":"2025121400142658000_5.6.e007430.38","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000164099.92112.29"},{"key":"2025121400142658000_5.6.e007430.39","doi-asserted-by":"publisher","DOI":"10.1002\/art.24543"},{"key":"2025121400142658000_5.6.e007430.40","doi-asserted-by":"crossref","first-page":"E455","DOI":"10.1097\/01.brs.0000174274.38485.ee","article-title":"Interrater reliability of scoring of pain drawings in a self-report health survey","volume":"30","author":"Lacey","year":"2005","journal-title":"Spine (Phila Pa 1976)"},{"key":"2025121400142658000_5.6.e007430.41","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20100385"},{"key":"2025121400142658000_5.6.e007430.42","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem374"},{"key":"2025121400142658000_5.6.e007430.43","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2011.03.007"},{"key":"2025121400142658000_5.6.e007430.44","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1016\/j.joca.2013.06.023","article-title":"Neuropathic pain symptoms on the modified painDETECT correlate with signs of central sensitization in knee osteoarthritis","volume":"21","author":"Hochman","year":"2013","journal-title":"Osteoarthr Cartil"},{"key":"2025121400142658000_5.6.e007430.45","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1016\/j.joca.2012.06.013","article-title":"Responsiveness of intermittent and constant osteoarthritis pain (ICOAP) after physical therapy for knee osteoarthritis","volume":"20","author":"Gon\u00e7alves","year":"2012","journal-title":"Osteoarthritis Cartilage"},{"key":"2025121400142658000_5.6.e007430.46","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.joca.2013.11.012","article-title":"The relationship between knee pain characteristics and symptom state acceptability in people with knee osteoarthritis","volume":"22","author":"Liu","year":"2014","journal-title":"Osteoarthritis Cartilage"},{"key":"2025121400142658000_5.6.e007430.47","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2011.00493.x"},{"key":"2025121400142658000_5.6.e007430.48","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2012.11.012"},{"key":"2025121400142658000_5.6.e007430.49","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8510(96)00822-6"},{"key":"2025121400142658000_5.6.e007430.50","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"2025121400142658000_5.6.e007430.51","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/38.9.807"},{"key":"2025121400142658000_5.6.e007430.52","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e3181a68c64"},{"key":"2025121400142658000_5.6.e007430.53","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker343"},{"key":"2025121400142658000_5.6.e007430.54","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.pain.2010.11.013","article-title":"Test-retest and interobserver reliability of quantitative sensory testing according to the protocol of the German Research Network on Neuropathic Pain (DFNS): a multi-centre study","volume":"152","author":"Geber","year":"2011","journal-title":"Pain"},{"key":"2025121400142658000_5.6.e007430.55","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2011.02.009"},{"key":"2025121400142658000_5.6.e007430.56","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1002\/j.1532-2149.2012.00190.x","article-title":"Temporal summation of second pain: variability in responses to a fixed protocol","volume":"17","author":"Anderson","year":"2014","journal-title":"Eur J Pain"},{"key":"2025121400142658000_5.6.e007430.57","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2010.02.004"},{"key":"2025121400142658000_5.6.e007430.58","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.sjpain.2011.05.006","article-title":"The inter- and intra-individual variance in descending pain modulation evoked by different conditioning stimuli in healthy men","volume":"2","author":"Oono","year":"2011","journal-title":"Scand J Pain"},{"key":"2025121400142658000_5.6.e007430.59","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330203"},{"key":"2025121400142658000_5.6.e007430.60","doi-asserted-by":"crossref","first-page":"pii:e002532","DOI":"10.1136\/bmjopen-2012-002532","article-title":"Reproducibility of tender point examination in chronic low back pain patients as measured by intrarater and inter-rater reliability and agreement: a validation study","volume":"3:","author":"Jensen","year":"2013","journal-title":"BMJ Open"},{"key":"2025121400142658000_5.6.e007430.61","doi-asserted-by":"publisher","DOI":"10.1002\/art.20902"},{"key":"2025121400142658000_5.6.e007430.62","doi-asserted-by":"publisher","DOI":"10.1054\/ptsp.2001.0062"},{"key":"2025121400142658000_5.6.e007430.63","doi-asserted-by":"publisher","DOI":"10.1016\/S1356-689X(02)00156-X"},{"key":"2025121400142658000_5.6.e007430.64","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.physio.2006.07.002","article-title":"The Sport Injury Rehabilitation Adherence Scale: a reliable scale for use in clinical physiotherapy","volume":"93","author":"Kolt","year":"2007","journal-title":"Physiotherapy"},{"key":"2025121400142658000_5.6.e007430.65","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-14-297"},{"key":"2025121400142658000_5.6.e007430.66","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.011601"},{"key":"2025121400142658000_5.6.e007430.67","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.08.012"},{"key":"2025121400142658000_5.6.e007430.68","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/(SICI)1099-1166(199908)14:8<643::AID-GPS997>3.0.CO;2-S","article-title":"Detection of subthreshold depression and subthreshold anxeity in the elderly","volume":"14","author":"Papassotiropoulos","year":"1999","journal-title":"Int J Geriatr Psychiatry"},{"key":"2025121400142658000_5.6.e007430.69","first-page":"159","article-title":"Is self-reported improvement in osteoarthritis pain and disability reflected in objective measures?","volume":"34","author":"Johnson","year":"2007","journal-title":"J Rheumatol"},{"key":"2025121400142658000_5.6.e007430.70","unstructured":"Jackson JE . A user's guide to principal components. 2nd edn. John Wiley & Sons, Inc, 2005."},{"key":"2025121400142658000_5.6.e007430.71","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.01.047"},{"key":"2025121400142658000_5.6.e007430.72","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(01)00341-9"},{"key":"2025121400142658000_5.6.e007430.73","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(96)00236-3"},{"key":"2025121400142658000_5.6.e007430.74","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38977.590752.0B"},{"key":"2025121400142658000_5.6.e007430.75","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1097\/AJP.0000000000000042","article-title":"Association between a composite score of pain sensitivity and clinical parameters in low-back pain","volume":"30","author":"O'Neill","year":"2014","journal-title":"Clin J Pain"},{"key":"2025121400142658000_5.6.e007430.76","first-page":"1785","article-title":"Determinants of pain severity in knee osteoarthritis: effect of demographic and psychosocial variables using 3 pain measures","volume":"26","author":"Creamer","year":"1999","journal-title":"J Rheumatol"},{"key":"2025121400142658000_5.6.e007430.77","first-page":"655","article-title":"Prognostic factors for musculoskeletal pain in primary care: a systematic review","volume":"57","author":"Mallen","year":"2007","journal-title":"Br J Gen Pract"},{"key":"2025121400142658000_5.6.e007430.78","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2008.05.010"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2014-007430","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:14:37Z","timestamp":1765700077000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2014-007430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6]]},"references-count":78,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2015,6,9]]},"published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1136\/bmjopen-2014-007430"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2014-007430","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2015,6]]}}}