"ORIGINAL ARTICLE: Prevalence Of Mechanisms Based Subgroups Among Patients With Musculoskeletal Pain-A Cross-Sectional Study - SENTHIL P KUMAR"

Abstract : Mechanism-based classification of musculoskeletal pain was originally put forth and was further emphasized in hypothetico-deductive model of clinical reasoning. Five categories of mechanisms were proposed- central sensitization, peripheral sensitization, cognitive-affective, sympathetically mediated, and nociceptive. The objective of this paper is to assess the prevalence of mechanism-based classification subgroups in a patient population with musculoskeletal pain referred for physical therapy. 116 patients (76 male, 40 female) were assessed by seven physical therapists who were trained in mechanism-based classification of pain, using a structured format. All assessments were done only once. Visual analogue scale scores and age were taken as continuous variables while other variables were categorical. Descriptive analysis was done initially where continuous variables were reported in mean, range (minimum-maximum) and standard deviations, and categorical variables were reported in numbers and frequencies. Nociceptive mechanism (43%) was most common, followed by equal contribution from cognitive-affective (20%) mechanism and central sensitization (20%), followed by peripheral sensitization (15%) and sympathetically mediated (2%) mechanism. Further studies on validation and reliability are warranted before using this classification for clinical decision-making in musculoskeletal pain.

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