OP0078 Is the efficacy of physical therapy related to the pain in the patient’s mind?
2018
Background The degree of improvement in functionality and pain after physical therapy in the patients with knee osteoarthritis (OA) may be due to various peripheral factors and used modalities. Additionally, in some patients, modifiable psychological factors such as pain catastrophizing and depression may influence the therapy outcome. 1 Objectives The aim of this study was to investigate the impact of pain catastrophizing and depression on pain and functionality in the patients with knee OA who were treated with physical therapy. Methods The prospective cohort study participants were 89 patients with knee OA who underwent 10 sessions of physical therapy consist of hot-pack, transcutaneous electrical nerve stimulation (TENS), and ultrasound (US). Socio-demographic and clinical data were initially recorded. At baseline, pain catastrophizing and depression were measured with the standardised questionnaires including Pain Catastrophizing Scale (PCS) and Beck Depression Inventory-II (BDI-II).The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the visual analogue scale (VAS) were performed at baseline, at the end of therapy and at first month after therapy. Results The patients’ mean age was 60.38 (0.97), 82% were women, and 58.4% were not working. At baseline, the mean VAS and WOMAC scores were 7.39 (1.07) and 43.03 (19.47), respectively. 47.20% of the patients had clinically proper catastrophizing. The baseline demographic and clinical characteristics, except BDI-II score, VAS, and WOMAC were not different among the low catastrophizing and high catastrophizing groups (table 1). The patients who had high scores on pain catastrophizing had a lower improvement in VAS and WOMAC scores at the end of therapy and at first month after therapy (figure 1). Conclusions We suggest that high levels of initial PCS score may cause lower improvement on pain and functional levels in the patients who underwent physical therapy. Screening for pain catastrophizing and depression in the patients who receive physical therapy and taking necessary precautions may improve outcomes. Reference [1] Deutscher D, Horn SD, Dickstein R, Hart DL, Smout RJ, Gutvirtz M, Ariel I. Associations between treatment processes, patient characteristics, and outcomes in outpatient physical therapy practice. Arch Phys Med Rehabil2009Aug;90(8):1349–63. Disclosure of Interest None declared
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