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KMID : 0363120230360020173
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Korean Journal of Pain
2023 Volume.36 No. 2 p.173 ~ p.183
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Long-term consistency of clinical sensory testing measures for pain assessment
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Pablo Bellosta-Lopez
Victor Domenech-Garcia
Thorvaldur Skuli Palsson
Pablo Herrero
Steffan Wittrup Mcphee Christensen
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Abstract
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Background : Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs.
Methods : Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated.
Results : Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96?0.99; MDC, 22?55 kPa) and from good to excellent at 6 months (ICC, 0.88?0.95; MDC, 47?91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91?0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57?0.74; MDC, 24%?35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86).
Conclusions : PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.
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KEYWORD
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Humans, Hyperalgesia, Pain Measurement, Pain Perception, Pain, Referred, Pain Threshold, Reproducibility of Results, Sample Size
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