Discipline of Physiotherapy, Department of Health Profession, Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, New South Wales, Australia.
The Centre for Physical Health, Macquarie University, North Ryde, New South Wales, Australia.
Pain. 2017 Jul;158(7):1217-1223. doi: 10.1097/j.pain.0000000000000901.
Quantitative sensory tests (QSTs) have been increasingly used to investigate alterations in somatosensory function in a wide range of painful conditions. The interpretation of these findings is based on the assumption that the measures are stable and reproducible. To date, reliability of QST has been investigated for short test-retest intervals. The aim of this study was to investigate the long-term reliability of a multimodal QST assessment in healthy people, with testing conducted on 3 occasions over 4 months. Forty-two healthy people were enrolled in the study. Static and dynamic tests were performed, including cold and heat pain threshold (CPT, HPT), mechanical wind-up [wind-up ratio (WUR)], pressure pain threshold (PPT), 2-point discrimination (TPD), and conditioned pain modulation (CPM). Systematic bias, relative reliability and agreement were analysed using repeated measure analysis of variance, intraclass correlation coefficients (ICCs3,1) and SE of the measurement (SEM), respectively. Static QST (CPT, HPT, PPT, and TPD) showed good-to-excellent reliability (ICCs: 0.68-0.90). Dynamic QST (WUR and CPM) showed poor-to-good reliability (ICCs: 0.35-0.61). A significant linear decrease over time was observed for mechanical QST at the back (PPT and TPD) and for CPM (P < 0.01). Static QST were stable over a period of 4 months; however, a small systematic decrease over time has been observed for mechanical QST. Dynamic QST showed considerable variability over time; in particular, CPM using PPT as the test stimulus did not show adequate reliability, suggesting that this test paradigm may be less useful for monitoring individuals over time.
定量感觉测试（QST）已越来越多地用于研究各种疼痛情况下体感功能的改变。这些发现的解释基于这样的假设，即这些测量是稳定和可重复的。迄今为止，已经研究了 QST 的短期测试-再测试间隔的可靠性。本研究的目的是调查健康人群中多模态 QST 评估的长期可靠性，测试在 4 个月内进行 3 次。42 名健康人参加了这项研究。进行了静态和动态测试，包括冷和热痛阈值（CPT、HPT）、机械性痛觉超敏（痛觉超敏比（WUR））、压力痛阈值（PPT）、两点辨别（TPD）和条件性疼痛调制（CPM）。使用重复测量方差分析、组内相关系数（ICC3,1）和测量的标准误差（SEM）分别分析系统偏差、相对可靠性和一致性。静态 QST（CPT、HPT、PPT 和 TPD）显示出良好到极好的可靠性（ICC：0.68-0.90）。动态 QST（WUR 和 CPM）显示出较差到良好的可靠性（ICC：0.35-0.61）。在背部（PPT 和 TPD）和 CPM （P<0.01）的机械 QST 随时间呈显著线性下降。在 4 个月的时间内，静态 QST 是稳定的；然而，机械 QST 随时间有一个小的系统下降。动态 QST 在随时间有很大的变异性；特别是，使用 PPT 作为测试刺激的 CPM 显示出足够的可靠性，这表明该测试方案可能不太适合随时间监测个体。
