Bellosta-López Pablo, Doménech-García Víctor, Palsson Thorvaldur Skuli, Herrero Pablo, Christensen Steffan Wittrup Mcphee
San Jorge University, Campus Universitario, Zaragoza, Spain.
Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark.
Korean J Pain. 2023 Apr 1;36(2):173-183. doi: 10.3344/kjp.23011.
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.
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.
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).
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.
了解定量感觉测试（QST）随时间的稳定性对于帮助临床医生选择一系列测试来评估和监测患者非常重要。本研究评估了所选QST的短期和长期可靠性。
20名健康女性参加了三个实验阶段：基线、2周和6个月。测量包括颈部、上背部和腿部的压痛阈值（PPT）；上臂周围的压力袖带疼痛耐受性；压力袖带刺激期间的条件性疼痛调制；以及阈上压力刺激后的牵涉痛。计算组内相关系数（ICC）和最小可检测变化（MDC）。
PPT在2周时所有部位的可靠性都非常好（ICC，0.96 - 0.99；MDC，22 - 55 kPa），6个月时从良好到非常好（ICC，0.88 - 0.95；MDC，47 - 91 kPa）。压力袖带疼痛耐受性的ICC表明在两个时间点的可靠性都非常好（0.91 - 0.97）。对于条件性疼痛调制，2周时所有部位的可靠性为中等（ICC，0.57 - 0.74；MDC，24% - 35%），而6个月时颈部为中等（ICC，0.54；MDC，27%），上背部和腿部较差。牵涉痛区域的ICC在2周时非常好（0.90），6个月时良好（0.86）。
PPT、压力疼痛耐受性和压力诱发的牵涉痛应被视为评估随时间变化的疼痛感觉特征的可靠方法。相比之下，条件性疼痛调制显示不稳定。未来前瞻性分析疼痛感觉特征的研究将能够更好地计算合适的样本量。
