Bilika Paraskevi, Kalamatas-Mavrikas Panagiotis, Vasilis Nikolaos, Strimpakos Nikolaos, Kapreli Eleni
Clinical Exercise Physiology & Rehabilitation Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, 351 32 Lamia, Greece.
Go Physio Laboratory, Sports Medicine & Rehabilitation Centre, 106 75 Athens, Greece.
Healthcare (Basel). 2024 Aug 31;12(17):1734. doi: 10.3390/healthcare12171734.
The objectives of this study were to estimate the intra-rater and inter-rater reliability of the Pressure Pain Threshold (PPT) and Conditioned Pain Modulation (CPM) in healthy participants and patients with chronic shoulder pain. Additionally, the Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC) were calculated. Thirty-one healthy volunteers and twenty patients with chronic shoulder pain were assessed using the PPT and CPM by two raters, with a 24 h interval between sessions. Excellent intra-rater reliability was demonstrated for PPT, with similar SEM and SDC when assessed by the same rater. The inter-rater reliability for PPTs in patients was moderate to good (ICC = 0.59-0.89) with higher SEM (73.83-121.98 kPa) and SDC (61.58-97.59) values than the asymptomatic group (ICC = 0.92-0.96, SEM = 49.61-103.12 kPa, SDC = 42.01-56.30) respectively. CPM's intra-rater reliability was good (ICC = 0.82) in the patients and moderate (ICC = 0.67) in the asymptomatic group, while inter-rater reliability was low for the asymptomatic group (ICC = 0.37) and extremely low (ICC = 0.074) for the patients, with comparable SEM and SDC outcomes in both groups. PPT and CPM measurements are highly reliable when conducted by the same rater on the same day. Patients had lower inter-rater PPT reliability but better intra-rater CPM reliability. Clinicians need to be mindful of potential variability when interpreting these test results.
本研究的目的是评估健康参与者和慢性肩痛患者的压力疼痛阈值（PPT）和条件性疼痛调制（CPM）的评分者内信度和评分者间信度。此外，还计算了测量标准误（SEM）和最小可检测变化（SDC）。31名健康志愿者和20名慢性肩痛患者由两名评分者使用PPT和CPM进行评估，两次评估之间间隔24小时。PPT显示出优秀的评分者内信度，由同一名评分者评估时具有相似的SEM和SDC。患者PPT的评分者间信度为中度至良好（ICC = 0.59 - 0.89），与无症状组（ICC = 0.92 - 0.96，SEM = 49.61 - 103.12 kPa，SDC = 42.01 - 56.30）相比，SEM（73.83 - 121.98 kPa）和SDC（61.58 - 97.59）值更高。CPM在患者中的评分者内信度良好（ICC = 0.82），在无症状组中为中度（ICC = 0.67），而无症状组的评分者间信度较低（ICC = 0.37），患者的评分者间信度极低（ICC = 0.074），两组的SEM和SDC结果相当。当由同一名评分者在同一天进行测量时，PPT和CPM测量具有高度可靠性。患者的评分者间PPT信度较低，但评分者内CPM信度较好。临床医生在解释这些测试结果时需要注意潜在的变异性。
