Korean J Pain.  2023 Apr;36(2):173-183. 10.3344/kjp.23011.

Long-term consistency of clinical sensory testing measures for pain assessment

• Bellosta-López P
• Doménech-García V
• Palsson TS
• Herrero P
• Christensen SWM

• KMID: 2541026
• DOI: http://doi.org/10.3344/kjp.23011

Abstract

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.

Keyword

Humans; Hyperalgesia; Pain Measurement; Pain Perception; Pain, Referred; Pain Threshold; Reproducibility of Results; Sample Size

Figure

• 

  Fig. 1 Schematic overview of the timeline and the assessment protocol. MOS-Sleep: medical outcomes study sleep scale, NRS: numeric rating scale.

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