본문 바로가기
KERD
논문KCI 등재

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

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

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.

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.

참고문헌 (49)

  1. McRae M, "Adults attending private physiotherapy practices seek diagnosis, pain relief, improved function, education and prevention : a survey", J Physiother, 63, pp.250~256 (2017)
  2. Cieza A, "Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019", Lancet, 397, pp.2006~2017 (2021)
  3. McMahon SB, "The burden of musculoskeletal pain and the role of topical non-steroidal anti-inflammatory drugs(NSAIDs)in its treatment. Ten underpinning statements from a global pain faculty", Curr Med Res Opin, 37, pp.287~292 (2021)
  4. Mills SEE, "Chronic pain : a review of its epidemiology and associated factors in population-based studies", Br J Anaesth, 123, pp.e273~e283 (2019)
  5. Roy JS, "Beyond the joint : the role of central nervous system reorganizations in chronic musculoskeletal disorders", J Orthop Sports Phys Ther, 47, pp.817~821 (2017)
  6. Edwards RR, "The role of psychosocial processes in the development and maintenance of chronic pain", J Pain, 17(9 Suppl), pp.T70~T92 (2016)
  7. Rabey M, "Somatosensory nociceptive characteristics differentiate subgroups in people with chronic low back pain : a cluster analysis", Pain, 156, pp.1874~1884 (2015)
  8. Lluch E, "Clinical descriptors for the recognition of central sensitization pain in patients with knee osteoarthritis", Disabil Rehabil, 40, pp.2836~2845 (2018)
  9. Daenen L, "Dysfunctional pain inhibition in patients with chronic whiplash-associated disorders : an experimental study", Clin Rheumatol, 32, pp.23~31 (2013)
  10. Beales D, "Masterclass : a pragmatic approach to pain sensitivity in people with musculoskeletal disorders and implications for clinical management for musculoskeletal clinicians", Musculoskelet Sci Pract, 51, pp.102221~ (2021)
  11. Georgopoulos V, "Quantitative sensory testing and predicting outcomes for musculoskeletal pain, disability, and negative affect : a systematic review and meta-analysis", Pain, 160, pp.1920~1932 (2019)
  12. Pavlaković G, "The role of quantitative sensory testing in the evaluation of musculoskeletal pain conditions", Curr Rheumatol Rep, 12, pp.455~461 (2010)
  13. Graven-Nielsen T, "Assessment of mechanisms in localized and widespread musculoskeletal pain", Nat Rev Rheumatol, 6, pp.599~606 (2010)
  14. Kanner R, "Pain management secrets", pp.9~14 (2009), Mosby
  15. Nir RR, "Conditioned pain modulation", Curr Opin Support Palliat Care, 9, pp.131~137 (2015)
  16. Doménech-García V, "Healthy pain-free individuals with a history of distal radius fracture demonstrate an expanded distribution of experimental referred pain toward the wrist", Pain Med, 21, pp.2850~2862 (2020)
  17. Zhu GC, "Concurrent validity of a low-cost and time-efficient clinical sensory test battery to evaluate somatosensory dysfunction", Eur J Pain, 23, pp.1826~1838 (2019)
  18. Marcuzzi A, "The long-term reliability of static and dynamic quantitative sensory testing in healthy individuals", Pain, 158, pp.1217~1223 (2017)
  19. Nothnagel H, "How stable are quantitative sensory testing measurements over time? Report on 10-week reliability and agreement of results in healthy volunteers", J Pain Res, 10, pp.2067~2078 (2017)
  20. Christensen SWM, "Changes in pain sensitivity and conditioned pain modulation during recovery from whiplash-associated disorders", Clin J Pain, 37, pp.730~739 (2021)
  21. Kottner J, "Guidelines for Reporting Reliability and Agreement Studies(GRRAS)were proposed", J Clin Epidemiol, 64, pp.96~106 (2011)
  22. Tanaka Y, "Classification of circadian pain rhythms and pain characteristics in chronic pain patients : an observational study", Medicine (Baltimore), 100, pp.e26500~ (2021)
  23. Rejas J, "Psychometric properties of the MOS(Medical Outcomes Study)Sleep Scale in patients with neuropathic pain", Eur J Pain, 11, pp.329~340 (2007)
  24. Azocar F, "Differential item functioning in a Spanish translation of the Beck Depression Inventory", J Clin Psychol, 57, pp.355~365 (2001)
  25. García Campayo J, "Validation of the Spanish version of the Pain Catastrophizing Scale in fibromyalgia", Med Clin (Barc), 131, pp.487~492 (2008)
  26. Balaguier R, "Is one trial sufficient to obtain excellent pressure pain threshold reliability in the low back of asymptomatic individuals? A test-retest study", PLoS One, 11, pp.e0160866~ (2016)
  27. Yarnitsky D, "Recommendations on practice of conditioned pain modulation(CPM)testing", Eur J Pain, 19, pp.805~806 (2015)
  28. Doménech-García V, "Pressure-induced referred pain is expanded by persistent soreness", Pain, 157, pp.1164~1172 (2016)
  29. Doménech-García V, "Pressure-induced referred pain areas are more expansive in individuals with a recovered fracture", Pain, 159, pp.1972~1979 (2018)
  30. Boudreau SA, "Digital pain drawings : assessing touch-screen technology and 3D body schemas", Clin J Pain, 32, pp.139~145 (2016)
  31. Koo TK, "A guideline of selecting and reporting intraclass correlation coefficients for reliability research", J Chiropr Med, 15, pp.155~163 (2016)
  32. Furlan L, "The applicability of standard error of measurement and minimal detectable change to motor learning research-a behavioral study", Front Hum Neurosci, 12, pp.95~ (2018)
  33. Waller R, "Reliability of pressure pain threshold testing in healthy pain free young adults", Scand J Pain, 9, pp.38~41 (2015)
  34. Black CD, "Day-to-day reliability of pressure pain threshold and pain ratings in college-aged men", Int J Rehabil Res, 38, pp.213~218 (2015)
  35. Walton DM, "Clinical pressure pain threshold testing in neck pain: comparing protocols, responsiveness, and association with psychological variables", Phys Ther, 94, pp.827~837 (2014)
  36. Kvistgaard Olsen J, "Reliability of pain measurements using computerized cuff algometry: a DoloCuff reliability and agreement study", Pain Pract, 17, pp.708~717 (2017)
  37. Graven-Nielsen T, "Assessment of musculoskeletal pain sensitivity and temporal summation by cuff pressure algometry: a reliability study", Pain, 156, pp.2193~2202 (2015)
  38. Arroyo-Fernandez R, "Pressure-induced referred pain as a biomarker of pain sensitivity in fibromyalgia", Pain Physician, 23, pp.E353~E362 (2020)
  39. Kennedy DL, "Reliability of conditioned pain modulation : a systematic review", Pain, 157, pp.2410~2419 (2016)
  40. Lewis GN, "Reliability of the conditioned pain modulation paradigm to assess endogenous inhibitory pain pathways", Pain Res Manag, 17, pp.98~102 (2012)
  41. Valencia C, "Stability of conditioned pain modulation in two musculoskeletal pain models : investigating the influence of shoulder pain intensity and gender", BMC Musculoskelet Disord, 14, pp.182~ (2013)
  42. Roldan CJ, "Quantitative sensory testing in pain management", Pain Manag, 5, pp.483~491 (2015)
  43. Mason KJ, "Psychosocial factors partially mediate the relationship between mechanical hyperalgesia and selfreported pain", Scand J Pain, 18, pp.59~69 (2018)
  44. Polianskis R, "Spatial and temporal aspects of deep tissue pain assessed by cuff algometry", Pain, 100, pp.19~26 (2002)
  45. Jensen B, "Chronic pain assessment from bench to bedside : lessons along the translation continuum", Transl Behav Med, 6, pp.596~604 (2016)
  46. Palsson TS, "Pain and disability in low back pain can be reduced despite no significant improvements in mechanistic pain biomarkers", Clin J Pain, 37, pp.330~338 (2021)
  47. McPhee ME, "Recurrent low back pain patients demonstrate facilitated pronociceptive mechanisms when in pain, and impaired antinociceptive mechanisms with and without pain", Pain, 160, pp.2866~2876 (2019)
  48. Walter SD, "Sample size and optimal designs for reliability studies", Stat Med, 17, pp.101~110 (1998)
  49. Kamper SJ, "Showing confidence(intervals)", Braz J Phys Ther, 23, pp.277~278 (2019)

관련 논문AI추천

Not just sensitization: sympathetic mechanisms contribute to expand experimental referred painAlberto Rubio Peirotén, Miren Lecea Imaz, Pablo Bellosta-López, Pablo Herrero, Thorvaldur Skuli Palsson, Víctor Doménech-García대한통증학회 · The Korean Journal of Pain2022 · 제35권 제3호The Availability of Quantitative Assessment of Pain Perception in Patients With Diabetic Polyneuropathy박진, 김성훈, 김지현, 박태준, 이희찬, 정세훈대한재활의학회 · Annals of Rehabilitation Medicine2018 · 제42권 제3호Reliability and Usefulness of the Pressure Pain Th reshold Measurement in Patients with Myofascial Pain김미정, 박시복, 장성호, Chan Woo Kim, Giburm Park대한재활의학회 · Annals of Rehabilitation Medicine2011 · 제35권 제3호Pain-Related Evoked Potential in Healthy Adults박진, 김성훈, 김종헌, 박태준, 신종목, 오경준, 이영희, 정홍선대한재활의학회 · Annals of Rehabilitation Medicine2015 · 제39권 제1호Comparison of the effects of transcutaneous electrical nerve stimulation and interferential current therapies in central sensitization in patients with knee osteoarthritisAslı Çalışkan Uçkun, Fatma Gül Yurdakul, Filiz Acar Sivas, Hatice Bodur, Şahide Eda Artuç대한통증학회 · The Korean Journal of Pain2023 · 제36권 제3호Altered Spinal Excitability in Patients with Primary Fibromyalgia: A Case-Control StudyAhmad Eza, Mohamed A. Ismael, Mohamed N. Thabit, Saber Hadad대한신경과학회 · Journal of Clinical Neurology2021 · 제17권 제1호

이 간행물의 다른 논문 (10건)