Abstract
Traumatic injuries affect approximately 978 million people worldwide with 56.2 million requiring inpatient care. Quantitative sensory testing (QST) can be useful in predicting outcome following trauma, however the reliability of multiple QST including temporal summation (TS), heat and cold pain thresholds (HPT, CPT) and pressure pain thresholds (PPT) is unknown. We assessed intra (between day) and inter-rater (within day) reliability of QST in asymptomatic participants (n = 21), and inter-rater (within day) reliability in participants presenting with acute musculoskeletal trauma (n = 25). Intra-class correlations with 95% confidence intervals (ICC 3,2), standard error of measurement (SEM) and Bland Altman Plots for limits of agreement were calculated. For asymptomatic participants, reliability was good to excellent for HPT (ICC range 0.76–0.95), moderate to good for PPT (ICC range 0.52–0.93), with one site rated poor (ICC 0.41), and poor to excellent for TS scores (ICC range 0.20–0.91). For musculoskeletal trauma participants reliability was good to excellent for HPT and PPT (ICC range 0.76–0.86), and moderate to good reliability for TS (ICC range 0.69–0.91). SEM for HPT for both sets of participants was ~1°C and an average of 7N for asymptomatic participants and less than 8N for acute musculoskeletal trauma participants for PPT. This study demonstrates moderate to excellent intra and inter-rater reliability for HPT and PPT in asymptomatic participants and good to excellent inter-rater reliability for acute musculoskeletal trauma participants, with TS showing more variability for both sets of participants. This study provides foundations for future work evaluating the sensory function over time following acute musculoskeletal trauma.
Highlights
978 million people worldwide sustain injuries, of which 56.2 million require inpatient care
The current study demonstrated good reliability for pressure pain thresholds (PPT) in both sets of participants, musculoskeletal trauma participants showed higher inter-rater reliability compared to asymptomatic participants
This study has demonstrated moderate to good intra-rater reliability and moderate to excellent inter-rater reliability for heat pain thresholds (HPT) and PPT in a sample of asymptomatic individuals with good to excellent inter-rater reliability demonstrated for HPT and PPT in an acute musculoskeletal trauma population
Summary
978 million people worldwide sustain injuries, of which 56.2 million require inpatient care. A high proportion of these injuries are musculoskeletal in nature with 21.7 million sustaining fractures [1]. If not expected, following trauma [2] and persistent pain is associated with a poor rate of return to work and reduced activities of daily living [3,4,5]. Reliability study of quantitative sensory testing in healthy and acute musculoskeletal trauma populations study design, data collection and analysis, decision to publish, or preparation of the manuscript
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