背景:压力疼痛阈值(PPT)测量需要标准化的口头指导提示,以确保在正确的时间一致地停止增加压力。本研究旨在比较不同教学线索对PPT值及其重测可靠性的影响。
方法:在两个单独的会议中,对于四个不同的教学提示中的每一个,在前膝进行了两次PPT测量:德国神经病学研究网络说明(“DFNS”)的提示,压力首先感到不舒服的地方(\'不舒服\'),3/10的数字疼痛评定量表(\'3NPRS\'),疼痛与图片增强的NPRS量表(\“图片\”)中的图像有关。线性混合模型用于量化教学线索对之间的差异。使用组内相关系数(ICC[2,1]和ICC[2,k])估计重测可靠性。
结果:招募了20名参与者。产生最大PPT值的提示是DFNS(394.32kPa,95CI[286.32至543.06]),其次是画报(342.49kPa,95CI[248.68至471.68]),然后不舒适(311.85kPa,95CI[226.43至429.48]),最后是3NPRS(289.78kPa,95CI[210.41至399.09])。六个成对对比中有五个具有统计学意义。不管有什么线索,ICC(2,1)的点估计值范围为0.80~0.86,ICC(2,k)值范围为0.89~0.93.在可靠性指标的任何成对对比之间均未发现统计学上的显着差异。
结论:当指导人们何时停止压力测量测试时,单词很重要。临床医生在评估疼痛阈值时应使用相同的指导提示,以确保可靠性。
BACKGROUND: Pressure pain threshold (PPT) measurements require standardised verbal instructional cues to ensure that the increasing pressure is stopped at the correct time consistently. This study aimed to compare how PPT values and their test-retest reliability were affected by different instructional cues.
METHODS: At two separate sessions, two PPT measurements were taken at the anterior knee for each of four different instructional cues: the cue of the German Neuropathic Research Network instructions (\'DFNS\'), the point where pressure first feels uncomfortable (\'Uncomfortable\'), 3/10 on the numerical pain rating scale (\'3NPRS\'), and where pain relates to an image from the pictorial-enhanced NPRS scale (\'Pictorial\'). Linear mixed modeling was used to quantify differences between pairs of instructional cues. Test-retest reliability was estimated using intraclass correlation coefficients (ICC[2,1] and ICC[2,k]).
RESULTS: Twenty participants were recruited. The cue resulting in greatest PPT value was DFNS (394.32 kPa, 95%CI [286.32 to 543.06]), followed by Pictorial (342.49 kPa, 95%CI [248.68 to 471.68]), then Uncomfortable (311.85 kPa, 95%CI [226.43 to 429.48]), and lastly 3NPRS (289.78 kPa, 95%CI [210.41 to 399.09]). Five of six pairwise contrasts were statistically significant. Regardless of the cues, the point estimates of ICC (2,1) ranged from 0.80 to 0.86, and the ICC (2,k) values ranged from 0.89 to 0.93. No statistically significant differences were found between any pairwise contrasts of reliability indices.
CONCLUSIONS: Words matter when instructing people when to stop testing in pressure algometry. Clinicians should use the same instructional cue when assessing pain thresholds to ensure reliability.