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Quantitative sensory testing in patients with incomplete spinal cord injury
A Krassioukov1, D L Wolfe, J T Hsieh
1Department of Physical Medicine & Rehabilitation, Parkwood Hospital/St. Joseph's Health Centre, The University of Western Ontario, London, Canada.
Objective:
To examine the utility of quantitative sensory testing (QST) to characterize sensory dysfunction in patients with spinal cord injury (SCI).
Design:
Perceptual thresholds to warm, cold, cold pain, and vibratory stimuli were investigated using a modified method of "limits."
Method:
Three QST trials were administered to six lower leg dermatomes, on two different days, to estimate the reliability of measurement.
Setting:
Regional Spinal Cord Injury Rehabilitation Center in Ontario, Canada.
Subjects:
Twenty-one SCI patients with incomplete neurologic deficits and 14 able-bodied controls of similar age.
Results:
ANOVA revealed significantly (p < .05) reduced perceptual threshold values (hypoesthesia) for warm, cold, and vibratory sensation in the SCI group. There were no differences between group mean values for cold pain because of the inclusion of patients with hypoalgesia and hyperalgesia. Intraclass correlation coefficient estimates of reliability revealed large between-subject variability in the SCI patients associated with relatively small trial-to-trial variability within each day of testing, and appreciable between-day variances.
Conclusions:
With QST in SCI there is a need for repeated measurements across days to establish stable baseline measures or outcomes following intervention. QST is a useful adjunct to clinical examination for assessment of preserved sensation.