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An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Pressure pain threshold testing demonstrates predictive ability in people with acute whiplash
David M Walton1, Joy C Macdermid, Warren Nielson
1School of Physical Therapy, The University of Western Ontario, London, Canada. Dwalton5@uwo.ca
The Journal of Orthopaedic and Sports Physical Therapy
|September 3, 2011
Summary
Pressure pain threshold (PPT) at a distal site, along with sex and baseline pain intensity, effectively predicts short-term neck disability in acute whiplash patients. This finding offers valuable prognostic insights for traumatic neck pain assessment.
Area of Science:
- Pain Medicine
- Musculoskeletal Rehabilitation
- Clinical Neurosciences
Background:
- Whiplash-associated disorder (WAD) is a common consequence of neck trauma.
- Accurate prognostic indicators are crucial for managing acute WAD.
- Pressure pain threshold (PPT) shows potential as a prognostic tool, but its predictive ability for short-term disability in acute WAD requires further investigation.
Purpose of the Study:
- To assess the prognostic value of PPT in predicting short-term outcomes for acute whiplash injuries.
- To determine if PPT measurements at specific sites offer additional predictive ability beyond established factors like age, sex, and baseline pain intensity.
- To explore the utility of PPT in clinical settings for individuals with recent whiplash-associated disorder.
Main Methods:
- A longitudinal cohort study involving 45 patients with acute whiplash-associated disorder recruited from Canadian physiotherapy clinics.
- Baseline assessments included pressure pain threshold (PPT) at two standardized sites, pain intensity, age, and sex.
- Neck-related disability was measured using the Neck Disability Index 1 to 3 months post-assessment, analyzed via multiple linear regression.
Main Results:
- A parsimonious regression model identified sex, baseline pain intensity, and PPT at the distal tibialis anterior site as significant predictors of short-term Neck Disability Index scores.
- This model explained 38.6% of the variance in 1-to-3-month follow-up disability scores.
- Neither age nor PPT measured at a local site provided significant additional predictive power beyond these three factors.
Conclusions:
- Sex, baseline pain intensity, and distal PPT measurements are key predictors of short-term neck-related disability in acute whiplash.
- These factors represent valuable additions to the assessment of traumatic neck pain, aiding in prognosis.
- Age and local PPT measurements did not significantly contribute to predicting short-term outcomes in this cohort.
