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The Current Perception Threshold Test Differentiates Categories of Mechanical Neck Disorder
Zakir Uddin1, Joy C Macdermid, Victoria Galea
1School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
Summary
Current perception threshold (CPT) testing effectively differentiates mechanical neck disorders (MNDs) with neurological signs from those without. This sensory testing shows moderate accuracy in classifying neck pain categories, aiding diagnosis.
Area of Science:
- Neurology
- Orthopedics
- Musculoskeletal Disorders
Background:
- Neck pain is a prevalent musculoskeletal disorder affecting a significant portion of the adult population annually.
- Mechanical neck disorders (MNDs) present with varying degrees of severity, including pain without signs, pain with musculoskeletal signs, and pain with neurological signs.
- Altered sensory perception, potentially indicating neurological changes, can be assessed through current perception threshold (CPT) testing.
Purpose of the Study:
- To evaluate the efficacy of current perception threshold (CPT) testing in distinguishing between different categories of mechanical neck disorders (MNDs).
- To determine if CPT can accurately classify patients with neck pain based on the presence or absence of neurological signs.
Main Methods:
- A cross-sectional discriminative study involving 106 patients with MNDs, categorized into three groups (MND-I, MND-II, MND-III) based on clinical examination.
- CPT testing was administered at three frequencies (5, 250, 2000 Hz) across three hand dermatomes.
- Statistical analyses included one-way ANOVA, post hoc comparisons, binary logistic regression, and ROC curve analysis to compare CPT scores and assess discriminatory capacity.
Main Results:
- Significant differences in mean CPT scores were observed across the three MND groups (MND-I: 9.7, MND-II: 10.6, MND-III: 11.8; P < .001).
- Post hoc tests revealed significant differences between MND-I and MND-II (P = .05) and between MND-II and MND-III (P = .01), with large effect sizes.
- CPT testing demonstrated moderate discriminatory accuracy, with a threshold of >11 effectively distinguishing MND-III, achieving 73% sensitivity and 81% specificity (AUC = .84).
Conclusions:
- Current perception threshold (CPT) testing exhibits moderate discriminatory accuracy, specificity, and sensitivity for classifying MND categories.
- CPT testing is a valuable tool for differentiating between neck pain with and without neurological signs, aiding in the classification of mechanical neck disorders.
