Repeatability of a cold stress test to assess cold sensitization

Area of Science:

• Physiology
• Dermatology
• Environmental Medicine

Background:

• Non-freezing cold injury (NFCI) results from peripheral tissue damage due to cold exposure without freezing.
• Assessing cold sensitization is crucial for understanding NFCI susceptibility.
• The cold stress test (CST) is a potential tool for evaluating cold sensitization.

Purpose of the Study:

• To evaluate the test-retest reliability of the cold stress test (CST).
• To determine the CST's effectiveness in assessing cold sensitization in healthy volunteers.

Main Methods:

• Healthy volunteers underwent the CST on three separate occasions.
• Thermal imaging and spot temperature recordings of hands and feet were performed.
• Cold sensitization was graded by clinicians, and data analyzed for agreement and reliability.

Main Results:

• Substantial agreement was found for hands and feet of white volunteers and hands of black volunteers (Cohen's kappa 0.61-0.8).
• High agreement was observed for toe and finger pad temperatures (absolute 95% LoA < 5.5°C).
• Lower reliability was noted for the feet of black volunteers (kappa = 0.38, LoA = 9.5°C).

Conclusions:

• The CST demonstrates adequate test-retest reliability for assessing cold sensitization in the hands and feet of white individuals and the hands of black individuals.
• Reliability for the feet of black volunteers was not adequately supported.
• Further studies involving patients with a history of NFCI are recommended.