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Verbal instructions influence pain thresholds assessment: A study using manual and electronic mechanical stimulators
K Suzuki1,2,3, L Baad-Hansen1,2, P Svensson1,2,4
1Section of Orofacial Pain and Jaw Function, Department of Dentistry, Health, Aarhus University, Denmark.
European Journal of Pain (London, England)
|January 21, 2017
Summary
Standardized verbal instructions significantly alter mechanical pain thresholds (MPTs) in quantitative sensory testing (QST). Careful wording is crucial for accurate MPT assessment, regardless of stimulation technique.
Area of Science:
- Neuroscience
- Pain research
- Psychophysics
Background:
- Quantitative sensory testing (QST) uses psychophysical methods to assess sensory perception.
- Standardized verbal instructions are integral to QST protocols for testing mechanical pain thresholds (MPTs).
- Variability in instructions may impact MPT measurements.
Purpose of the Study:
- To investigate the effect of different verbal instructions on MPTs.
- To compare the impact of 'pinprick' versus 'pain' instructions.
- To assess test-retest reliability and within-session variability of MPTs under different instructions and stimulation techniques.
Main Methods:
- Sixteen healthy volunteers participated in the study.
- MPTs were measured using weighted pinprick stimulators and an electronic von Frey (EvF) device.
- Two verbal instructions ('pinprick' and 'pain') were used across three body sites (face, gingiva, tongue), with protocol repetition for reliability.
Main Results:
- MPT values were significantly higher with 'pain' instructions compared to 'pinprick' instructions across all sites and devices (p < .001).
- Instructional wording significantly affected absolute MPT values.
- No significant differences in test-retest reliability or within-session variability were observed between instruction types (p > .079).
Conclusions:
- The specific wording of standardized QST instructions significantly influences MPT values.
- This effect is independent of the stimulation technique used (pinprick or EvF).
- Emphasizes the critical need for meticulous standardization of verbal instructions in QST protocols.
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