Validating a home-based proxy- and self-administered quantitative sensory testing in youth and young adults...

Laboratory-based quantitative sensory testing (lab-QST) is a valuable tool for assessing sensory function but is limited by high costs, logistical constraints, and the need for trained personnel. This study aimed to validate a home-based proxy- and self-administered QST (proxy-/self-QST) toolkit in youth and young adults undergoing regional anesthesia for orthopedic procedures.

Patients aged 8-25 scheduled for orthopedic surgery with regional anesthesia were enrolled. Each participant underwent lab-QST followed by self-QST before surgery. Proxy-QST was then conducted in the postanesthesia care unit and on postoperative days 1, 2, and 3. Measures included mechanical or thermal detection and pain thresholds. Agreement between proxy-/self-QST and lab-QST was evaluated using Bland-Altman and correlation analyses. Reliability was assessed using intraclass correlation coefficients, and sensory changes were analyzed using non-parametric tests.

15 participants completed mechanical sensory testing, while another 15 participants completed thermal sensory testing. Proxy-/self-QST showed agreement with lab-QST for most parameters, particularly for vibration detection and pressure pain thresholds. Inter and intrarater reliability were moderate-to-excellent across most sensory measures. The toolkit detected sensory loss immediately after surgery and heightened sensitivity to pain by day 3. Acceptability was high among participants and proxies, with no adverse events reported. Feedback highlighted ease of use and advantages, though minor improvements were suggested.

Proxy-/self-QST is a feasible and reliable method for assessing sensory function in youth postoperatively. It offers a cost-effective alternative to lab-QST, enabling remote monitoring of sensory changes and expanding accessibility in research and clinical contexts.