Concurrent validity of a low‐cost and time‐efficient clinical sensory test battery to evaluate somatosensory dysfunction

Abstract

BackgroundThis study describes a low‐cost and time‐efficient clinical sensory test (CST) battery and evaluates its concurrent validity as a screening tool to detect somatosensory dysfunction as determined using quantitative sensory testing (QST).MethodThree patient cohorts with carpal tunnel syndrome (CTS, n = 76), non‐specific neck and arm pain (NSNAP, n = 40) and lumbar radicular pain/radiculopathy (LR, n = 26) were included. The CST consisted of 13 tests, each corresponding to a QST parameter and evaluating a broad spectrum of sensory functions using thermal (coins, ice cube, hot test tube) and mechanical (cotton wool, von Frey hairs, tuning fork, toothpicks, thumb and eraser pressure) detection and pain thresholds testing both loss and gain of function. Agreement rate, statistical significance and strength of correlation (phi coefficient) between CST and QST parameters were calculated.ResultsSeveral CST parameters (cold, warm and mechanical detection thresholds as well as cold and pressure pain thresholds) were significantly correlated with QST, with a majority demonstrating >60% agreement rates and moderate to relatively strong correlations. However, agreement varied among cohorts. Gain of function parameters showed stronger agreement in the CTS and LR cohorts, whereas loss of function parameters had better agreement in the NSNAP cohort. Other CST parameters (16 mN von Frey tests, vibration detection, heat and mechanical pain thresholds, wind‐up ratio) did not significantly correlate with QST.ConclusionSome of the tests in the CST could help detect somatosensory dysfunction as determined with QST. Parts of the CST could therefore be used as a low‐cost screening tool in a clinical setting.SignificanceQuantitative sensory testing, albeit considered the gold standard to evaluate somatosensory dysfunction, requires expensive equipment, specialized examiner training and substantial time commitment which challenges its use in a clinical setting. Our study describes a CST as a low‐cost and time‐efficient alternative. Some of the CST tools (cold, warm, mechanical detection thresholds; pressure pain thresholds) significantly correlated with the respective QST parameters, suggesting that they may be useful in a clinical setting to detect sensory dysfunction.

Sensory bedside testing: a simple stratification approach for sensory phenotyping

“…Recently, attempts have been made to develop bedside test devices most indicative for lab-QST parameters, 4 , 21 without touching upon the demand for a bedside-QST cluster stratification. Both studies used correlation approaches in combination with a standard laboratory-based QST to identify the most reliable sensory testing parameters.…”

Sensory Perception in Lumbosacral Radiculopathy with Radicular Pain: Feasibility Study of Multimodal Bedside-Suitable Somatosensory Testing

“…The use of nonstandardized testing instruments has already been investigated in atypical odontalgia patients [8] and exhibited sufficiently high intra-rater and inter-rater reliability. Also, some bedside sensory testing tools for detecting of cold, warm, mechanical, and pressure pain thresholds have already been proven to correlate with the respective QST parameters significantly [25]. We used strictly standardized instrumentality for superficial sensory testing.…”

Qualitative Sensory Testing in Outcome Prediction of Transforaminal Epidural Steroid Injection for Chronic Painful Unilateral Lumbosacral Radiculopathy: Prospective Observational Study

“…Some simple clinical sensory testing tools for detecting cold, warm, mechanical, and pressure pain thresholds have already been proven to correlate with the respective QST parameters significantly. 32 In addition, the evaluation of other factors that influence the effectiveness of epidural steroid injections in regard to sensory testing would be promising. These factors include morphological changes of the spine, duration of pain, and some demographic and psychosocial factors.…”