An investigation of the use of a numeric pain rating scale with ice application to the neck to determine cold hyperalgesia

Maxwell, Samuel and Sterling, Michele M. (2013) An investigation of the use of a numeric pain rating scale with ice application to the neck to determine cold hyperalgesia. Manual Therapy, 18 2: 172-174. doi:10.1016/j.math.2012.07.004


Author Maxwell, Samuel
Sterling, Michele M.
Title An investigation of the use of a numeric pain rating scale with ice application to the neck to determine cold hyperalgesia
Journal name Manual Therapy   Check publisher's open access policy
ISSN 1356-689X
1532-2769
Publication date 2013-04-01
Year available 2012
Sub-type Article (original research)
DOI 10.1016/j.math.2012.07.004
Open Access Status DOI
Volume 18
Issue 2
Start page 172
End page 174
Total pages 3
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Language eng
Subject 3612 Physical Therapy, Sports Therapy and Rehabilitation
Abstract The presence of cold hyperalgesia is a predictor of poor health outcomes following whiplash injury. An appropriate clinical test to identify cold hyperalgesia may help in gauging the prognosis.A repeated measures, within subjects design was used. Sixty-three participants with chronic Whiplash Associated Disorder (WAD) (grade II and III) underwent testing at the cervical spine for sites of cold hyperalgesia with laboratory testing equipment, as well as a test of reported pain intensity on an 11 step numerical rating scale (NRS) after 10 s of ice application at the same sites. A receiver operating characteristic analysis was used to evaluate the ability of the ice application test to discriminate between cold hyperalgesic and non-cold hyperalgesic sites, as determined by the laboratory equipment.Pain sensation on ice application was significantly better than chance in discriminating between cold hyperalgesic and non-cold hyperalgesic sites (AUC 0.822 (95% CI 0.742-0.886); p < 0.0001). Sensitivities, specificities and likelihood ratios for different NRS values for pain intensity are presented. A pain intensity rating of >5 gave a positive likelihood ratio of 8.44 suggesting that if this value is reported, clinicians could be suspicious of the presence of cold hyperalgesia.This study demonstrates simple clinical test that may aid in gauging prognosis and guiding treatment decisions in people with WAD.
Formatted abstract
The presence of cold hyperalgesia is a predictor of poor health outcomes following whiplash injury. An appropriate clinical test to identify cold hyperalgesia may help in gauging the prognosis.

A repeated measures, within subjects design was used. Sixty-three participants with chronic Whiplash Associated Disorder (WAD) (grade II and III) underwent testing at the cervical spine for sites of cold hyperalgesia with laboratory testing equipment, as well as a test of reported pain intensity on an 11 step numerical rating scale (NRS) after 10 s of ice application at the same sites. A receiver operating characteristic analysis was used to evaluate the ability of the ice application test to discriminate between cold hyperalgesic and non-cold hyperalgesic sites, as determined by the laboratory equipment.

Pain sensation on ice application was significantly better than chance in discriminating between cold hyperalgesic and non-cold hyperalgesic sites (AUC 0.822 (95% CI 0.742–0.886); p < 0.0001). Sensitivities, specificities and likelihood ratios for different NRS values for pain intensity are presented. A pain intensity rating of >5 gave a positive likelihood ratio of 8.44 suggesting that if this value is reported, clinicians could be suspicious of the presence of cold hyperalgesia.

This study demonstrates simple clinical test that may aid in gauging prognosis and guiding treatment decisions in people with WAD.
Keyword Thermal hyperalgesia
Whiplash Injury
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 11 August 2012.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Health and Rehabilitation Sciences Publications
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 11 times in Thomson Reuters Web of Science Article | Citations
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Created: Fri, 22 Feb 2013, 03:02:04 EST by Chesne McGrath on behalf of Medicine - Royal Brisbane and Women's Hospital