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Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs.Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated.Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86).Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes. Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs.Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated.Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86).Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.

Neck pain is a common musculoskeletal problem often accompanied by reduced exercise-induced hypoalgesia (EIH) or hyperalgesia compared with an asymptomatic population. This study investigated EIH in a healthy population during experimental neck pain. Forty participants were randomized into this double-blinded parallel-group study. On 4 separate test days (day 0, day 2, day 4, and day 15), participants completed the Neck Disability Index and scored neck pain intensity during head movements on a numerical rating scale. At the end of day 0 and day 2, nerve growth factor (NGF) or isotonic saline (control) was injected into the right splenius capitis muscle. Pressure pain thresholds (PPTs) were recorded bilaterally over splenius capitis (neck), temporalis (head), and tibialis anterior (leg) muscles on all days. On day 0, day 4, and day 15, PPTs were recorded before and after a hand-bike exercise. Exercise-induced hypoalgesia was defined as the PPT increase caused by the exercise. Compared with the control group, the NGF group demonstrated higher Neck Disability Index scores at day 2 and day 4 (P < 0.001, η 2> 0.557) and higher numerical rating scale scores (P < 0.03, η 2> 0.09) along with reduced neck PPTs (P < 0.01, d > 0.44) at day 2 (right: 95% confidence interval [CI] [26.0-54.0]; left: 95% CI [6.8-26.9]), day 4 (right: 95% CI [40.5-67.9]; left: 95% CI [6.9-28.2]), and day 15 (right: 95% CI [5.6-37.2]; left: 95% CI [6.9-34.8]). Across days, the EIH effect was reduced at the neck site in the NGF group compared with the control group (P < 0.001, ηp2 = 0.367, 95% CI [-34.5 to -13.7]). At the head and leg sites, the NGF group showed reduced EIH effect compared with the control group (P < 0.05, d > 0.43) on day 4 (head: 95% CI [-61.4 to -22.9]; leg: 95% CI [-154.7 to -72.4]) and day 15 (head: 95% CI [-54.3 to -7.6]; leg: 95% CI [-122.7 to -34.4]). These results indicate that a few days of clinically comparable neck pain and hyperalgesia might have a negative impact on EIH responses and may help explain why some patients with neck pain do not experience immediate positive effects of exercise.

ObjectiveThe aim of this study was to develop a multifactorial, self-report questionnaire: Prevent for Work Questionnaire (P4Wq). The questionnaire is intended for screening for risk factors in work-related musculoskeletal disorders (WMSDs).DesignData were collected from otherwise healthy workers employed in three service areas at a specialist hospital in Italy: healthcare, administration and ancillary services.Setting and participantsIn all, 115 participants were enrolled (67% women; average age 41.5±9.94 years). The content of the tool for WMSDs was derived from three participation rounds of analysis involving a select group of experts who identified the questionnaire domains and items. Participants responded to 89 items in addition to the EuroQol 5 Dimensions Questionnaire (EQ-5D-5L), Fear-Avoidance Beliefs Questionnaire (FABq) and Oswestry Disability Index (ODI). The proportion of missing data and the distribution of responses were analysed for each item. Items with a discrimination index >0.40 and an interitem correlation ResultsA total of 52 items were included in the factor analysis and four subscales identified: Physical Stress Subscore (six items); Mental Stress Subscore (six items); Job Satisfaction Subscore (four items) and Kinesiophobia/Catastrophizing Subscore (four items). The items in the final questionnaire version had a factor loading >0.7. The questionnaire consisted of 20 items with good internal consistency (Cronbach’s alpha 0.81–0.91), reliability (weighted kappa coefficient 0.617–1.00), good construct validity (EQ-5D-5L, r=−0.549, pConclusionThe P4Wq is a 20-item, multifactorial self-report risk assessment questionnaire. It may provide a useful tool for screening for WMSDs by specifically addressing back disorders. It investigates risks for individual workers and may inform educational programmes and preventive strategies tailored to a worker’s needs.Trial registration numberNCT04192604