Quantitative sensory testing in patients with incomplete spinal cord injury

Objective: To examine the utility of quantitative sensory testing (QST) to characterize sensory dysfunction in patients with spinal cord injury (SCI). Design: perceptual thresholds to warm, cold, cold pain, and vibratory stimu li were investigated using a modified method of "limits." Method: Three QST trials were administered to six lower leg dermatomes, on two different days, to estimate the reliability of measurement. Setting: Regional Spinal Cord Injury Rehabilitation Center in Ontario, Cana da. Subjects: Twenty-one SCI patients with incomplete neurologic deficits and 1 4 able-bodied controls of similar age. Results: ANOVA revealed significantly (p < .05) reduced perceptual threshol d values (hypoesthesia) for warm, cold, and vibratory sensation in the SCI group. There were no differences between group mean values for cold pain be cause of the inclusion of patients with hypoalgesia and hyperalgesia. Intra class correlation coefficient estimates of reliability revealed large betwe en-subject variability in the SCI patients associated with relatively small trial-to-trial variability within each day of testing, and appreciable bet ween-day variances. Conclusions: With QST in SCI then is a need for repeated measurements acros s days to establish stable baseline measures or outcomes following interven tion. QST is a useful adjunct to clinical examination for assessment of pre served sensation. (C) 1999 by the American Congress of Rehabilitation Medicine and the Americ an Academy of Physical Medicine and Rehabilitation.