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Tests to Use When Measuring Treatment Results with Chronic Whiplash Patients

Twenty-one chronic whiplash patients from the Spinal Care Unit in Tel Aviv were included in this study. The goal was to see if tests of pain and pressure threshold could measure small changes in patient symptoms and disability.

The idea is that tests should not be used unless they can be used to judge the status of the patient. Test results don't mean anything if they aren't truly measuring changes that have taken place as a result of treatment. And treatment should be proven effective before using it on patients routinely.

Three tests were used with each patient: the visual analogue scale (VAS), the Neck Disability Index (NDI), and the Pain Pressure Threshold (PPT). The VAS is a simple way to show how much pain the patient is experiencing. The NDI is a self-rated disability test. And the PPT measures the amount of pressure used to cause pain at six specific sites in the neck.

The tests were given to all 21 patients by three different people. The researchers then compared the results to see if the three testers had the same responses. This is a measure of intertester reliability. Tests must be reliable enough so that no matter who uses them, so long as the test is given properly, each tester gets the same response from the patient.

Analysis of the results found that the VAS should only be used with patients who rate their pain as a four (centimeters) or higher on the scale. PPT can be used for measuring changes in chronic whiplash patients so long as the same tester gives the test each time.


Tamara Prushansky, PhD, et al. Reproducibility of Pressure Pain Thresholds and Visual Analog Scale Findings in Chronic Whiplash Patients. In Clinical Journal of Pain. May 2007. Vol. 23. No. 4. Pp. 339-345.


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