Skip to main content

Advertisement

Log in

Reliability of the method of levels for determining cutaneous temperature sensitivity

  • Original Paper
  • Published:
International Journal of Biometeorology Aims and scope Submit manuscript

Abstract

Determination of the thermal thresholds is used clinically for evaluation of peripheral nervous system function. The aim of this study was to evaluate reliability of the method of levels performed with a new, low cost device for determining cutaneous temperature sensitivity. Nineteen male subjects were included in the study. Thermal thresholds were tested on the right side at the volar surface of mid-forearm, lateral surface of mid-upper arm and front area of mid-thigh. Thermal testing was carried out by the method of levels with an initial temperature step of 2°C. Variability of thermal thresholds was expressed by means of the ratio between the second and the first testing, coefficient of variation (CV), coefficient of repeatability (CR), intraclass correlation coefficient (ICC), mean difference between sessions (S1-S2diff), standard error of measurement (SEM) and minimally detectable change (MDC). There were no statistically significant changes between sessions for warm or cold thresholds, or between warm and cold thresholds. Within-subject CVs were acceptable. The CR estimates for warm thresholds ranged from 0.74°C to 1.06°C and from 0.67°C to 1.07°C for cold thresholds. The ICC values for intra-rater reliability ranged from 0.41 to 0.72 for warm thresholds and from 0.67 to 0.84 for cold thresholds. S1-S2diff ranged from −0.15°C to 0.07°C for warm thresholds, and from −0.08°C to 0.07°C for cold thresholds. SEM ranged from 0.26°C to 0.38°C for warm thresholds, and from 0.23°C to 0.38°C for cold thresholds. Estimated MDC values were between 0.60°C and 0.88°C for warm thresholds, and 0.53°C and 0.88°C for cold thresholds. The method of levels for determining cutaneous temperature sensitivity has acceptable reliability.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Arezzo JC, Schaumburg HH, Laudadio C (1986) Thermal sensitivity tester: device for quantitative assessment of thermal sense in diabetic neuropathy. Diabetes 35:590–592

    Article  CAS  Google Scholar 

  • Armstrong FM, Bradbury JE, Ellis SH, Owens DR, Rosen I, et al. (1991) A study of peripheral diabetic neuropathy. The application of age related reference values. Diabet Med 8 Symposium: S94-9

  • Beaton DE, Boers M, Wells GA (2002) Many faces of the minimal clinically important difference (MCID): a literature review and directions for future research. Curr Opin Rheumatol 14(2):109–114

    Article  Google Scholar 

  • Becser N, Sand T, Zwart J-A (1998) Reliability of cephalic thermal thresholds in healthy subjects. Cephalgia 18:574–582

    Article  CAS  Google Scholar 

  • Bird SJ, Brown MJ, Spino C, Watling S, Floyt HL (2006) Value of repeated measures of nerve conduction and quantitative sensory testing in diabetic neuropathy trial. Muscle Nerve 34:214–224

    Article  Google Scholar 

  • Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310

    Article  CAS  Google Scholar 

  • Chong PS, Cros DP (2004) American Association Of Electrodiagnostic Medicine Review: Quantitative sensory testing equipment and reproducibility studies. Available at: http://www.aanem.org/documents/qstReview.pdf. Accessed on December 21, 2010

  • Claus D, Hilz MJ, Neuendoerfer B (1990) Thermal discrimination thresholds: a comparison of different methods. Acta Neurol Scand 81:533–540

    Article  CAS  Google Scholar 

  • Dyck PJ, Kratz KM, Lehman KA, Karnes JL, Melton LJ et al (1991) The Rochester diabetic neuropathy study: design criteria for types of neuropathy, selection bias, and repeatability of neuropathic tests. Neurology 41:799–807

    Article  CAS  Google Scholar 

  • Gelber DA, Pfeifer MA, Broadstone VL, Munster EW, Peterson M et al (1995) Components of variance for vibratory and thermal threshold testing in normal and diabetic subjects. J Diabetes Complications 9:170–176

    Article  CAS  Google Scholar 

  • Guyton AC, Hall JE (2000) Textbook of medical physiology. W.B. Saunders Company, London

  • Hagander LG, Midani HA, Kuskowski MA, Parry GJ (2000) Quantitative sensory testing: effect of site and skin temperature on thermal thresholds. Clin Neurophysiol 111(1):17–22

    Article  CAS  Google Scholar 

  • Hensel H, Andres KH, von Düring M (1974) Structure and function of cold receptors. Pflugers Arch 352:1–10

    Article  CAS  Google Scholar 

  • Hopkins WG (2000) Measures of reliability in sports medicine and science. Sports Med 30(1):1–15

    Article  CAS  Google Scholar 

  • Hsieh YW, Wang CH, Wu SC, Chen PC, Sheu CF et al (2007) Establishing the minimal clinically important difference of the Barthel Index in stroke patients. Neurorehabil Neural Repair 21(3):233–238

    Article  Google Scholar 

  • Huck SW, Cormier WH (1996) Reading statistics and research, 2nd edn. Harper Collins, New York

    Google Scholar 

  • Kojo I, Pertovaara A (1987) The effects of stimulus area and adaptation temperature on warm and heat pain thresholds in man. Int J Neurosci 32(3–4):875–880

    Article  CAS  Google Scholar 

  • Meier PM, Berde CB, DiCanzio J, Zurakowski D, Sethna NF (2001) Quantitative assessment of cutaneous thermal and vibration sensation and thermal pain detection thresholds in healthy children and adolescents. Muscle Nerve 24:1339–1345

    Article  CAS  Google Scholar 

  • Merchut MP, Toleikis C (1990) Aging and quantitative sensory thresholds. Electromyogr Clin Neurophysiol 30:293–297

    CAS  Google Scholar 

  • Moravcová E, Bednařík J, Svobodník A, Dušek L (2005) Reproducibility of thermal threshold assessment in small-fibre neuropathy patients. Scripta Medica (Brno) 78(3):177–184

    Google Scholar 

  • Roebroeck ME, Harlaar J, Lankhorst GJ (1993) The application of generalizability theory to reliability assessment: an illustration using isometric force measurement. Phys Ther 73:386–401

    CAS  Google Scholar 

  • Stratford PW, Finch E, Solomon P et al (1996) Using the Roland-Morris questionnaire to make decisions about individual patients. Physiother Can 48:107–110

    Google Scholar 

  • Strigo IA, Carli F, Bushnell MC (2000) Effect of ambient temperature on human pain and temperature perception. Anesthesiology 92:699–707

    Article  CAS  Google Scholar 

  • Valensi P, Attali J-R, Gagant S (1993) Reproducibility of parameters for assessment of diabetic neuropathy. French Group for Research of Diabetic Neuropathy. Diabet Med 10:933–939

    Article  CAS  Google Scholar 

  • Yarnitsky D (1997) Quantitative sensory testing. Muscle Nerve 20(2):198–204

    Article  CAS  Google Scholar 

  • Yarnitsky D, Ochoa JL (1991) Warm and cold specific somatosensory systems. Psychophysical thresholds, reaction times and peripheral conduction velocities. Brain 114:1819–1826

    Article  Google Scholar 

  • Yarnitsky D, Sprecher E (1994) Thermal testing: normative data and repeatability for various test algorithms. J Neurol Sci 125:39–45

    Article  CAS  Google Scholar 

  • Zwart J-A, Sand T (2002) Repeatability of dermatomal warm and cold sensory thresholds in patients with sciatica. Eur Spine J 11:441–446

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Miroljub Jakovljević.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jakovljević, M., Mekjavić, I.B. Reliability of the method of levels for determining cutaneous temperature sensitivity. Int J Biometeorol 56, 811–821 (2012). https://doi.org/10.1007/s00484-011-0483-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00484-011-0483-9

Keywords

Navigation