Patient preferences for order of the sensory portion of the international standards for neurological classification of spinal cord injury (ISNCSCI) examination

Model System:

SCI

Reference Type:

Journal article

Accession No.:

J82585

Journal:

Journal of Spinal Cord Medicine - JSCM (formerly Journal of the American Paraplegia Society)

Year, Volume, Issue, Page(s):

2019 , 42, 6, 719-724

Publication Website:

Abstract:

The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) includes testing light touch (LT) and sharp/dull discrimination, also known as pinprick (PP) testing. The order these tests are performed varies by clinician and no true standard exists. This study examined patients’ perceptions of discomfort from each modality and their preferences for the order of the sensory exam. Ninety-one adults with traumatic SCI, 55 percent with neurologically complete injuries and 34 percent who were first-time examinees or those who did not recall a previous sensory examination, were tested. The order of the sensory examination (either PP or LT modality) was left to the individual physician’s preference. A questionnaire was administered following the exam regarding the degree of pain/discomfort experienced from each modality and patients’ preferences for testing order. All subjects reported that LT was not painful. Fifty-seven percent reported the PP testing as not painful, 24 percent as moderately painful, and 18.7 percent as very painful. The majority (66 percent) reported no preference for testing order; however, first-time examinees and those who did not recall previous sensory testing, were more likely to describe PP testing as “very painful” and report more “very painful” experiences when PP testing was completed first. First-time examinees, including those who did not recall previous sensory testing, may experience more pain/discomfort from PP testing especially when PP is tested first. Therefore, testing LT first, especially for the first-time examinee and those who do not recall a previous exam, may allow for a more comfortable experience.

Author(s):