title: Pressure pain threshold testing demonstrates predictive ability in people with acute whiplash.
abstract: METHODS
  Longitudinal cohort study.
  
  
  OBJECTIVE
  To determine whether pressure pain threshold (PPT), tested at 2 standardized sites, could provide additional prognostic ability to predict short-term outcomes in people with acute whiplash, after controlling for age, sex, and baseline pain intensity.
  
  
  BACKGROUND
  PPT may be a valuable assessment and prognostic indicator for people with whiplash-associated disorder. The extent to which PPT can predict short-term disability scores has yet to be explored in people with acute (of less than 30 days in duration) whiplash-associated disorder in a clinical setting.
  
  
  METHODS
  Eligible patients were recruited from community-based physiotherapy clinics in Canada. Baseline measurements included PPT, as well as pain intensity, age, and sex. Neck-related disability was collected with the Neck Disability Index 1 to 3 months after PPT testing. Multiple linear regression models were constructed to evaluate the unique contribution of PPT in the prediction of follow-up disability scores.
  
  
  RESULTS
  A total of 45 subjects provided complete data. A regression model that included sex, baseline pain intensity, and PPT at the distal tibialis anterior site was the most parsimonious model for predicting short-term Neck Disability Index scores 1 to 3 months after PPT testing, explaining 38.6% of the variance in outcome. None of the other variables significantly improved the predictive power of the model.
  
  
  CONCLUSIONS
  Sex, pain intensity, and PPT measured at a site distal to the injury were the most parsimonious set of predictors of short-term neck-related disability score, and represented promising additions to assessment of traumatic neck pain. Neither age nor PPT at the local site was able to explain significant variance beyond those 3 predictors. Limitations to interpretation are addressed.
authors: School of Physical Therapy, The University of Western Ontario, London, Canada. Dwalton5@uwo.ca
authors: David M
authors: DM
authors: Walton
authors: Joy C
authors: JC
authors: Macdermid
authors: Warren
authors: W
authors: Nielson
authors: Robert W
authors: RW
authors: Teasell
authors: Hilary
authors: H
authors: Reese
authors: Lenerdene
authors: L
authors: Levesque
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002170:Canada; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000295:instrumentation / Q000379:methods*; D017288:Pain Threshold; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014911:Whiplash Injuries / Q000503:physiopathology*; D055815:Young Adult