Repeatability of a cold stress test to assess cold sensitization.
BACKGROUND
Non-freezing cold injury (NFCI) is a syndrome in which damage to peripheral tissues occurs without the tissues freezing following exposure to low ambient temperatures.


OBJECTIVE
To assess the test-retest reliability of a cold stress test (CST) used to assess cold sensitization.


METHODS
Volunteers with no self-reported history of NFCI undertook the CST on three occasions. Thermal images were taken of the foot and hand before, immediately after and 5min after immersion of the limb in cold water for 2min. Cold sensitization was graded by the two clinicians and the lead author. Spot temperatures from the toe and finger pads were recorded.


RESULTS
There were 30 white and 19 black male participants. The ratings indicated substantial agreement [a Cohen's kappa (κ) value of 0.61-0.8] to within ± one grading category for the hands and feet of the white volunteers and the hands of the black volunteers. Limits of agreement (LoA) analysis for toe and finger pad temperatures indicated high agreement (absolute 95% LoA < 5.5°C). Test-retest reliability for the feet of the black volunteers was not supported by the gradings (κ = 0.38) and toe pad temperatures (absolute 95% LoA = 9.5°C and coefficient of variation = 11%).


CONCLUSIONS
The test-retest reliability of the CST is considered adequate for the assessment of the cold sensitization of the hands and feet of white and the hands of black healthy non-patients. The study should be repeated with patients who have suffered a NFCI.
Environmental Medicine and Science, Institute of Naval Medicine, Gosport PO12 2EG, UK, carol.house721@mod.uk.
C M
CM
House
Environmental Medicine and Science, Institute of Naval Medicine, Gosport PO12 2EG, UK, Navy Physical Development, HMS Temeraire, Portsmouth PO1 2HB, UK.
R J
RJ
Taylor
Environmental Medicine and Science, Institute of Naval Medicine, Gosport PO12 2EG, UK.
E H N
EH
Oakley
D000293:Adolescent; D000328:Adult; D044383:Black People; D000067390:Cold Injury / Q000175:diagnosis*; D003080:Cold Temperature; D005528:Foot; D005615:Freezing; D006225:Hand; D006801:Humans; D007101:Immersion; D008297:Male; D012016:Reference Values; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D012881:Skin Temperature; D013312:Stress, Physiological; D013577:Syndrome; D013817:Thermography; D044465:White People; D055815:Young Adult
Cold stress test; ethnicity; non-freezing cold injury; perfusion.