Cold intolerance and pain can be a substantial problem in patients with peripheral nerve injury. We aimed at investigating the relationships among sensory recovery, cold intolerance, and neuropathic pain in patients affected by upper limb peripheral nerve injury (Sunderland type V) treated with microsurgical repair, followed by early sensory re‐education. In a cross‐sectional clinical study, 100 patients (male/female 81/19; age 40.5 ± 14.8 years and follow‐up 17 ± 5 months, mean ± SD), with microsurgical nerve repair and reconstruction in the upper extremity and subsequent early sensory re‐education, were evaluated, using Cold Intolerance Symptoms Severity questionnaire‐Italian version (CISS‐it, cut‐off pathology >30/100 points), CISS questionnaire‐12 item version (CISS‐12, 0‐46 points‐grouping: healthy that means no cold intolerance [0‐14], mild [15‐24], moderate [25‐34], severe [35‐42], very severe [43‐46] cold intolerance), probability of neuropathic pain (DouleurNeuropathique‐4; [DN4] 4/10), deep and superficial sensibility, tactile threshold (monofilaments), and two‐point discrimination (cutoff S2; Medical Research Council scale for sensory function; [MRC‐scale]). A high CISS score is associated with possible neuropathic pain (DN4 ≥ 4). Both a low CISS‐it score (ie, < 30) and DN4 < 4 is associated with good sensory recovery (MRC ≥ 2). In conclusion patients affected by upper limb peripheral nerve injuries with higher CISS scores more often suffer from cold intolerance and neuropathic pain, and the better their sensory recovery is, the less likely they are to suffer from cold intolerance and neuropathic pain.
The aim of this study was to analyse the Cold Intolerance Symptom Severity (CISS) questionnaire in its Italian validated version, using Rasch analysis, to gain insights for a possible refinement of the questionnaire. The CISS was administered to a convenience sample of 96 consecutively recruited outpatients with upper limb peripheral nerve injury. Data were analysed using Rasch analysis. According to rating scale diagnostics, response options of items 3 and 5 did not comply with the pre-set criteria for an optimal category functioning. After collapsing the malfunctioning categories, all items fitted the measured construct. Principal component analysis of standardized residuals showed local dependence between two items (one of them was considered redundant and deleted); after this deletion, unidimensionality of the 12-item questionnaire (CISS-12) was achieved. The reliability indices of CISS-12 were high (>0.85). Some clearer item wording was introduced in response to comments from an expert panel and patient feedback. Overall, Rasch analysis provided the rationale for improving the measurement qualities of the questionnaire, refining its rating scales, identifying those items most useful for measuring the intended construct and confirming the high reliability of its person-ability and item-difficulty estimates. In conclusion, the new simplified CISS-12 presents robust psychometric properties for measuring cold intolerance in patients with upper limb peripheral nerve injury and represents a solid basis for clinical studies aimed at a precise (interval level) measurement of cold-induced symptoms in these patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.