Intra- and Inter-examiner Reliability of Quantitative Sensory Testing of Knee Joints in Healthy Subjects

Abstract

ABSTRACT Objectives: Examiner reliability of dynamic quantitative sensory testing (QST) of the knee varies across studies, and the optimal assessment site remains unclear. This study aimed to examine the intra- and inter-examiner reliability of QST performed at the medial joint space of the knee. Methods: A cross-sectional study was conducted in 30 healthy adults. QST was assessed at the medial knee joint space using the following measures: pressure pain threshold (PPT) for static QST and temporal summation (TS) and conditioned pain modulation (CPM) for dynamic QST. Two examiners performed each measurement twice on the same day. Intra-examiner reliability was evaluated using intraclass correlation coefficients [ICC (1, k)], and inter-examiner reliability was evaluated using ICC (2, k) and ICC (3, k). Results: The intra-examiner reliability ICCs for Examiners A/B were 0.98/0.99 for PPT, 0.81/0.88 for TS, 0.79/0.90 for CPM absolute change, and 0.84/0.95 for CPM percentage change. Inter-examiner reliability showed ICC (2, k)/ICC (3, k) values of 0.89/0.91 for PPT, 0.91/0.91 for TS, 0.66/0.66 for CPM absolute change, and 0.64/0.64 for CPM percentage change. Conclusions: This exploratory study suggested that QST performed at the medial joint space of the knee exhibited good intra- and inter-examiner reliability, with low variability compared to previously reported assessment sites. These preliminary findings indicate a potential advantage of this location for assessing knee pain. Future studies are needed to verify the clinical validity and applicability of these findings in patients with knee disorders.