QST normative values have been published and serve as a reference against which patients’ results can be evaluated (Rolke et al 2006a). However, as many variables can affect the results of an assessment comparing scores from different subjects, examiners, settings or, perhaps most significantly, testing apparatus,
can be difficult (Shy et al 2003). As with any psychophysical test (ie, a test requiring co-operation from the patient) care must be taken in the interpretation of results. This is particularly relevant with the interpretation of tQST scores since the tests rely heavily on patient perceptions and responses (Backonja et al 2009, Shy et al 2003). In order to optimise the reliability of the measure, there is a critical need for standardised physical properties of KU-57788 manufacturer the stimulus, closely standardised instruction, and investigator training (Backonja et al 2009). The lack of evidence-based diagnostic criteria for tQST for neurological conditions is a likely explanation of why tQST is more common
in the neuroscience research setting than in clinics. Practical considerations and cost are likely to also play a significant role (the tQST assessment takes around 45 minutes Protein Tyrosine Kinase inhibitor to set up, perform, and record, and tQST units can cost around AU$40 000). However the study of neuropathic pain is a rapidly developing area of clinical research in which tQST is likely to play an increasingly significant
role. With appropriate application and interpretation the tool will likely be utilised more in clinical practice (Backonja et al 2009). tQST robustness will ultimately depend on investigator training and method, and its results are likely best interpreted in light of the broader clinical picture. “
“2D realtime ultrasound can be used for non invasive assessment of pelvic floor muscle (PFM) function with standardised protocols described for both transabdominal (TA) (Sherburn et al 2005, Thopmson and O’Sullivan 2003) and transperineal (TP) approaches (Dietz 2004). The TA approach requires a moderately full bladder; the probe is placed over the supra-pubic region to visualise the bladder and the bladder base. The sound head is angled caudally to obtain a also clear image of the bladder wall. The TP approach is undertaken without a full bladder; the probe is placed directly on the perineum, and allows direct visualisation of the ano-rectum, urethra, and bladder neck. In neither approach are the PFMs visualised directly. Movement of the bladder base (TA), and bladder neck or ano-rectal angle (TP) are the surrogate markers for PFM action. Movement of the pelvic floor, during voluntary PFM contractions, and automatic activity in functional tasks are visualised and linear displacement (mm) is measured (Peng et al 2007).