Water temperature during the cold pressor test: A scoping review

• Published in: Physiology & behavior Vol. 271; p. 114354
• Main Authors: Fanninger, Selina, Plener, Paul L., Fischer, Michael J. M., Kothgassner, Oswald D., Goreis, Andreas
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.11.2023
• Subjects: Cold pressor; Experimental pain; Experimental stress; Laboratory pain; Laboratory stress; Methodology; Experimental pain; Experimental stress; Laboratory stress; Methodology; Cold pressor; Laboratory pain
• DOI: 10.1016/j.physbeh.2023.114354
• ISSN: 0031-9384

•Water temperature for the Cold Pressor Test (CPT) and other variables were reviewed.•Temperatures varied substantially; 1 °C (33.8°F) was most frequently used.•Other factors impacting outcomes were also inconsistently implemented or reported.•Water temperature should be standardized, and the protocol should be reported in detail.•We suggest a stable temperature of 1°C (33.8°F) for future CPT studies. The cold pressor test (CPT) is a commonly used method to induce pain and stress in experimental settings. Previous research has found that the temperature of the water used in the test significantly affects outcome measures such as pain tolerance. Variations in CPT protocols, specifically regarding temperature, have been criticized. Hence, our objective is to investigate water temperature and associated methodological factors through a scoping review of the CPT in adults. Among 331 included trials, the most commonly reported temperature was 1°C (33.8°F). Reporting of the water temperature was adequate (93% of all trials), but a precise range within which the temperature was maintained was reported only in 27% of all trials. Pain measurement was the primary focus for most studies (90%), predominantly utilizing pain tolerance as the main outcome (78%). Water circulation was reported in 44% of studies, and 10% reported manually agitating the water. The most common maximum immersion time (i.e., ceiling time) was 180 s; notably, 64% of trials lacked information on participant awareness of this limit specification. The limb most immersed was the hand (76%). Overall, multiple methodological factors significantly impacting outcome measures were inconsistently implemented or reported. For future studies, we advocate for precise standardization of the water temperature used during the CPT. We suggest using 1°C (33.8°F), especially when assessing pain tolerance. A cooling apparatus allowing precise temperature control and continuous water circulation is advised. At the bare minimum, the temperature should be monitored continuously. While other decisions regarding the implementation of the CPT may differ depending on the specific aims of the respective study, it remains essential to standardize the water temperature and to provide a comprehensive report of the experimental protocol.