scholarly journals Measuring pressure pain threshold in the cervical region of dizzy patients-The reliability of a pressure algometer

2018 ◽  
Vol 23 (4) ◽  
pp. e1736 ◽  
Author(s):  
Mari Kalland Knapstad ◽  
Stein Helge Glad Nordahl ◽  
Ingvill Fjell Naterstad ◽  
Tove Ask ◽  
Jan Sture Skouen ◽  
...  
Keyword(s):  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Cervical Region ◽  
Pressure Pain ◽  
Pressure Algometer

scholarly journals A novel metric of reliability in pressure pain threshold measurement

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bernard Liew ◽  
Ho Yin Lee ◽  
David Rügamer ◽  
Alessandro Marco De Nunzio ◽  
Nicola R. Heneghan ◽  
...  
Keyword(s):  
Mixed Models ◽  
Variance Components ◽  
Pain Threshold ◽  
Intraclass Correlation ◽  
Pressure Pain Threshold ◽  
Total Variance ◽  
Lumbar Region ◽  
Pressure Pain ◽  
Pressure Algometer ◽  
Testing Protocols

AbstractThe inter-session Intraclass Correlation Coefficient (ICC) is a commonly investigated and clinically important metric of reliability for pressure pain threshold (PPT) measurement. However, current investigations do not account for inter-repetition variability when calculating inter-session ICC, even though a PPT measurement taken at different sessions must also imply different repetitions. The primary aim was to evaluate and report a novel metric of reliability in PPT measurement: the inter-session-repetition ICC. One rater recorded ten repetitions of PPT measurement over the lumbar region bilaterally at two sessions in twenty healthy adults using a pressure algometer. Variance components were computed using linear mixed-models and used to construct ICCs; most notably inter-session ICC and inter-session-repetition ICC. At 70.1% of the total variance, the source of greatest variability was between subjects ($${\sigma }_{subj}^{2}$$ σ subj 2 = 222.28 N2), whereas the source of least variability (1.5% total variance) was between sessions ($${\sigma }_{sess}^{2}$$ σ sess 2 = 4.83 N2). Derived inter-session and inter-session-repetition ICCs were 0.88 (95%CI: 0.77 to 0.94) and 0.73 (95%CI: 0.53 to 0.84) respectively. Inter-session-repetition ICC provides a more conservative estimate of reliability than inter-session ICC, with the magnitude of difference being clinically meaningful. Quantifying individual sources of variability enables ICC construction to be reflective of individual testing protocols.

Design and Evaluation of a Computer-Controlled Pressure Algometer

2011 ◽  
Vol 5 (3) ◽  
Author(s):  
Michael M. Zimkowski ◽  
Emily M. Lindley ◽  
Vikas V. Patel ◽  
Mark E. Rentschler
Keyword(s):  
Blood Pressure ◽  
Real Time ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Pain Tolerance ◽  
Large Variability ◽  
Pressure Pain ◽  
New Device ◽  
Pressure Algometer ◽  
Computer Controlled

A challenge is always presented when attempting to measure the pain an individual patient experiences. Unfortunately, present technologies rely nearly exclusively on subjective techniques. Using these current techniques, a physician may use a manually operated algometer and a series of questionnaires to gauge an individual patient’s pain scale. Unfortunately these devices and test methods have been suggested to introduce error due to variability and inconsistent testing methods. Some studies have shown large variability, while others have shown minimal variability, both between patients and within the same patient during multiple testing sessions. Recent studies have also shown a lack of correlation between pain threshold and pain tolerance in pain sensitivity tests. Hand-held algometer devices can be difficult to maintain consistent application rates over multiple test periods, possibly adding to widespread variability. Furthermore, there are limited test results that correlate pain ratings with biological measures in real time. The computer-controlled pressure algometer described is not hand-held or dependent on significant examiner input. This new device is capable of recording electrocardiograph (ECG), blood pressure (BP), pressure pain threshold (PPT), and pressure pain tolerance (PPTol) in real time. One major goal is the capability of correlating pain stimuli with algometer pressure, heart rate, and blood pressure. If a predictable correlation between vital signs and pain could be established, significant gains in the understanding of pain could result. Better understanding of pain will ultimately lead to improvements in treatment and diagnosis of pain conditions, helping patients and physicians alike.

scholarly journals The Relationship between Fibromyalgia and Pressure Pain Threshold in Patients with Dyspareunia

2015 ◽  
Vol 20 (3) ◽  
pp. 137-140 ◽  
Author(s):  
Hasan Terzi ◽  
Rabia Terzi ◽  
Ahmet Kale
Keyword(s):  
Beck Depression Inventory ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Control Group ◽  
Tender Points ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Pressure Algometer ◽  
Significant Difference

OBJECTIVE: To evaluate the number of tender points, pressure pain threshold and presence of fibromyalgia among women with or without dyspareunia.METHODS: The present cross-sectional study included 40 patients with dyspareunia and 30 healthy controls. The participants were asked if they had engaged in sexual intercourse during the previous four weeks, and dyspareunia was rated from 0 to 3 based on the Marinoff Dyspareunia Scale. A pressure algometer (dolorimeter) was used to measure the pressure pain threshold. Fibromyalgia was diagnosed based on the 1990 American College of Rheumatology criteria. The depression status of the participants was assessed using the Beck Depression Inventory.RESULTS: No statistically significant difference was found with regard to age, body mass index, habits (alcohol use and smoking), educational status and occupational status between the two groups. Total myalgic score, total control score and tender point mean pain threshold were significantly lower in the group with dyspareunia. The number of tender points was significantly higher in patients with dyspareunia. The mean Beck Depression Inventory score was 14.7 ±8.4 in the dyspareunia group compared with 11.2 ±7.1 in the control group. Five (12.5%) of the patients with dyspareunia were diagnosed with fibromyalgia, whereas no patients in the control group were diagnosed with fibromyalgia. There was no significant difference between the two groups with regard to the presence of fibromyalgia.CONCLUSION: The finding of lower pressure pain thresholds and a higher number of tender points among patients with dyspareunia suggests that these patients may have increased generalized pain thresholds. Additional studies involving a larger number of patients are required to investigate the presence of central mechanisms in the pathogenesis of dyspareunia.

scholarly journals Instrumental validity and intra/inter-rater reliability of a novel low-cost digital pressure algometer

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10162
Author(s):  
Daniel Jerez-Mayorga ◽  
Carolina Fernanda dos Anjos ◽  
Maria de Cássia Macedo ◽  
Ilha Gonçalves Fernandes ◽  
Esteban Aedo-Muñoz ◽  
...  
Keyword(s):  
Standard Error ◽  
Pain Threshold ◽  
Low Cost ◽  
Pressure Pain Threshold ◽  
Force Platform ◽  
Rater Reliability ◽  
Pressure Pain ◽  
Pressure Algometer ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

Background Pain assessment is a key measure that accompanies treatments in a wide range of clinical settings. A low-cost valid and reliable pressure algometer would allow objective assessment of pressure pain to assist a variety of health professionals. However, the pressure algometer is often expensive, which limits its daily use in both clinical and research settings. Objectives This study aimed to assess the instrumental validity, and the intra- and inter-rater reliability of an inexpensive digital adapted pressure algometer. Methods A single rater applied 60 random compressions on a force platform. The pressure pain thresholds of 20 volunteers were collected twice (3 days apart) by two raters. The main outcome measurements were as follows: the maximal peak force (in kPa) and the pressure pain threshold (adapted pressure algometer vs. force platform). Cronbach’s α test was used to assess internal consistency. The standard error of measurement provided estimates of measurement error, and the measurement bias was estimated with the Bland–Altman method, with lower and upper limits of agreement. Results No differences were observed when comparing the compression results (P = 0.51). The validity and internal intra-rater consistencies ranged from 0.84 to 0.99, and the standard error of measurement from 0.005 to 0.04 kPa. Very strong (r = 0.73–0.74) to near-perfect (r = 0.99) correlations were found, with a low risk of bias for all measurements. The results demonstrated the validity and intra-rater reliability of the digitally adapted pressure algometer. Inter-rater reliability results were moderate (r = 0.55–0.60; Cronbach’s α = 0.71–0.75). Conclusion The adapted pressure algometer provide valid and reliable measurements of pressure pain threshold. The results support more widespread use of the pressure pain threshold method among clinicians.

scholarly journals AN OBSERVATIONAL STUDY ON ASSESSMENT OF PAIN THRESHOLD IN TRIVIDHA SATWABALA

2021 ◽  
Vol 9 (10) ◽  
pp. 2385-2391
Author(s):  
Anushree M. S ◽  
Soumya Saraswathi. M ◽  
Vidyanath R.
Keyword(s):  
Visual Analog Scale ◽  
Pain Threshold ◽  
Objective Assessment ◽  
Pressure Pain Threshold ◽  
Experimental Pain ◽  
Analog Scale ◽  
Pressure Pain ◽  
Pressure Algometer ◽  
Mind And Body ◽  
Pain Visual Analog Scale

Introduction: ‘Purusha’ the sentient being in Ayurveda is formed by the combination of Satwa (Mind), Atma (Soul) and Shareera (Body). Among these, paramount importance has been given to the role of the mind in both health and diseased states. In the present study, the term Satwa has been used to denote Satwabala or the psychic strength of an individual. The assessment of Satwabala is an important part in examination of the patient and while planning the treatment. The interrelationship of mind and body is well explained in Ayurveda. The pain inflicted on one's body has influence on his mind. Some people feel pain more intensely than others and some tolerate it so much more than others. Thus, quantification of pain with reference to psychic strength is essential for diagnostic and pain monitoring purposes in clinical practice. Aim and Objectives: The study was carried out with an aim to assess the Pain threshold in the form of Pressure Pain Threshold [PPT] and the Pain intensity in the form of the Visual Analog Scale [VAS] in three types of Satwabala. It was hypothesised that there could be a positive relation between Satwabala and Pain threshold. Methods: For the objective assessment of Pressure Pain Threshold a simple handheld pressure Algometer has been used. For the subjective measurement of experimental pain, Visual Analog Scale was used. Further, the Satwa of participants was assessed using a standard questionnaire. Results: The resultssuggested that in people between the age group of 18-40 years, there exist a statistically highly significant positive correlation between Satwabala and Pain threshold with P< 0.01. Keywords: Satwa, Satwabala, Pain threshold, Pressure Pain Threshold, Visual Analog Scale.

Pressure-pain threshold in human temporal region. Evaluation of a new pressure algometer

Pain ◽  
1986 ◽  
Vol 25 (3) ◽  
pp. 313-323 ◽  
Author(s):  
Kai Jensen ◽  
Henrik Ørbaek Andersen ◽  
Jes Olesen ◽  
Ulf Lindblom
Keyword(s):  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Temporal Region ◽  
Pressure Pain ◽  
Pressure Algometer

scholarly journals Pressure Pain Threshold Values Obtained Through Algometers

2021 ◽  
Author(s):  
◽  
J. H. Trueba-Perdomo
Keyword(s):  
Pain Threshold ◽  
Primary Outcome ◽  
Pressure Pain Threshold ◽  
The Body ◽  
Threshold Values ◽  
Pressure Pain ◽  
Leg Muscles ◽  
Body Regions ◽  
Pressure Algometer ◽  
Design Requirements

A review of the scientific literature on pressure pain obtained through algometers is carried out. A comparison of the pain pressure thresholds (PPT) obtained or considered within the analyzed studies was performed. The primary outcome of this work is the collection of these PPT values concerning the body regions where the algometers applied the pressure: trapezius muscles, back muscles, upper extremities, leg muscles, foot area, and muscles of the head. Furthermore, a comparison between the results of manual and electromechanical algometers is presented. Several tables are created, which can be useful to compare future studies that adopt pressure algometers. These values can also be considered a reference to evaluate the accuracy and reliability of new algometers, either manual or electromechanical. Besides, from the information obtained, the design requirements of an electromechanical pressure algometer are presented. These requirements are defined to develop a portable instrument that is also smaller, lighter, and cheaper than the existing ones and can measure the pressure in different parts of the human body.

Predicting Postoperative Pain by Preoperative Pressure Pain Assessment

2005 ◽  
Vol 103 (3) ◽  
pp. 613-618 ◽  
Author(s):  
Yung-Wei Hsu ◽  
Jacques Somma ◽  
Yu-Chun Hung ◽  
Pei-Shan Tsai ◽  
Chen-Hsien Yang ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Pain Tolerance ◽  
Morphine Consumption ◽  
Gynecologic Surgery ◽  
Postanesthesia Care Unit ◽  
Pressure Pain ◽  
Pressure Algometer

Background The goal of this study was to evaluate whether preoperative pressure pain sensitivity testing is predictive of postoperative surgical pain. Methods Female subjects undergoing lower abdominal gynecologic surgery were studied. A pressure algometer was used preoperatively to determine the pressure pain threshold and tolerance. A visual analog scale (VAS) was used to assess postoperative pain. A State-Trait Anxiety Inventory was used to assess patients' anxiety. Subjects received intravenous patient-controlled analgesia for postoperative pain control. The preoperative pain threshold and tolerance were compared with the postoperative VAS pain score and morphine consumption. Results Forty women were enrolled. Their preoperative pressure pain threshold and tolerance were 141 +/- 65 kPa and 223 +/- 62 kPa, respectively. The VAS pain score in the postanesthesia care unit and at 24 h postoperatively were 81 +/- 24 and 31 +/- 10, respectively. Highly anxious patients had higher VAS pain scores in the postanesthesia care unit (P &lt; 0.05). Pressure pain tolerance was significantly correlated with the VAS at 24 h postoperatively (P &lt; 0.001, r = -0.52). Pressure pain tolerance after fentanyl administration (mean, 272 +/- 68 kPa) correlated significantly with morphine consumption in the first 24 h postoperatively (P &lt; 0.002, r = -0.48). Conclusions Assessment of preoperative pressure pain tolerance is significantly correlated with the level of postoperative pain. Pain tolerance assessment after fentanyl was administered and fentanyl sensitivity predicted the dose of analgesics used in the first 24 h after surgery. The algometer is thus a simple, useful tool for predicting postoperative pain and analgesic consumption.

The Effect of Diacutaneous Fibrolysis on Local and Widespread Hyperalgesia and Muscle Length in Patients With Patellofemoral Pain Syndrome: Secondary Analysis of a Pretest–Posttest Clinical Trial

2020 ◽  
pp. 1-8
Author(s):  
Pablo Fanlo-Mazas ◽  
Elena Bueno-Gracia ◽  
Alazne Ruiz de Escudero-Zapico ◽  
Carlos López-de-Celis ◽  
César Hidalgo-García ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Muscle Length ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Pressure Pain ◽  
Pressure Algometer

Context: Localized and widespread hyperalgesia has been observed in patients with patellofemoral pain. Diacutaneous fibrolysis (DF) has shown to be effective in reducing pain in several musculoskeletal conditions including patellofemoral pain syndrome, but no studies have evaluated the effects of this technique in reducing localized and widespread hyperalgesia. Objective: To assess the effect of DF on the pressure pain threshold and muscle length tests in patients with patellofemoral pain syndrome. Design: A single-group, pretest–posttest clinical trial. Setting: University of Zaragoza. Participants: Forty-six subjects with patellofemoral pain (20 males and 26 females: age 27.8 [6.9] y). Intervention: Three sessions of DF. Main Outcome Measures: Pressure pain threshold using a handheld pressure algometer (4 sites around the knee, on tibialis anterior muscle, and one remote site on the upper contralateral limb); muscle length test of the iliotibial band, rectus femoris, and hamstring muscles; and patient-perceived treatment effect score. Results: The application of 3 sessions of DF significantly increased the pressure pain threshold in all sites at posttreatment evaluation (P < .001) and at a 1-week follow-up (P < .001). A significant increase in muscle length was also observed at the posttreatment evaluation (P < .001) and 1-week follow-up (P < .001). Ninety-seven percent of the patients reported subjective improvement at posttreatment and at 1-week follow-up. Conclusion: This study found that local and widespread hyperalgesia was significantly reduced after 3 sessions of diacutaneous fibrolysis and at the 1-week follow-up. A significant improvement on muscle length tests was also observed, with high clinical satisfaction among patients.

scholarly journals Somatosensory Testing in Pediatric Patients with Chronic Pain: An Exploration of Clinical Utility

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 275
Author(s):  
Anna Kersch ◽  
Panchalee Perera ◽  
Melanie Mercado ◽  
Andrew Gorrie ◽  
David Sainsbury ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Temporal Summation ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Pressure Pain ◽  
Pressure Algometer ◽  
Inflated Cuff ◽  
Biopsychosocial Assessment ◽  
Deep Pressure

We aimed to evaluate the utility of clinical somatosensory testing (SST), an office adaptation of laboratory quantitative sensory testing, in a biopsychosocial assessment of a pediatric chronic somatic pain sample (N = 98, 65 females, 7–18 years). Stimulus–response tests were applied at pain regions and intra-subject control sites to cutaneous stimuli (simple and dynamic touch, punctate pressure and cool) and deep pressure stimuli (using a handheld pressure algometer, and, in a subset, manually inflated cuff). Validated psychological, pain-related and functional measures were administered. Cutaneous allodynia, usually regional, was elicited by at least one stimulus in 81% of cases, most frequently by punctate pressure. Central sensitization, using a composite measure of deep pressure pain threshold and temporal summation of pain, was implied in the majority (59.2%) and associated with worse sleep impairment and psychological functioning. In regression analyses, depressive symptoms were the only significant predictor of pain intensity. Functional interference was statistically predicted by deep pressure pain threshold and depressive symptoms. Manually inflated cuff algometry had comparable sensitivity to handheld pressure algometry for deep pressure pain threshold but not temporal summation of pain. SST complemented standard biopsychosocial assessment of pediatric chronic pain; use of SST may facilitate the understanding of disordered neurobiology.

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