Experimental pressure-pain assessments: Test-retest reliability, convergence and dimensionality

2012 ◽  
Vol 3 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Tamara E. Lacourt ◽  
Jan H. Houtveen ◽  
Lorenz J.P. van Doornen
Keyword(s):  
Convergent Validity ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Experimental Pain ◽  
Threshold Value ◽  
Pain Tolerance ◽  
Pressure Pain ◽  
Pain Ratings ◽  
Left And Right ◽  
Body Point

AbstractIntroductionExperimental pain studies can provide unique insight into the dimensions of pain and into individual differences in pain responsiveness by controlling different aspects of pain-eliciting stimuli and pain measures. In experimental pain studies, pain responsiveness can be assessed as pain threshold, pain tolerance or pain ratings. The test-theoretical qualities of these different measures, however, have not yet been completely documented. In the current study, several of these qualities were investigated in a pain experiment applying different algometric techniques. The objective of the study was to investigate the reliability (test–retest) and the convergent validity (correspondence) of the different methods found in the literature of measuring pressure-pain threshold, and the interrelationship between pressure-pain threshold, pressure-pain tolerance, and pressure-pain ratings.MethodsSixty-six healthy female subjects were enrolled in the study. All pressure stimuli were applied by a trained investigator, using a digital algometer with a 1 cm2 rubber tip. Pressure-pain thresholds were assessed repeatedly on six different body points (i.e. left and right calf one third of total calf muscle length below the popliteal space), the lower back (5 cm left and right from the L3), and left and right forearm (thickest part of brachioradialis muscle). Next, pressure-pain tolerance was measured on the thumbnail of the non-dominant hand, followed by rating affective and sensory components (on visual analogue scales) of a stimulus at tolerance level. Last, affective and sensory ratings were obtained for two pressure intensities.ResultsWith intraclass correlations above .75 for pain responses per body point, test–retest reliability was found to be good. However, values obtained from all first measurements were significantly higher as compared with the two succeeding ones. Convergent validity of pain thresholds across different body points was found to be high for all combinations assessed (Cronbach’s alpha values >.80), but the highest for bilateral similar body parts (>.89). Finally, principal components analysis including measures of threshold, tolerance and pain ratings yielded a three-factor solution that explained 81.9% of the variance: Moderate-level stimulus appraisal & pain tolerance; Pain threshold; Tolerance-level stimulus appraisal.Conclusion and implicationsFindings of the current study were used to formulate recommendations for future algometric pain studies. Concerning pressure-pain threshold, it is recommended to exclude first measurements for every body point from further analyses, as these measurements were found to be consistently higher compared with the following measurements. Further, no more than two consecutive measurements (after the first measurement) are needed for a reliable mean threshold value per body point. When combining threshold values of several body points into one mean-aggregated threshold value, we suggest to combine bilateral similar points, as convergent validity values were highest for these combinations. The three-factor solution that was found with principal components analyses indicates that pressure-pain threshold, subjective ratings of moderate intensity stimuli, and subjective ratings of the maximum (tolerance) intensity are distinct aspects of pain responsiveness. It is therefore recommended to include a measure of each of these three dimensions of pain when assessing pressure pain responsiveness. Some limitations of our study are discussed.

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 Can Injuries Have a Lasting Effect on the Perception of Pain in Young, Healthy Women and Men?

2020 ◽  
pp. 194173812095316
Author(s):  
Agnieszka Maciejewska-Skrendo ◽  
Maciej Pawlak ◽  
Agata Leońska-Duniec ◽  
Alina Jurewicz ◽  
Mariusz Kaczmarczyk ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pain Threshold ◽  
Pain Perception ◽  
Emotional Experience ◽  
Pressure Pain Threshold ◽  
Pain Tolerance ◽  
Female Group ◽  
Pressure Pain ◽  
Left Hand ◽  
Healthy Women

Background: Pain is a characteristic, unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain is a subjective sensation, modulated by many factors such as age, sex, emotional state, national origin, or physical activity. Moreover, it is closely associated with intense physical activity, injuries, and traumas, which can significantly modulate pain tolerance. Hypothesis: We postulate that there are correlations between past injuries, physical activity, and intensity of pain perception (pain threshold and pain tolerance) in a population of healthy men and women. Study Design: Retrospective cohort study. Level of Evidence: Level 4. Methods: A total of 302 participants aged 18 to 32 years were included. The participants were divided into 2 groups (active and inactive individuals), in accordance with the scope of physical activity they had indicated. The test of pressure pain threshold and pressure pain tolerance was performed using an algometer. Results: Active women achieved significantly higher pain threshold and pain tolerance values in all measurements on the upper limb (except for the pain threshold on the left hand) compared with inactive women. In mediation analysis, the effect of injury remained significant only for the pressure pain tolerance in the dominant arm and the left hand in the female group. In the case of men, there were no significant differences in all measurements in view of the threshold and tolerance for pain between the groups of active and inactive and between men with injuries and without injuries. Conclusion: Intense, regular physical activity is a factor modulating the perception of pain. This was demonstrated as lowered sensitivity to pain stimuli in a population of healthy women. Clinical Relevance: Injuries should be treated as an important factor modulating the perception of pain. We recommend detailed monitoring of injuries during treatment and control of pain sensation.

scholarly journals The Relationship between Acculturation and Experimental Pain Sensitivity in Asian Americans with Knee Osteoarthritis

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Hyochol Ahn ◽  
Setor K. Sorkpor ◽  
Miyong Kim ◽  
Hongyu Miao ◽  
Chengxue Zhong ◽  
...  
Keyword(s):  
Asian Americans ◽  
Pain Sensitivity ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Experimental Pain ◽  
Pain Tolerance ◽  
Sociocultural Factors ◽  
Regression Analyses ◽  
Experimental Pain Sensitivity ◽  
The Relationship

Multiple studies in healthy populations and clinical samples have shown that ethnic minorities have greater pain sensitivity than their majority counterparts. Acculturation is speculated to be one of the sociocultural factors contributing to pain sensitivity since cultural beliefs and practices can influence the way patients perceive and respond to pain. However, the relationship of acculturation to pain sensitivity in minority populations remains poorly understood. Therefore, in this cross-sectional study, we examined the relationship between acculturation and experimental pain sensitivity in 50 Asian Americans residing in North Central Florida with knee osteoarthritis pain. The Suinn-Lew Asian Self Identity Acculturation Scale was used to assess acculturation, and multimodal quantitative sensory testing was performed to measure experimental sensitivity, including heat pain tolerance, pressure pain threshold, and punctate mechanical pain. Descriptive and regression analyses were performed. Participants’ mean age was 55.7 years, and about half of this sample were Korean American (56%). The participants had lived in the United States for 21 years on average. Regression analyses indicated that lower acculturation to American culture may contribute to greater experimental pain sensitivity. Asian Americans who were more acculturated to the American culture had higher heat pain tolerance (beta = 0.61, P=0.01), higher pressure pain threshold (beta = 0.59, P=0.02), and lower ratings of punctate mechanical pain (beta = −0.70, P<0.01). These findings add to the literature regarding sociocultural factors associated with pain in Asian Americans; additional research with a larger and more diverse sample of Asian Americans is warranted for cross-validation.

Pressure Pain Threshold and Pain Tolerance in Episodic Tension-Type Headache Do Not Depend on the Presence of Headache

Cephalalgia ◽  
1999 ◽  
Vol 19 (3) ◽  
pp. 174-178 ◽  
Author(s):  
GM Bove ◽  
N Nilsson
Keyword(s):  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Underlying Mechanism ◽  
Tension Type Headache ◽  
Pain Tolerance ◽  
Mechanical Stimuli ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Tension Type Headaches

Pressure pain thresholds and responses to painful mechanical stimuli were obtained from 20 subjects with episodic tension-type headaches (TTH). Tender points in the temporalis and trapezius muscles were studied, along with two nontender points, one in the temporalis and one on the Achilles tendon. Two examinations were performed, one during and one without a headache, and results were compared. No significant differences were found in either variable for any tested points. The data demonstrate that the sensitivity level of these points does not differ based on the presence or absence of TTH. This suggests that the muscle sensitivity in TTH is constant. The observation that the sensitivity levels of both tender and nontender points did not vary suggests that the underlying mechanism or effect of TTH is not restricted to tender muscles.

scholarly journals An Experimental Investigation of the Effect of Age and Sex/Gender on Pain Sensitivity in Healthy Human Participants

2018 ◽  
Vol 11 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Hanan El-Tumi ◽  
Mark I. Johnson ◽  
Osama A. Tashani
Keyword(s):  
Pain Sensitivity ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Heat Pain ◽  
Detection Thresholds ◽  
Pressure Pain ◽  
Heat Pain Threshold ◽  
Cold Pressor Pain

Background: Ageing is associated with alterations of the structure and function of somatosensory tissue that can impact on pain perception. The aim of this study was to investigate the relationship between age and pain sensitivity responses to noxious thermal and mechanical stimuli in healthy adults. Methods: 56 unpaid volunteers (28 women) aged between 20 and 55 years were categorised according to age into one of seven possible groups. The following measurements were taken: thermal detection thresholds, heat pain threshold and tolerance using a TSA-II NeuroSensory Analyzer; pressure pain threshold using a handheld electronic pressure algometer; and cold pressor pain threshold, tolerance, intensity and unpleasantness. Results: There was a positive correlation between heat pain tolerance and age (r = 0.228, P = 0.046), but no statistically significant differences between age groups for cold or warm detection thresholds, or heat pain threshold or tolerance. Forward regression found increasing age to be a predictor of increased pressure pain threshold (B = 0.378, P = 0.002), and sex/gender to be a predictor of cold pressor pain tolerance, with women having lower tolerance than men (B = -0.332, P = 0.006). Conclusion: The findings of this experimental study provide further evidence that pressure pain threshold increases with age and that women have lower thresholds and tolerances to innocuous and noxious thermal stimuli. Significance: The findings demonstrate that variations in pain sensitivity response to experimental stimuli in adults vary according to stimulus modality, age and sex and gender.

scholarly journals HOME-BASED TRANSCRANIAL DIRECT-CURRENT STIMULATION AND EXPERIMENTAL PAIN SENSITIVITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S338-S338
Author(s):  
Hyochol Ahn ◽  
Chengxue Zhong ◽  
Setor Sorkpor ◽  
Hongyu Miao
Keyword(s):  
Older Adults ◽  
Pain Sensitivity ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Experimental Pain ◽  
Pain Tolerance ◽  
Heat Pain ◽  
Knee Oa ◽  
Home Based ◽  
Experimental Pain Sensitivity

Abstract Osteoarthritis (OA) of the knee is one of the most common causes of pain in older adults. Clinic-based transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that has been shown to reduce pain, but no published studies have reported using home-based self-administered tDCS in older adults with knee OA. Thus, the purpose of this study was to examine the effect of home-based tDCS on experimental pain sensitivity in older adults with knee OA. Twenty community-dwelling participants aged 50–85 years with knee OA pain received ten daily sessions of 2 mA tDCS for 20 minutes at home. A multimodal quantitative sensory testing battery was completed, including heat pain tolerance, pressure pain threshold, and punctate mechanical pain. Participants (75% female) had a mean age of 61 years, and a mean body mass index in the sample was 28.33 kg/m2. All 20 participants completed all ten home-based tDCS sessions without serious adverse effects. The Wilcoxon Signed-Rank test showed that all the differences between the baseline measurements and experimental pain sensitivity measurements after 10 sessions were statistically significant. Effect sizes (Rosenthal’s R) were R = 0.35 for heat pain tolerance (P = 0.02), R = 0.40 for pressure pain threshold (P &lt; 0.01), and R = 0.32 for punctate mechanical pain (P = 0.02). We demonstrated that home-based self-administered tDCS was feasible and reduced experimental pain sensitivity in older adults with knee OA. Future studies with well-designed randomized controlled trials are needed to validate our findings.

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.

scholarly journals Pain Sensitisation in Women with Active Rheumatoid Arthritis: A Comparative Cross-Sectional Study

Arthritis ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Nora Vladimirova ◽  
Anders Jespersen ◽  
Else Marie Bartels ◽  
Anton W. Christensen ◽  
Henning Bliddal ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Temporal Summation ◽  
Pain Threshold ◽  
Cuff Pressure ◽  
Pressure Pain Threshold ◽  
Pain Tolerance ◽  
Leg Pain ◽  
Central Pain ◽  
Pressure Pain ◽  
Pain Sensitisation

Objectives. In some rheumatoid arthritis (RA) patients, joint pain persists without signs of inflammation. This indicates that central pain sensitisation may play a role in the generation of chronic pain in a subgroup of RA. Our aim was to assess the degree of peripheral and central pain sensitisation in women with active RA compared to healthy controls (HC). Methods. 38 women with active RA (DAS28>2.6) and 38 female HC were included in, and completed, the study. Exclusion criteria were polyneuropathy, pregnancy, and no Danish language. Cuff Pressure Algometry measurements were carried out on the dominant lower leg. Pain threshold, pain tolerance, and pain sensitivity during tonic painful stimulation were recorded. Results. Women with active RA had significantly lower pain threshold (p<0.01) and pain tolerance (p<0.01) than HC. The mean temporal summation- (TS-) index in RA patients was 0.98 (SEM: 0.09) and 0.71 (SEM: 0.04) in HC (p<0.01). Conclusion. Patients with active RA showed decreased pressure-pain threshold compared to HC. In addition, temporal summation of pressure-pain was increased, indicating central pain sensitization, at least in some patients. Defining this subgroup of patients may be of importance when considering treatment strategies.

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