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.

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 < 0.05). Pressure pain tolerance was significantly correlated with the VAS at 24 h postoperatively (P < 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 < 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.

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.

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 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 Effects of Different Neck Manual Lymphatic Drainage Maneuvers on the Nervous, Cardiovascular, Respiratory and Musculoskeletal Systems in Healthy Students

2020 ◽  
Vol 9 (12) ◽  
pp. 4062
Author(s):  
Ángela Río-González ◽  
Ester Cerezo-Téllez ◽  
Cristina Gala-Guirao ◽  
Laura González-Fernández ◽  
Raquel Díaz-Meco Conde ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Control Group ◽  
Pressure Pain ◽  
Significant Difference ◽  
Healthy Participants

The aim of this study is to describe the short-term effects of manual lymph drainage (MLD) isolated in supraclavicular area in healthy subjects. A 4-week cross-sectional, double-blinded randomized clinical trial was conducted. Participants: 24 healthy participants between 18 and 30 years old were recruited from Universidad Europea de Madrid from December 2018 to September 2019. A total of four groups were studied: control, placebo, Vodder, and Godoy. The order of the interventions was randomized. Resting Heart Rate and Oxygen Saturation, blood pressure, pressure pain threshold of trapezius muscle, respiratory rate, range of active cervical movements were measured before and after every intervention. All the participants fulfilled four different interventions with a one-week-wash-out period. No statistically significant differences were found between groups in descriptive data; neither in saturation of oxygen, diastolic blood pressure and cervical range of motion. Significant differences were found in favor of Vodder (p = 0.026) in heart rate diminution and in cardiac-rate-reduction. A significant difference in respiratory rate diminution is found in favor of the Godoy group in comparison with the control group (p = 0.020). A significant difference is found in favor of the Godoy group in systolic blood pressure decrease (p = 0.015) even in pressure pain threshold (p < 0.05). MLD decreases systolic blood pressure in healthy participants. However, it does not produce any changes in other physiologic outcomes maintaining physiologic values, which may suggest the safety of the technique in patients suffering from other pathologies.

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.

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 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.

Sign in / Sign up

Export Citation Format

Share Document