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Updated: Jun 22, 2026
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Published on: June 16, 2018
A simple and objective marker for stress.
Soeren Ballegaard1, Benny Karpatschof, Werner Trojaborg
1Ull Care, Hellerup, Denmark. sba@ullcare.com
Summary
Pressure pain sensitivity (PPS) at the sternum correlates with physiological stress markers in opera singers and patients. This suggests PPS is a simple, reliable indicator of both transitional and persistent stress.
Area of Science:
- Physiology
- Psychophysiology
- Pain Research
Background:
- Physiological stress is commonly measured using metrics like heart rate and blood pressure.
- Objective measures for assessing both acute and chronic stress are valuable in clinical and performance settings.
Purpose of the Study:
- To investigate the association between sternal pressure pain sensitivity (PPS) and established physiological stress indicators.
- To evaluate PPS as a potential measure for transitional stress in opera singers and persistent stress in out-clinic patients.
Main Methods:
- Collected data on PPS, mean arterial pressure (MAP), heart rate (HR), pressure-rate-product (PRP), and salivary cortisol (SCO) in 26 opera singers during performances.
- Recorded resting PPS, HR, MAP, PRP, and noxious withdrawal reflex (NWR) in 181 out-clinic patients.
Main Results:
- During performances, sternal PPS correlated significantly with MAP, HR, and PRP.
- At rest, sternal PPS showed significant correlations with HR, PRP, and the presence of NWR.
- Salivary cortisol also showed a trend of correlation with sternal PPS during performance.
Conclusions:
- Sternal pressure pain sensitivity (PPS) is associated with established physiological stress measures.
- PPS measurement offers a simple, objective, and reliable method for assessing physiological stress.
- This method is potentially applicable to both professional performers and general patient populations.
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