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A Protocol of Manual Tests to Measure Sensation and Pain in Humans
Published on: December 19, 2016
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Hand-held dynamometer to measure pressure pain thresholds: A double-blinded reliability and validity study.
Dhinu J Jayaseelan1, Keith R Cole1, Carol A Courtney2
1The George Washington University, Department of Health, Human Function, and Rehabilitation Sciences, Washington, DC, USA.
Musculoskeletal Science & Practice
|October 7, 2020
Summary
A hand-held dynamometer (HHD) is a valid and reliable tool for measuring pressure pain threshold (PPT) when force is normalized by applicator circumference. This clinical tool can aid in pain mechanism identification.
Area of Science:
- Musculoskeletal pain research
- Pain assessment methodologies
- Clinical instrumentation validation
Background:
- Pain is a prevalent complaint in musculoskeletal conditions.
- Quantitative sensory testing (QST) aids pain mechanism identification but is typically research-based.
- Clinical use of QST could improve with reliable and valid accessible tools.
Purpose of the Study:
- To validate a hand-held dynamometer (HHD) for measuring pressure pain threshold (PPT).
- To assess the reliability of HHD for PPT measurement.
Main Methods:
- A double-blinded validation study involving 18 healthy subjects.
- Two testers independently assessed PPT using HHD and a digital algometer.
- Force normalization by applicator circumference was analyzed.
Main Results:
- Excellent intra- and inter-rater reliability (ICC > 0.9) for both devices.
- Good-excellent agreement and minimal bias when normalizing force to circumference (ICC 95%CI: 0.56-0.95).
- Poor-good agreement and significant bias when normalizing to area (pressure).
Conclusions:
- A HHD is a valid and reliable tool for PPT measurement when force is normalized by applicator circumference.
- Clinicians can utilize HHD for pain mechanism evaluation and treatment.
- Further research in pathological populations is recommended.
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