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Updated: Jul 26, 2025

A Protocol of Manual Tests to Measure Sensation and Pain in Humans
Published on: December 19, 2016
Reliability and minimal detectable difference of pressure pain thresholds in a pain-free population
Ryan Gl Koh1, Tracy M Paul2, Karlo Nesovic1,3
1KITE, Toronto Rehab, University Health Network, Toronto, ON, Canada.
Abstract:
The objective of this work was to evaluate the inter-rater and intra-rater reliability and minimal detectable difference (MDD) of pressure pain thresholds (PPTs) in pain-free participants with two examiners over two consecutive days in a cross-sectional study design. Examiners used a standardized method to measure and locate a specific testing site over tibialis anterior for PPT testing with a hand-held algometer. The mean of each examiner's three PPT measurements was used to calculate the intraclass correlation coefficient, inter-rater reliability, and intra-rater reliability. The minimal detectable difference (MDD) was calculated. Eighteen participants were recruited (11 female). The inter-rater reliability was 0.94 and 0.96 on day 1 and day 2, respectively. Intra-rater reliability for the examiners was 0.96 and 0.92 on day 1 and day 2, respectively. The MDD on day 1 was 1.24 kg/cm2 (CI: 0.76-2.03) and the MDD on day 2 was 0.88 kg/cm2 (CI: 0.54-1.43). This study demonstrates high inter- and intra-rater reliability and the MDD values for this method of pressure algometry.
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