A novel metric of reliability in pressure pain threshold measurement

Liew, Bernard X. W.; Lee, Ho Yin; Rügamer, David; Nunzio, Alessandro Marco De; Heneghan, Nicola R; Falla, Deborah; Evans, David W.

doi:10.1038/s41598-021-86344-6

Cited by 12 publications

(10 citation statements)

References 31 publications

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“…In favor of larger samples, we preferred to maximize the number of subjects. As recent findings of Liew et al (2021) indicate, our decision not to increase the number of repeats seems to barely affect the results we have achieved. According to their findings, the variance in a subject's pressure pain threshold measured in separate sessions can be expected to be irrelevant compared to the inter-subject variance.…”

Section: Limitations Of the Statistical Analysismentioning

confidence: 57%

A Statistical Model to Determine Biomechanical Limits for Physically Safe Interactions With Collaborative Robots

Behrens

Pliske

Umbreit³

et al. 2022

Front. Robot. AI

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Collaborative robots (cobots) provide a wide range of opportunities to improve the ergonomics and efficiency of manual work stations. ISO/TS 15066 defines power and force limiting (PFL) as one of four safeguarding modes for these robots. PFL specifies biomechanical limits for hazardous impacts and pinching contacts that a cobot must not exceed to protect humans from serious injuries. Most of the limits in ISO/TS 15066 are preliminary, since they are based on unverified data from a literature survey. This article presents a human-subject study that provides new and experimentally verified limits for biomechanically safe interactions between humans and cobots. The new limits are specifically tailored to impact and pinching transferred through blunt and semi-sharp surfaces as they can occur in the event of human error or technical failures. Altogether 112 subjects participated in the study and were subjected to tests with emulated impact and pinching loads at 28 different body locations. During the experiments, the contact force was gradually increased until the load evoked a slightly painful feeling on the subject’s body location under test. The results confirm that the pain thresholds of males and females are different in specific body regions. Therefore, when defining biomechanical limits, the gender difference must be taken into account. A regression model was utilized to incorporate the gender effect as a covariate into a conventional statistical distribution model that can be used to calculate individual limits, precisely fitted to a specific percentile of a mixed group of male and female workers which interacting with cobots.

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Section: Limitations Of the Statistical Analysismentioning

confidence: 57%

A Statistical Model to Determine Biomechanical Limits for Physically Safe Interactions With Collaborative Robots

Behrens

Pliske

Umbreit³

et al. 2022

Front. Robot. AI

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“…In addition to the different settings (laboratory versus real-world), other factors may explain the lack of a significant PPT increase observed in this study. In QST research, it is well known that the initial pain test often introduces more variance in pain sensitivity than subsequent tests [ 38 – 40 ]. This is likely due to an initial degree of apprehension about unfamiliar painful tests on behalf of study participants.…”

Section: Discussionmentioning

confidence: 99%

“…Potentially, our study would have higher reproducibility if two or three trials were used instead. The first PPT trial is likely different from the second, but it is not clear in what direction [ 38 – 40 ]. Some studies report it as higher, while others as lower.…”

Section: Discussionmentioning

confidence: 99%

Pressure pain thresholds in a real-world chiropractic setting: topography, changes after treatment, and clinical relevance?

et al. 2022

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Background Changes in pain sensitivity are a commonly suggested mechanism for the clinical effect of spinal manipulative therapy (SMT). Most research has examined pressure pain thresholds (PPT) and has primarily been conducted in controlled experimental setups and on asymptomatic populations. Many important factors are likely to differ between research and clinical settings, which may affect PPT changes following SMT. Therefore, we planned to investigate PPT before and after clinical chiropractic care and investigate relationships with various potentially clinically-relevant factors. Methods We recruited participants from four Danish chiropractic clinics between May and August 2021. A total of 129 participants (72% of the invited) were included. We measured PPT at eight pre-determined test sites (six spinal and two extra-spinal) immediately before (pre-session) and immediately after (post-session) the chiropractic consultation. We used regression analyses to investigate PPT changes, including the following factors: (i) vertebral distance to the nearest SMT site, (ii) rapid clinical response, (iii) baseline PPT, (iv) number of SMTs performed, (v) at the region of clinical pain compared to other regions, and (vi) if other non-SMT treatment was provided. We also performed topographic mapping of pre-session PPTs. Results After the consultation, there was a non-significant mean increase in PPT of 0.14 kg (95% CIs = − 0.01 to 0.29 kg). No significant associations were found with the distance between the PPT test site and nearest SMT site, the clinical response of participants to treatment, the pre-session PPT, the total number of SMTs performed, or the region/s of clinical pain. A small increase was observed if myofascial treatment was also provided. Topographic mapping found greater pre-session PPTs in a caudal direction, not affected by the region/s of clinical pain. Conclusions This study of real-world chiropractic patients failed to demonstrate a substantial local or generalized increase in PPT following a clinical encounter that included SMT. This runs counter to prior laboratory research and questions the generalizability of highly experimental setups investigating the effect of SMT on PPT to clinical practice.

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“…higher level of self-efficacy) could contribute to greater pain tolerance 53 – 55 . It was further advised to reflect on the influence of psychosocial characteristics on PPT-measurements 52 .…”

Section: Discussionmentioning

confidence: 99%

“…higher level of self-efficacy) could contribute to greater pain tolerance [53][54][55] . It was further advised to reflect on the influence of psychosocial characteristics on PPT-measurements 52 . Different ICCs were observed concerning the left (0.69) and right (0.89) suboccipitals.…”

Section: Mechanical Pain Sensation Varies Between Patients With Cehmentioning

confidence: 99%

Inter-individual variability in mechanical pain sensation in patients with cervicogenic headache: an explorative study

Mingels

Dankaerts

Bruckers

et al. 2022

Sci Rep

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Currently, evidence for effective physiotherapy interventions in patients with cervicogenic headache (CeH) is inconsistent. Although inter-individual variability in pain response is predictive for successful physiotherapy interventions, it was never explored in patients with CeH. Therefore the objective of the current study was to explore inter-individual variability in mechanical pain sensation, and its association with biopsychosocial-lifestyle (BPSL) characteristics in patients with CeH. A cross-sectional explorative analysis of inter-individual variability in mechanical pain sensation in 18 participants with CeH (29–51 years) was conducted. Inter-individual variability in mechanical pain sensation (standard deviations (SDs), F-statistics, Measurement System Analysis) was deducted from bilateral pressure pain thresholds of the suboccipitals, erector spine, tibialis anterior. BPSL-characteristics depression, anxiety, stress (Depression Anxiety Stress Scale-21), quality of life (Headache Impact Test-6), sleep-quality (Pittsburgh Sleep Quality Index), and sedentary time (hours/week) were questioned. Inter-individual variability in mechanical pain sensation explained 69.2% (suboccipital left), 86.8% (suboccipital right), 94.6% (erector spine left), 93.2% (erector spine right), 91.7% (tibialis anterior left), and 82% (tibialis anterior right) of the total variability in patients with CeH. The significant p-values and large F-statistic values indicate inter-individual differences in SDs. Significant associations between (1) lower quality of life and lower SDs of the suboccipital left PPT (p .005), and (2) longer sedentary time and higher SDs of the suboccipital left PPT (p .001) were observed. Results from our explorative study could suggest inter-individual variability in mechanical pain sensation at the left suboccipitals which associates with quality of life and sedentary time. These novel findings should be considered when phenotyping patients and ‘individually’ match interventions.

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A novel metric of reliability in pressure pain threshold measurement

Cited by 12 publications

References 31 publications

A Statistical Model to Determine Biomechanical Limits for Physically Safe Interactions With Collaborative Robots

A Statistical Model to Determine Biomechanical Limits for Physically Safe Interactions With Collaborative Robots

Pressure pain thresholds in a real-world chiropractic setting: topography, changes after treatment, and clinical relevance?

Inter-individual variability in mechanical pain sensation in patients with cervicogenic headache: an explorative study

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