Reliability and validity of a simple and clinically applicable pain stimulus: sustained mechanical pressure with a spring-clamp

O’Neill, Søren; Graven‐Nielsen, Thomas; Manniche, Claus; Arendt-Nielsen, Lars

doi:10.1186/s12998-014-0030-y

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…The specifics of the CPM test utilized in this study are similar to those described by O'Neill and O'Neill in 2015 [24]: Test stimulus: The pressure pain intensity (PPI) was measured using a spring-operated clamp (two 2.8 cm × 1.9 cm pads). The clamp used is commercially available, procured by Clas Ohlson (article number 40-7211) and exerts a force of 7.3 kg at a 2.6 cm opening.…”

Section: Conditioned Pain Modulationmentioning

confidence: 99%

“…The mean change in individual CPM responses was 0.22 from baseline to Week 1 (SD=1.35), and −0.15 from Week 1 to Week 2 (SD=1. 24). An Intra-class Correlation Coefficient (ICC3single, fixed rater) for CPM across the three time points yielded a moderate or fair reliability coefficient of 0.54 (p<0.001)see Table 4.…”

Section: Quantitative Sensory Testing and Temporal Stability Of Cpmmentioning

confidence: 99%

“…Whilst CPT is commonly used as the conditioning stimulus in CPM paradigms, the use of a mechanical clamp as a test stimulus is not. Whilst CPM responses have previously been demonstrated using such a setup [24,30], it is possible that the test stimulus was insufficiently intense to make a CPM response detectable (i.e. a flooring effect).…”

Section: Qst Technical Considerationsmentioning

confidence: 99%

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Temporal stability and responsiveness of a conditioned pain modulation test

Bakken

Axén

Eklund

et al. 2023

Scandinavian Journal of Pain

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Objectives Conditioned pain modulation is a commonly used quantitative sensory test, measuring endogenous pain control. The temporal stability of the test is questioned, and there is a lack of agreement on the effect of different pain conditions on the conditioned pain modulation response. Thus, an investigation of the temporal stability of a conditioned pain modulation test among patients suffering from persistent or recurrent neck pain is warranted. Further, an investigation into the difference between patients experiencing a clinically important improvement in pain and those not experiencing such an improvement will aid the understanding between changes in pain and the stability of the conditioned pain modulation test. Methods This study is based on a randomized controlled trial investigating the effect of home stretching exercises and spinal manipulative therapy vs. home stretching exercises alone. As no difference was found between the interventions, all participants were studied as a prospective cohort in this study, investigating the temporal stability of a conditioned pain modulation test. The cohort was also divided into responders with a minimally clinically important improvement in pain and those not experiencing such an improvement. Results Stable measurements of conditioned pain modulation were observed for all independent variables, with a mean change in individual CPM responses of 0.22 from baseline to one week with a standard deviation of 1.34, and −0.15 from the first to the second week with a standard deviation of 1.23. An Intraclass Correlation Coefficient (ICC3 – single, fixed rater) for CPM across the three time points yielded a coefficient of 0.54 (p<0.001). Conclusions Patients with persistent or recurrent neck pain had stable CPM responses over a 2 week course of treatment irrespective of clinical response.

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Section: Conditioned Pain Modulationmentioning

confidence: 99%

Section: Quantitative Sensory Testing and Temporal Stability Of Cpmmentioning

confidence: 99%

Section: Qst Technical Considerationsmentioning

confidence: 99%

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Temporal stability and responsiveness of a conditioned pain modulation test

Bakken

Axén

Eklund

et al. 2023

Scandinavian Journal of Pain

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Test procedures to assess somatosensory abnormalities in individuals with back pain: a systematic review of psychometric properties

Alqarni

Manlapaz

Baxter

et al. 2018

Physical Therapy Reviews

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Reliability of pressure pain threshold to discriminate individuals with neck and low back pain

Zicarelli

Santos

Poli‐Frederico

et al. 2021

BMR

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BACKGROUND: Pressure pain threshold (PPT) is decreased in several musculoskeletal disorders, giving indirect evidence regarding pain status. Despite the fact that PPT has been already proven to be reliable in patients with acute conditions, there is great variability of methods and results observed within studies, and only a few evidences confirming its reliability in chronic conditions. OBJECTIVE: The objective of this study was to determine the test-retest reliability of PPT in the neck and low back regions to discriminate individuals with neck or low back pain from healthy individuals. Additionally, one secondary aim was to establish the minimum detectable change (MDC) and the standard error of measurement for future clinical studies and interventions. METHODS: In this reliability study, 74 individuals (15 individuals from the neck pain and 17 from the neck control group; 21 individuals from the low back pain and 21 from the low back control group). PPT was measured in the neck region (suboccipital, trapezius and supraspinal muscles) and in the lower back region (paraspinal muscles in the levels of L1, L3 and L5). Intrarater reliability was assessed using intraclass correlation coeficient and Bland-Altman. RESULTS: Excellent intra-rater reliability was observed for both (ICC of 0.874 for the neck pain versus ICC of 0.895 in neck control group; ICC of 0.932 for the low back pain group versus ICC of 0.839 for the control group). A small bias was observed for all groups (-0.08 for the neck pain group versus 0.10 in the control group; and 0.32 in low back pain group versus 0.44 in the control group). Minimum detectable change of 0.63 kgf of neck pain and 1.21 kgf of low back pain was calculated. It was found difference in PPT between pain and control groups (p< 0.05). CONCLUSION: It may be suggested that the protocol with PPT is reliable and able to discriminate individuals with and without neck and low back pain with a minor measurement error. Therefore, this method may be used to detect possible progress after interventions in patients with neck or low back pain.

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Reliability and validity of a simple and clinically applicable pain stimulus: sustained mechanical pressure with a spring-clamp

Cited by 3 publications

References 19 publications

Temporal stability and responsiveness of a conditioned pain modulation test

Temporal stability and responsiveness of a conditioned pain modulation test

Test procedures to assess somatosensory abnormalities in individuals with back pain: a systematic review of psychometric properties

Reliability of pressure pain threshold to discriminate individuals with neck and low back pain

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