Visual Analog Scale and Pressure Pain Threshold for Delayed Onset Muscle Soreness Assessment

Abstract

Objectives: To investigate the relationship between two assessments to quantify delayed onset muscle soreness [DOMS]: visual analog scale [VAS], and pressure pain threshold [PPT].Methods: Thirty one healthy young men [25.8 ± 5.5 years] performed 10 sets of six maximal eccentric contractions of the elbow flexors with their non-dominant arm. Before and one to four days after the exercise, muscle pain perceived upon palpation of the biceps brachii at three sites [5, 9, and 13 cm above the elbow crease] was assessed by VAS with a 100 mm line [0 = no pain, 100 = extremely painful], and PPT of the same sites was determined by an algometer. Changes in VAS and PPT over time were compared amongst three sites by a two-way repeated measures analysis of variance, and the relationship between VAS and PPT was analyzed using a Pearson product-moment correlation. Conclusion: These results suggest that the level of muscle pain is not region specific, at least among the three sites investigated in the study, and VAS and PPT provide different information about DOMS, indicating that VAS and PPT represent different aspects of pain.

Assessment of Muscle Pain Induced by Elbow-Flexor Eccentric Exercise

“…subjectively during exercise exertion. 16,32 The changes in MVIC, ROM, and serum CK activity after eccentric exercise in our study were similar to those reported in previous studies 22,33 and indicate that muscle damage was induced by the exercise. The time course of the changes in VAS score and PPT was also similar to those reported after eccentric elbow-flexor exercise in previous research.…”

“…The time course of the changes in VAS score and PPT was also similar to those reported after eccentric elbow-flexor exercise in previous research. 22,28 As shown in Figure 2, no differences among the 3 sites (3, 9, and 15 cm above the elbow crease) were evident for the changes in the VAS and CR-10 scale values upon palpation or the PPT. A previous study 22 also showed no difference in VAS changes after elbow-flexor eccentric exercise among the 3 sites (ie, 5, 9, and 13 cm above the elbow crease).…”

“…22,28 As shown in Figure 2, no differences among the 3 sites (3, 9, and 15 cm above the elbow crease) were evident for the changes in the VAS and CR-10 scale values upon palpation or the PPT. A previous study 22 also showed no difference in VAS changes after elbow-flexor eccentric exercise among the 3 sites (ie, 5, 9, and 13 cm above the elbow crease). It should be noted that the sites were more dispersed in the present study than in the previous study 15 ; however, the results were the same and showed that pain rated on the VAS upon palpation was similar along the central region of the biceps brachii, at least between 3 and 15 cm above the elbow crease.…”

“…The VAS and PPT methods have been widely used in previous studies 22,30,31 to quantify DOMS, which is a prominent symptom after exercise-induced muscle damage, whereas the CR-10 scale is used to quantify pain Figure 2. A, Changes in visual analog scale scores upon palpation, B, category ratio-10 scale upon palpation, and C, pressure-pain threshold of biceps brachii at 3, 9, and 15 cm above the elbow crease before (pre), immediately after (0), and 1-5 days after eccentric elbow-flexor exercise.…”

“…17,18 The PPT has been demonstrated as reliable for measuring the pain threshold 19,20 and has often been used to assess DOMS. 21,22 Some investigators studying the muscular distribution of PPT in response to DOMS in the lower limb muscles have found that the pain sensation is unevenly distributed. 23,24 For example, Edwards et al 23 reported that, after 15 minutes of eccentric stepping exercise, muscle pain in the quadriceps femoris was located close to the distal insertion of the myotendinous junction of the vastus medialis and lateralis.…”