Conventional deep pressure algometry is not suitable for clinical assessment of nociception in painless diabetic neuropathy

Chantelau, Ernst

doi:10.3402/dfa.v7.31922

Cited by 4 publications

(5 citation statements)

References 35 publications

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“…This effect has been attributed to an artifact due to the time lag between the activation of nociceptors, the conscious pain sensations, and the motor response to pain. The same effect has been described for pressure algometry with a 0.5 cm 2 probe [ 9 ] and a 3 cm 2 probe [ 7 ].…”

Section: Introductionmentioning

confidence: 76%

“…Several studies have described different stimuli to evaluate pain thresholds, such as pressure [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ], heat [ 11 , 12 ], electric current [ 13 , 14 , 15 , 16 , 17 , 18 ], and intra-epidermal injection of chemical substances (e.g., capsaicin [ 19 ] or acid type solution at pH 4.3 [ 20 ]). Despite the fact that the most abundant nociceptors are polymodal, generally different stimuli activate different nociceptors clusters; for this reason, it is important to study all kinds of stimuli to improve all technical aspects of pain threshold evaluation.…”

Section: Introductionmentioning

confidence: 99%

“…This kind of algometer is mainly used with a round tip with a surface of 1 cm 2 to evaluate pressure pain evoked in muscles or over tendon insertions, which is relevant for some pathologies (e.g., fibromyalgia). A similar procedure, commonly referred to as pinprickalgometry, is used with smaller probes (below 1 mm in diameter) to evaluate pain evoked on the skin, which can be preferentially affected in some pathologies (e.g., diabetic neuropathy) [ 7 ]. In the case of pinprickalgometry, however, the procedure is longer; considering that various probes of predefined weight are usually applied, the evaluation of the perceived pain intensity for each probe must be recorded.…”

Section: Introductionmentioning

confidence: 99%

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Autoalgometry: An Important Tool for Pressure Pain Threshold Evaluation

Lorusso

Salerno

Sessa

et al. 2018

JCM

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The term “pain threshold” refers to the measurement of the intensity of a physical stimulus that evokes pain. To estimate the pain threshold, a mechanical or electrical stimulus with increasing intensity is usually applied until the subject under evaluation refers to a pain sensation. This study aims to evaluate the autoalgometric pain threshold as a perfect technique to determine the effects of stimulation rate in relation to both gender and the site of stimulation. In this experimental model, pressure algometry was applied: the subject under evaluation pushed a finger against a small round metal tip, producing and at the same time controlling the intensity of the noxious stimulus. Through autoalgometry, the stimulus intensity was recorded over time, measuring the force change rate applied and studying the subject’s behavior on approaching pain. This test was performed with 50 healthy volunteers on two days, applying a fast or slow rate of stimulation. The results described demonstrate that there is a positive correlation between the pressure increase rate and the pressure threshold evaluation. In light of these findings, autoalgometry can be proposed as an objective measure of pressure pain threshold for clinical and research use.

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Section: Introductionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Autoalgometry: An Important Tool for Pressure Pain Threshold Evaluation

Lorusso

Salerno

Sessa

et al. 2018

JCM

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“…PA has been widely used in a variety of studies to measure the pressure pain stimulus response of subcutaneous muscles, as an abdominal examination value [22]; for the assessment of muscle hyperalgesia and a few number of studies used pressure algometer to assess the pressure pain thresholds in the temporomandibular joint and masticatory muscles [23][24][25]. In recent years, expensive and valid electronic pressure algometers have already been introduced on the market [22,26,27]. Additionally, several glove prototypes have been developed to assess the discomfort threshold level at 12 zones on the palmar surface of the hand [28].…”

Section: Discussionmentioning

confidence: 99%

New Pressure Algometry Device for the Quantification of Acupuncture Induced Pain Relief

Seca¹

2017

ACIM

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Background: Acupuncture is still a controversial topic, as methodologic problems associated to its research impair scientific progress. Besides effective allocation of acupoints and double blinding, quantification of its effects is still a problem that has to be addressed. In particular, the effects of acupuncture need to be quantified more clearly for relieving pain and reducing inflammatory effects associated to Rheumatoid Arthritis (RA).We aim to study the effects of acupuncture resorting to an algometry device specifically designed to assess the pressure tolerated by RA patients.Methods/Design: A quasi-experimental nature design was developed. Fourteen RA patients with a Traditional Chinese Medicine (TCM) (Heidelberg Model) diagnosis of a so called pivotal or turning point syndrome, and meeting the criteria of the American College of Rheumatology, received three acupuncture treatments in one week with a standardized treatment.A newly developed pressure algometry device, designed to assess the tolerance in hand pain in RA, was tested. We compared the outcome of clinical acupuncture, as measured by Pressure Algometry (PA) and Visual Analogue Scale (VAS). Results:The patients tolerated higher pressure on the hands (p=0.001) as well as improved VAS scores along with the treatment (p=0.005). All 14 patients displayed improvements in PA, while 11 improved their VAS scores. Out of the remaining, two patients had their VAS score unaltered and one (who also displayed the smallest improvement in PA) worsened slightly. Discussion:The findings of this study suggest that acupuncture effects in hand pain relief can be measured by the PA device. This opens the door to quantify the differences between the tolerated hand pressure before and after the acupuncture treatment to one specific TCM syndrome designed as turning point in a future double blinded acupuncture study on pain in RA patients.Trial Registration Number: NCT02553005.Keywords: Acupuncture; Pain; Pressure algometry; Rheumatoid arthritis; Turning point syndrome Citation: Seca S, Miranda D, Patrício M, Correia R, Kirch S, et al. (2017) Although self reported pain intensity is important, it is a composition of the physiological and psychological features of the patient and their health problem that is further mediated by social aspects, which can make it difficult to interpret the responses [17].Physicians often assume that inflammation is the main determinant factor of RA pain intensity. However more than one in ten RA patients that are shown to be in remission by the Disease Activity Score 28 (DAS28) still report clinically significant pain levels. The fact is that pain persists despite the absence of signs of inflammation [2].The magnitude of symptoms may not necessarily correlate with the severity of the underlying disease and symptoms may persist even when disease exacerbations have apparently settled.Pain and tenderness associated with the disease are not only present in directly affected joints but also in adjacent, apparently normal, tissues. Thes...

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“…In [22] , an analysis of different studies was carried out, collecting the following average ranges of PPTs: from 400 to 900 kPa for the hindfoot area (medial malleolus), 200 to 500 kPa for the midfoot area (instep), and 400 to 700 kPa for the forefoot area (second or third MTP joint).…”

Section: Analysis Of Ppt Of the Foot Areamentioning

confidence: 99%

Pressure Pain Threshold Values Obtained Through Algometers

Trueba-Perdomo¹,

Gasparini

Cuautle

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A review of the scientific literature on pressure pain obtained through algometers is carried out. A comparison of the pain pressure thresholds (PPT) obtained or considered within the analyzed studies was performed. The primary outcome of this work is the collection of these PPT values concerning the body regions where the algometers applied the pressure: trapezius muscles, back muscles, upper extremities, leg muscles, foot area, and muscles of the head. Furthermore, a comparison between the results of manual and electromechanical algometers is presented. Several tables are created, which can be useful to compare future studies that adopt pressure algometers. These values can also be considered a reference to evaluate the accuracy and reliability of new algometers, either manual or electromechanical. Besides, from the information obtained, the design requirements of an electromechanical pressure algometer are presented. These requirements are defined to develop a portable instrument that is also smaller, lighter, and cheaper than the existing ones and can measure the pressure in different parts of the human body.

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Conventional deep pressure algometry is not suitable for clinical assessment of nociception in painless diabetic neuropathy

Cited by 4 publications

References 35 publications

Autoalgometry: An Important Tool for Pressure Pain Threshold Evaluation

Autoalgometry: An Important Tool for Pressure Pain Threshold Evaluation

New Pressure Algometry Device for the Quantification of Acupuncture Induced Pain Relief

Pressure Pain Threshold Values Obtained Through Algometers

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