Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20240055-en
Brazilian Journal of Pain
Original Article

Reproducibility and reliability of pressure algometry: are digital and analogue devices comparable?

Reprodutibilidade e confiabilidade da algometria de pressão: os algômetros digital e analógico são comparáveis?

Natália Cristina de Oliveira; Klara Reis Silva; Adna Costa Santos; Fábio Marcon Alfieri

Downloads: 0
Views: 0

Abstract

BACKGROUND AND OBJECTIVES: Digital and analogue algometry have been widely employed in clinical studies, but a recent investigation observed a systematic error between devices, which may hinder comparison of data from different studies. The objective of this study was to evaluate the reproducibility and reliability of analogue and digital algometers.

METHODS: This was an observational transversal study involving 40 healthy adults. They had preserved cognitive capacity and no chronic or acute pain. Participants were submitted to pressure pain threshold (PPT) assessment by two different algometers, 15 minutes apart: a digital device (Wagner Pain Test FPX) and an analogue one (Wagner Force Dial). Data collection involved 2 evaluators and occurred once a week. The muscles evaluated were teres major, upper trapezius, elevator scapulae, supraspinatus, infraspinatus, pectoralis, middle gluteus, paraspinal and deltoid.

RESULTS: Reliability between the measurements taken by the same evaluator (intra-rater reliability) or with the same device (inter-rater reliability) on different days was analyzed using the Intraclass Correlation Coefficient (ICC). When comparing the intra-rater reliability (evaluator 1, weeks 1 and 3), good or excellent reproducibility was observed in most of the sites, with both analogue and digital algometers, with statistical significance. The inter-device reliability (digital and analogue algometers) showed a significant and excellent correlation (r > 0.75) in all evaluated sites for both evaluators. The analysis of inter-rater reliability (2 different evaluators) for the digital algometer revealed good or excellent significant correlation in almost all sites, except for the left pectoralis major. For the analogue algometer, all evaluated sites exhibited good or excellent correlation with statistical significance.

CONCLUSION: The data highlight that digital and analogue algometry have good intra-rater reliability (reproducibility), inter-device reliability and inter-rater reliability in a sample of healthy young individuals.

Keywords

Evaluation study; Pain; Pain threshold; Reproducibility of results

Resumo

JUSTIFICATIVA E OBJETIVOS: A algometria digital e a analógica têm sido amplamente utilizadas em estudos clínicos, mas uma investigação recente observou um erro sistemático entre os dispositivos, o que pode dificultar a comparação de dados de diferentes estudos. O objetivo deste estudo foi avaliar a reprodutibilidade e a confiabilidade de algômetros analógicos e digitais.

MÉTODOS: Este foi um estudo transversal observacional que envolveu 40 estudantes saudáveis. Eles tinham capacidade cognitiva preservada e não apresentavam dor crônica ou aguda. Os participantes foram submetidos à avaliação do limiar de tolerância à dor por pressão (LTDP) por dois algômetros diferentes, com 15 minutos de intervalo: um algômetro digital (Wagner Pain Test FPX) e um analógico (Wagner Force Dial). A coleta de dados envolveu dois avaliadores e ocorreu uma vez por semana. Os músculos avaliados foram o redondo maior, o trapézio superior, o levantador da escápula, o supraespinhal, o infraespinhal, o peitoral, o glúteo médio, o paraespinhal e o deltoide.

RESULTADOS: A confiabilidade entre as medidas realizadas pelo mesmo avaliador (confiabilidade intra-avaliador) ou com o mesmo aparelho (confiabilidade interavaliador), em dias diferentes, foi analisada por meio do Coeficiente de Correlação Intraclasse (CCI). Ao comparar a confiabilidade intra-avaliador (avaliador 1, semanas 1 e 3), observou-se reprodutibilidade boa ou excelente na maioria dos sítios, tanto com algômetro analógico quanto digital, com significância estatística. A confiabilidade interdispositivos (algômetro digital e analógico) apresentou correlação significativa e excelente (r > 0,75) em todos os locais avaliados e para ambos os avaliadores. A análise da confiabilidade interavaliadores (2 avaliadores diferentes) para o algômetro digital revelou correlação significativa boa ou excelente em quase todos os locais, exceto no peitoral maior esquerdo. Para o algômetro analógico, todos os locais avaliados apresentaram correlação boa ou excelente com significância estatística.

CONCLUSÃO: Os dados destacam que a algometria digital e a analógica apresentam boa confiabilidade intra-avaliador (reprodutibilidade), confiabilidade entre dispositivos e confiabilidade entre avaliadores em uma amostra de jovens saudáveis.

Palavras-chave

Estudos de avaliação; Dor; Limiar da dor; Reprodutibilidade dos testes

References

1 Stausholm MB, Bjordal JM, Moe-Nilssen R, Naterstad IF. Pain pressure threshold algometry in knee osteoarthritis: intra- and inter-rater reliability. Physiother Theory Pract. 2023;39(3):615-22.

2 Coombes BK, Bisset L, Vicenzino B. Cold hyperalgesia associated with poorer prognosis in lateral epicondylalgia: a 1-year prognostic study of physical and psychological factors. Clin J Pain. 2015;31(1):30-5.

3 Fischer AA. Pressure algometry over normal muscles. Standard values. validity and reproducibility of pressure threshold. Pain. 1987;30(1):115-26.

4 Imamura M, Chen J, Matsubayashi SR, Targino RA, Alfieri FM, Bueno DK, Hsing WT. Changes in pressure pain threshold in patients with chronic nonspecific low back pain. Spine. 2013;38(24):2098-107.

5 Cristina de Oliveira N, Alfieri FM, Lima ARS, Portes LA. Lifestyle and Pain in Women With Knee Osteoarthritis. Am J Lifestyle Med. 2017;13(6):606-10.

6 King CD, Mano KE. Barnett KA. Pfeiffer M. Ting TV. Kashikar-Zuck S. Pressure pain threshold and anxiety in adolescent females with and without juvenile fibromyalgia: a pilot study. Clin J Pain. 2017;33(7):620.

7 Nunes AMP, Moita JPAM, Espanha MMMR, Petersen KK, Arendt-Nielsen L. Pressure pain thresholds in office workers with chronic neck pain: A systematic review and meta-analysis. Pain Pract. 2021;21(7):799-814.

8 Więckiewicz W, Woźniak K, Piątkowska D, Szyszka-Sommerfeld L, Lipski M. The diagnostic value of pressure algometry for temporomandibular disorders. Biomed Res Int. 2015;2015:575038.

9 Aweid O, Gallie R, Morrissey D, Crisp T, Maffulli N, Malliaras P, Padhiar N. Medial tibial pain pressure threshold algometry in runners. Knee Surg Sports Traumatol Arthrosc. 2014;22(7):1549-55.

10 Koh RG, Paul TM, Nesovic K, West D, Kumbhare D, Wilson RD. Reliability and minimal detectable difference of pressure pain thresholds in a pain-free population. Br J Pain. 2023;17(3):239-43.

11 Castien RF, Coppieters MW, Durge TSC, Scholten-Peeters GGM. High concurrent validity between digital and analogue algometers to measure pressure pain thresholds in healthy participants and people with migraine: a cross-sectional study. J Headache Pain. 2021;22(1):69.

12 Pan LH, Ling YH, Lai KL, Wang YF, Hsiao FJ, Chen SP, Liu HY, Chen WT, Wang SJ. The normative values of pain thresholds in healthy Taiwanese. Brain Behav. 2024;14(4):e3485.

13 Dissanayaka TD, Farrell M, Zoghi M, Egan GF, Jaberzadeh S. Test-retest reliability of subjective supra-threshold scaling of multiple pressure-pain sensations among healthy individuals: a study using hydraulic pressure algometry. Somatosens Mot Res. 2018;35(3-4):153-61.

14 Ciocchetti DV. Guidelines. criteria. and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess. 1984;6(4):184-290.

15 Alfieri FM, Lima ARS, Oliveira NC, Portes LA. The influence of physical fitness on pressure pain threshold of elderly women. J Bodyw Mov Ther. 2017;21(3):599-604.

16 Santos GK, Silva NC, Alfieri FM. Effects of cold versus hot compress on pain in university students with primary dysmenorrhea. BrJP. 2020;3(1):25-8.

17 Vargas e Silva NCO, Rubio AL, Alfieri FM. Associations between skin surface temperature and pressure pain tolerance thresholds of asymptomatic individuals exposed to cryotherapy and thermotherapy. J Chiropr Med. 2019;18(3):171-9.

18 Vitorino CF, Oliveira NC, Alfieri FM. Skin surface temperature and pain tolerance threshold in young and elderly individuals. Thermol Int. 2023;33(2):27-32.

19 Egloff N, Klingler N, von Känel R, Cámara RJ, Curatolo M, Wegmann B, Marti E, Ferrari ML. Algometry with a clothes peg compared to an electronic pressure algometer: a randomized cross-sectional study in pain patients. BMC Musculoskelet Disord. 2011;12:174.

20 Imamura M, Alfieri FM, Filippo TR, Battistella LR. Pressure pain thresholds in patients with chronic nonspecific low back pain. J Back Musculoskelet Rehabil. 2016;29(2):327-36.

21 Reezigt RR, Slager GEC, Coppieters MW, Scholten-Peeters GGM. Novice assessors demonstrate good intra-rater agreement and reliability when determining pressure pain thresholds: a cross-sectional study. Peer J. 2023;11:e14565.

22 Pelfort X, Torres-Claramunt R, Sánchez-Soler JF, Hinarejos P, Leal-Blanquet J, Valverde D, Monllau JC. Pressure algometry is a useful tool to quantify pain in the medial part of the knee: an intra- and inter-reliability study in healthy subjects. Orthop Traumatol Surg Res. 2015;101(5):559-63.

23 Arendt-Nielsen L. Reliability of pressure pain threshold testing (PPT) in healthy pain free young adults. Scand J Pain. 2015;9(1):28-9.

24 Waller R, Straker L, O’Sullivan P, Sterling M, Smith A. Reliability of pressure pain threshold testing in healthy pain free young adults. Scand J Pain. 2015;9(1):38-41.

25 Zhang YH, Wang YC, Hu GW, Ding XQ, Shen XH, Yang H, Rong JF, Wang XQ, Intra-rater and inter-rater reliability of pressure pain threshold assessment in stroke patients, Eur J Phys Rehabil Med. 2022;58(4):549-57.

26 Zicarelli CAM, Santos JPM, Poli-Frederico RC, Silva RA, Barrilec F, Barrette G, Iida LM, Russo PP, Larangeira LLS, Fernandes MTP, Fernandes KBP. Reliability of pressure pain threshold to discriminate individuals with neck and low back pain. J Back Musculoskelet Rehabil. 2021;34(3):363-70.
 


Submitted date:
04/19/2024

Accepted date:
07/26/2024

678e8d37a95395048d325004 brjp Articles

BrJP

Share this page
Page Sections