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Introduction: General practitioners (GPs) often face challenges in explaining to patients with persistent physical symptoms (PPS) why their symptoms persist. Providing an explanation of the central sensitisation (CS) mechanism to patients could be helpful, yet GPs do not routinely test for signs of CS in these patients. The aim of this study was to explore the value of applying a test to assess CS in enhancing explanations provided to patients. Methods: In this prospective study, 25 GPs applied three tests, selected through a Delphi study, to assess CS-related symptoms: (1) the Central Sensitisation Inventory (CSI); (2) an algometer for measuring pressure pain thresholds (PPT); and (3) a monofilament for assessing temporal summation. Following the tests, both the GP and the patient completed a short questionnaire. Subsequently, GPs shared their experiences in focus groups and interviews, while a sample of patients was interviewed individually. The questionnaires were analysed quantitatively, and the focus groups and interviews were analysed qualitatively. Results: GPs reported that all tests were feasible to perform during consultations; testing took less than 5 min in 25% of cases and between 5 and 10 min in 60% of cases. In approximately 50% of cases, an additional consultation was required to perform the test. The results of the CSI confirmed CS-related symptoms more frequently (74%) than the algometer (46%) and the monofilament (43%). Consequently, many GPs preferred the CSI. Patients did not show a preference for any specific test; two-third found the tests valuable and approximately 50% reported that the explanation of CS was clearer when a test was used. Conclusions: Testing during the consultation was feasible, although an additional consultation was required in 50% of the cases. GPs preferred the CSI because its results confirmed CS-related symptoms more frequently than those from the algometer and monofilament. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine the reliability and validity of the pressure algometer in predicting gynecological surgery pain. We looked into the predictive value of preoperative pain sensitivity to gynecological pain and the relationship between preoperative pressure pain threshold (PPT), pressure pain tolerance (PTO), and postoperative pain outcomes. Methods: Reliability test: We recruited 60 volunteers at Nantong University. For three consecutive days, two examiners measured the pain sensitivity of each participant using a pressure algometer. Its test–retest and intra-rater reliability were assessed using the intraclass correlation coefficient (ICC). Validity test: We selected patients who underwent gynecological surgery in a hospital for the validity test. Before surgery, we assessed the patient's pain sensitivity to various stimuli. To determine the relationship between preoperative pain sensitivity and postoperative pain, we collected postoperative Numerical Rating Scale (NRS) and sufentanil consumption data. Results: The algometer revealed a high test–retest and intra-rater reliability. According to the calculation of Youden's index, there was a 73.1% chance of patients with moderate to severe postoperative pain having a PTO <6.22 N, and patients with PTO <6.22 N had an 87.5% probability of moderate to severe postoperative pain. Conclusions: The pressure algometer has a high degree of accuracy in measuring the PPT and PTO of normal healthy individuals, making it a reliable tool for quantifying pain sensitivity. PTO can be used to predict the occurrence of moderate to severe postoperative pain. [ABSTRACT FROM AUTHOR]

Introduction: Low back pain is the most common type of chronic pain. We examined pain-related behaviors across 18 weeks in rats that received injury to one or two lumbar intervertebral discs (IVD) to determine if multi-level disc injuries enhance/prolong pain. Methods: Twenty-three Sprague-Dawley adult female rats were used: 8 received disc puncture (DP) of one lumbar IVD (L5/6, DP-1); 8 received DP of two lumbar IVDs (L4/5 & L5/6, DP-2); 8 underwent sham surgery. Results: DP-2 rats showed local (low back) sensitivity to pressure at 6- and 12- weeks post-injury, and remote sensitivity to pressure (upper thighs) at 12- and 18-weeks and touch (hind paws) at 6, 12 and 18-weeks. DP-1 rats showed local and remote pressure sensitivity at 12-weeks only (and no tactile sensitivity), relative to Sham DP rats. Both DP groups showed reduced distance traveled during gait testing over multiple weeks, compared to pre-injury; only DP-2 rats showed reduced distance relative to Sham DP rats at 12-weeks. DP-2 rats displayed reduced positive interactions with a novel adult female rat at 3-weeks and hesitation and freezing during gait assays from 6-weeks onwards. At study end (18-weeks), radiological and histological analyses revealed reduced disc height and degeneration of punctured IVDs. Serum BDNF and TNFα levels were higher at 18-weeks in DP-2 rats, relative to Sham DP rats, and levels correlated positively with remote sensitivity in hind paws (tactile) and thighs (pressure). Discussion: Thus, multi-level disc injuries resulted in earlier, prolonged and greater discomfort locally and remotely, than single-level disc injury. BDNF and TNFα may have contributing roles. [ABSTRACT FROM AUTHOR]

Exercise-Induced Hypoalgesia (EIH) refers to an acute reduced pain perception after exercise. This systematic review and meta-analysis investigated the effect of a single aerobic exercise session on local and remote EIH in healthy individuals, examining the role of exercise duration, intensity, and modality. Pressure pain thresholds (PPT) are used as the main measure, applying the Cochrane risk of bias tool and GRADE approach for certainty of evidence assessment. Mean differences (MD; Newton/cm²) for EIH effects were analysed. Thirteen studies with 23 exercises and 14 control interventions are included (498 participants). Most studies used bicycling, with only two including running/walking and one including rowing. EIH occurred both locally (MD = 3.1) and remotely (MD = 1.8), with high-intensity exercise having the largest effect (local: MD = 7.5; remote: MD = 3.0) followed by moderate intensity (local: MD = 3.1; remote: MD = 3.0). Low-intensity exercise had minimal impact. Neither long nor short exercise duration induced EIH. Bicycling was found to be effective in eliciting EIH, in contrast to the limited research observed in other modalities. The overall evidence quality was moderate with many studies showing unclear risk biases. [ABSTRACT FROM AUTHOR]

Background and Objectives: No studies have reported corrugator muscle activity associated with pain in people with pain. This study aimed to develop an objective pain assessment method using corrugator muscle activity with pressure pain stimulation to the skeletal muscle. Methods: Participants were 20 adults (a mean ± SD age of 22.0 ± 3.1 years) with chronic neck/shoulder pain. Surface electromyography (sEMG) of corrugator muscle activity at rest (baseline) and without and with pressure pain stimulation applied to the most painful tender point in the shoulder was recorded. Participants evaluated the intensity of the neck/shoulder pain and the sensory and affective components of pain with pressure stimulation using a visual analogue scale (VAS). The percentages of integrated sEMG (% corrugator activity) without and with pressure pain stimulation to the baseline integrated sEMG were compared, and the relationships between the % corrugator activity and the sensory and affective components of pain VAS scores were evaluated. Results: Without pressure stimulation, an increase in corrugator muscle activity due to chronic neck/shoulder pain was not observed. The % corrugator activity with pressure pain stimulation was significantly higher than that without stimulation (p < 0.01). A significant positive correlation between corrugator muscle activity and the affective components of pain VAS scores with pressure stimulation was found (ρ = 0.465, p = 0.039) and a tendency of positive correlation was found for the sensory component of pain VAS scores (ρ = 0.423, p = 0.063). Conclusions: The increase in corrugator muscle activity with pressure pain stimulation to the tender point in adults with chronic neck/shoulder pain was observed, although increased corrugator muscle activity resulting from the chronic neck/shoulder pain was not. These findings suggest that corrugator muscle activity with pressure pain stimulation can be a useful objective indication for tender point sensitivity assessment in the skeletal muscle with pain. [ABSTRACT FROM AUTHOR]

IntroductionLow back pain is the most common type of chronic pain. We examined pain-related behaviors across 18 weeks in rats that received injury to one or two lumbar intervertebral discs (IVD) to determine if multi-level disc injuries enhance/prolong pain.MethodsTwenty-three Sprague-Dawley adult female rats were used: 8 received disc puncture (DP) of one lumbar IVD (L5/6, DP-1); 8 received DP of two lumbar IVDs (L4/5 & L5/6, DP-2); 8 underwent sham surgery.ResultsDP-2 rats showed local (low back) sensitivity to pressure at 6- and 12-weeks post-injury, and remote sensitivity to pressure (upper thighs) at 12- and 18-weeks and touch (hind paws) at 6, 12 and 18-weeks. DP-1 rats showed local and remote pressure sensitivity at 12-weeks only (and no tactile sensitivity), relative to Sham DP rats. Both DP groups showed reduced distance traveled during gait testing over multiple weeks, compared to pre-injury; only DP-2 rats showed reduced distance relative to Sham DP rats at 12-weeks. DP-2 rats displayed reduced positive interactions with a novel adult female rat at 3-weeks and hesitation and freezing during gait assays from 6-weeks onwards. At study end (18-weeks), radiological and histological analyses revealed reduced disc height and degeneration of punctured IVDs. Serum BDNF and TNFα levels were higher at 18-weeks in DP-2 rats, relative to Sham DP rats, and levels correlated positively with remote sensitivity in hind paws (tactile) and thighs (pressure).DiscussionThus, multi-level disc injuries resulted in earlier, prolonged and greater discomfort locally and remotely, than single-level disc injury. BDNF and TNFα may have contributing roles.

Background: The aim of this study was to evaluate the effect of medical massage on inspiratory accessory muscle function and sensory sensitivity in patients with chronic obstructive pulmonary disease. Materials and Methods: The participants were divided into two groups: group II (22 patients with COPD in the stable period), and group II (II: 17 participants with no respiratory disorders). Each group was subjected to a series of five massages. The treatment was performed for the sternocleidomastoid, levator scapulae, and the descending part of the trapezius muscle. The parameters of muscle frequency and stiffness were measured using a Myoton Pro Digital device. The compression sensitivity was measured using a Force algometer. Results: The results obtained showed significant differences in the stiffness parameters of the muscles studied between the groups, which indicates a positive effect of massage on muscle function in patients with COPD. The greatest significant differences were found in the patient's sensitivity parameters. The application of the massage series significantly improved the parameters of frequency and decreased stiffness of inspiratory accessory muscles in patients with COPD compared to the group of healthy participants. Conclusions: This massage is an effective method to normalize muscle tone and thus improve the functional status of patients with COPD. [ABSTRACT FROM AUTHOR]

Corrugator muscle activity with pressure pain stimulation has not yet been studied. We recorded corrugator muscle activity at rest and before, during and after pressure pain stimulation to the shoulder three times each in 14 healthy adults (20.0 ± 2.1 years of age (mean ± SD)) without pain using surface electromyography. Corrugator muscle activity with pressure pain and the relationships between corrugator muscle activity and pressure pain or unpleasantness intensity on a visual analogue scale measured three times were examined. The corrugator muscle activity during pressure pain stimulation was significantly higher than that before (p < 0.001) and after (p = 0.019) stimulation. There were significant differences among the three measurements examining reproducibility in pain (p = 0.037) and unpleasantness (p = 0.014) but not among corrugator muscle activities before (p = 0.526), during (p = 0.145) and after (p = 0.109) stimulation. Significant correlations were revealed for corrugator muscle activity vs. pain (ρ = 0.465, p = 0.002) and corrugator muscle activity vs. unpleasantness (ρ = 0.558, p < 0.001). Pressure pain increased corrugator muscle activity with reproducibility and correlated with subjective pain assessments, which indicates the utility of corrugator muscle activity as an objective indication of pain assessment. [ABSTRACT FROM AUTHOR]

The studies carried out to date on vulvodynia treatment with botulinum neurotoxin type A (BoNT/A) have followed generic injection protocols and reported contradictory outcomes on its effects. The aim of the present study was thus to propose a protocol for injecting BoNT/A into targeted painful points, to comprehensively assess the clinical effect of BoNT/A treatment and identify the risk/protective factors for successful treatment. Thirty-five vestibulodynia patients were treated with submucosal injections of incobotulinumtoxinA and assessed 8, 12 and 24 weeks after their treatment. Their clinical and pelvic statuses were assessed from self-reported questionnaires (Visual Analogue Scale (VAS), Female Sexual Function Index (FSFI), Marinoff's Dyspareunia Scale (MDS), Hospital Anxiety and Depression Scale (HADS), Catastrophizing Scale (CS)), physical examinations and surface electromyography (sEMG). The patients reported a reduction in provoked vestibulodynia (FSFI, p < 0.01;

Simple Summary: Femoral head and neck excision is a common and straightforward surgical procedure that provides pain relief for dogs with severe coxofemoral joint disease. Early mobilization of the coxofemoral joint after surgery promotes the development of a fibrous pseudo-articulation with an improved range of motion. In this study, we explored three analgesic protocols (preoperative epidural anesthesia with morphine, intraoperative ropivacaine at the ostectomy site, and postoperative tramadol) either individually or in combination, as part of the standard analgesic protocol for managing 30 dogs undergoing femoral head and neck excision. The aim was to investigate their impact on the time it took for the dogs to bear weight on the limb. Clinical parameters, algometer measurements, and various scale scores were used to evaluate the outcomes. The study concluded that multimodal analgesia, incorporating the aforementioned analgesic techniques, resulted in faster weight bearing for dogs with femoral head and neck excision. This study aimed to compare postoperative analgesia and the time of limb weight bearing induced by the intraoperative administration of a local anesthetic at the site of the femoral head and neck excision (FHNE) in dogs, with and without the administration of preoperative epidural anesthesia. Additionally, the impact of postoperative opioid drug administration on weight-bearing time was examined. This randomized, blinded, prospective clinical study included 30 client-owned dogs. The dogs were randomly divided into three groups (A, B, C), each further divided into two subgroups (A1, A2, B1, B2, C1, C2). Group A received epidural anesthesia and ropivacaine at the ostectomy site, Group B received only ropivacaine, and Group C served as the control group. Subgroup 1 received a non-steroidal anti-inflammatory drug postoperatively, while Subgroup 2 had tramadol added to their regimen. Pain assessment was conducted using the University of Melbourne Pain Scale (UMPS) and an algometer. The study concluded that multimodal analgesia, utilizing all the aforementioned analgesic techniques, resulted in faster limb weight bearing for dogs undergoing FHNE. [ABSTRACT FROM AUTHOR]

Disturbed nocturnal sleep contributes to the central sensitization of pain, thus predisposing to orofacial pain. Central disorders of hypersomnolence are characterized by excessive daytime sleepiness (EDS) not linked to impairment of nocturnal sleep or misaligned circadian rhythms. The main disorder of this group is narcolepsy type 1 (NT1), which seems to be related to alterations in pain perception mediation, supposedly caused by low orexin levels. The aim of this study was to evaluate the pain sensitivity and the prevalence of temporomandibular disorders (TMDs) in patients with NT1. After a 3-day hospital evaluation with laboratory polysomnography, 39 consecutive adult patients diagnosed with NT1 and 39 matched heathy controls were evaluated by means of Axis I and Axis II of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol. Furthermore, pain sensitivity was investigated by measuring the pressure pain thresholds (PPTs) on the head–neck muscles by means of a Fischer algometer. No significant differences were found between the PPTs of the two groups for all the muscles evaluated, nor in the prevalence of TMD diagnoses, but the NT1 group reported significantly higher values in the Patient Health Questionnaire (PHQ-9), corresponding to a depressive state. The present study presents an important investigation into NT1 patients, showing no alterations in pain perception and no differences in the prevalence of TMD diagnosis compared to the controls. [ABSTRACT FROM AUTHOR]

Purpose: To our knowledge, no study has demonstrated the effects of Kinesio Taping (KT) tension on pressure-pain threshold and tolerance. The aim of the study was to investigate the effect of KT tension tensions on pressure pain threshold and tolerance. Material and Methods: A double-blind, randomized controlled study was conducted with 90 healthy male subjects with an average age of 21.04 ± 2.0 years. The subjects were randomized into four groups: 0% tension (n=23), 50% tension (n= 24), 75% tension (n=22) and 100% tension groups (n=21). The KT was applied from distal to proximal, exposing the lateral epicondyle region on the dominant side. Pressure pain threshold and pain tolerance were measured using digital algometer over the lateral epicondyle. Measurements were carried out, before, immediate after and 30 minutes after KT. Results: There was no statistically significant difference between the groups in terms of PP threshold, pain tolerance and intensity (p>0.05). There was a significant in-group difference only in the 100% Tension Group in terms of PP threshold (p<0.05). On the other hand, a significant difference was observed in the 0% tension and 50% tension groups on the pain severity measurements (p<0.05). Conclusion: The results demonstrated that the KT at different tensions did not affect the pressure pain threshold or tolerance. The outcomes also considered the efficacy of low- and high-tension KT on pain tolerance and severity, respectively. A further study should investigate the pain threshold and tolerance in clinical cases with a long-term follow-up. [ABSTRACT FROM AUTHOR]

With increasing age, the frequency of chronic pain increases compared to acute pain. This is due to structural and functional changes caused by ageing of the nervous system. The aim of this study was to investigate relationships between personality traits, optimism, quality of life, and subjective assessment of pain measured experimentally with an algometer and clinically with the Visual Analoque Scale (VAS). In the group of 133 seniors (61-86 years; 78% women), we used an algometer to measure pain threshold and tolerance, the VAS scale to assess subjective intensity, and standardized questionnaires (EPQ-R(s), LOTR, SWLS) to measure psychological variables. Extraversion was found to promote both higher pain threshold and higher pain tolerance, whereas pain tolerance was negatively correlated with neuroticism. Higher severity of the psychotic trait was associated with more intense subjective pain experience. Optimism and overall quality of life were not associated with any pain measures. A better understanding of the personality correlates of pain perception could support a more accurate tailoring of pain management in elderly patients. [ABSTRACT FROM AUTHOR]

Study design, case-control study: Background, Morton's extension (ME) is a kind of orthotic that has been used as a conservative treatment of painful hallux rigidus (HR) osteoarthritis, but only their effects on first metatarsophalangeal joint (MPJ) mobility and position in healthy subjects have been studied, but not on its applied pulled tension forces neither in subjects with HR. Objectives: This study sought to understand how ME's orthotics with three different thicknesses could influence the kinematic first MPJ by measuring hallux dorsiflexion using Jack's test and a digital algometer with a rigid strip anchored to the iron hook's extremity and comparing subjects with healthy first MPJ mobility to those with HR. We aimed to clarify whether tension values were different between healthy and HR subjects. Methods: Fifty-eight subjects were selected, of whom thirty were included in the case group according to HR criteria and twenty-eight were included in the control group. A digital algometer (FPX®® 25, Wagner Instruments®®, Greenwich, CT, USA) was used to assess the pulled tension values (kgf) of the first MPJ during Jack's test. Results: The pulled tension values were highly reliable (ICC > 0.963). There were no statistically significant differences between the pulled tension values for the different ME conditions in the case (p = 0.969) or control (p = 0.718) groups. However, as it's expected, there were statistically significant differences comparing all pulled tension values between case and control group subjects (p < 0.001). Conclusions: Different ME's thicknesses had no influence on the pulled effort applied during the dorsiflexion Jack's test between the healthy and HR groups; therefore, it can be prescribed without joint-care danger. In addition, it is proven that there is greater resistance to performing Jack's test in the HR group than in the healthy group, regardless of ME's orthotics. Furthermore, it is shown that the digital algometer device is a valid tool to detect the first MPJ restriction and is more reliable than other tests. [ABSTRACT FROM AUTHOR]

Algometers are commonly used to measure the pain-pressure threshold (PPT) in various tissues, such as muscle, tendons, or fascia. However, to date, it is not clear if the repeated application of a PPT assessment can adjust the pain thresholds of the various muscles. Therefore, the purpose of this study was to investigate the repeated application of PPT tests (20 times) in the elbow flexor, knee extensor, and ankle plantar flexor muscles in both sexes. In total, 30 volunteers (15 females, 15 males) were tested for their PPT using an algometer on the respective muscles in random order. We found no significant difference in the PPT between the sexes. Moreover, there was an increase in the PPT in the elbow flexors and knee extensors, starting with the eighth and ninth assessments (out of 20), respectively, compared to the second assessment. Additionally, there was a tendency to change between the first assessment and all the other assessments. In addition, there was no clinically relevant change for the ankle plantar flexor muscles. Consequently, we can recommend that between two and a maximum of seven PPT assessments should be applied so as not to overestimate the PPT. This is important information for further studies, as well as for clinical applications. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the pain relief effects of chewing gum and mechanical vibration methods on orthodontic pain caused by the initial archwire.Methods: In this study, 57 patients, having a 3-6 mm maxillary dental crowding and non-extraction treatment modality were included. The pressure pain thresholds of the subjects were measured. Patients were distributed equally by sex and randomly allocated into 3 groups: mechanical vibration, chewing gum, and control. The fixed orthodontic treatment was started in the upper jaw only. In the first and second groups, mechanical vibration was applied and sugar-free gum was chewed, respectively. The third group was used as the control. The pain perceptions were measured using the Visual Analog Scale. Kruskal–Wallis and Friedman tests were used for statistical analysis.Results: The groups were similar at the beginning of the study in terms of age and algometer scores (P = .138 and P =.155, respectively). Statistical significant differences in the Visual Analog Scale scores among the groups could not be detected at any time point. The highest pain scores were detected at the 24th hour of treatment in all 3 groups. There was no statistically significant difference in the highest pain level among the groups (P = .279).Conclusion: Although the average pain values were perceived as lower, particularly in the mechanical vibration group, the temporary displacement of the teeth has no clinically significant pain relief effect on orthodontic pain.

'I"he purpose of this study was to determine if subjective pain scales commonly used (a) are correlated to each other and with algometric measurements and (b) differ between collegiate athletes and noncollegiate athletes. There were consistent significant positive correlations between all pain scales, regardless of groupings (collegiate athletes: r = .234-.730, p ≤ .007; noncollegiate athletes: r= .518:820, p 5.002; female: r= .437-.690. p ≤ .010; male: r= .492-.784,p ≤. 005). These findings suggest that the pain scales studied could be used with both athletic and nonathletic populations. Algometric assessments may be better suited for patients with altered pain processing compared with those without. [ABSTRACT FROM AUTHOR]

Objective: To determine and compare the effects of the Dynamic Exercise Program (DEP) and matrix rhythm therapy (MaRhyThe©) along with conventional physiotherapy in asymptomatic subjects with forward head posture (FHP) on a craniovertebral angle (CVA), strength, pain, and quality of life (QoL) using CVA, pressure biofeedback unit, pain algometer, and short form (SF-36), respectively. Methodology: Sixty-five people were screened for the study, of which 30 were included (18 females and 12 males) who participated in the study. The study participants were randomly allocated to Group A (DEP) or Group B (MaRhyThe©). Preintervention outcome measures used were CVA for the neck position, a craniocervical flexion endurance test for strength, a pain algometer for pain pressure threshold, and SF-36 for QoL. Postintervention outcome measures were recorded on the 6th day after intervention. Results: Data were analyzed descriptively with a priori establishment of success criteria of P < 0.05. Within-group analysis of both groups demonstrated statistically significant parameters of CVA, strength, and pain as P < 0.05. Between groups analysis demonstrated Group B to be statistically significant in all the outcome measures CVA (P < 0.0001), strength (P < 0.0001), and pain (P < 0.0001). SF-36 showed a positive effect on some subdomains as to emotional well-being (0.0320) and pain (0.0047*). Conclusion: It was determined that both deep exercise programs and MaRhyThe© when combined with conventional physiotherapy are effective in treating FHP. However, MaRhyThe© with conventional physiotherapy was found to be superior in reducing pain and improving range of motion, strength, and QoL.

Study aim: To evaluate and compare the effectiveness of single ischemic compression and cupping therapy on the most common trigger point, on the descending part of the trapezius muscle.

With increasing age, the frequency of chronic pain increases compared to acute pain. This is due to structural and functional changes caused by ageing of the nervous system. The aim of this study was to investigate relationships between personality traits, optimism, quality of life, and subjective assessment of pain measured experimentally with an algometer and clinically with the Visual Analoque Scale (VAS). In the group of 133 seniors (61-86 years; 78% women), we used an algometer to measure pain threshold and tolerance, the VAS scale to assess subjective intensity, and standardized questionnaires (EPQ-R(s), LOTR, SWLS) to measure psychological variables. Extraversion was found to promote both higher pain threshold and higher pain tolerance, whereas pain tolerance was negatively correlated with neuroticism. Higher severity of the psychotic trait was associated with more intense subjective pain experience. Optimism and overall quality of life were not associated with any pain measures. A better understanding of the personality correlates of pain perception could support a more accurate tailoring of pain management in elderly patients.

Objective: To determine and compare the effects of the Dynamic Exercise Program (DEP) and matrix rhythm therapy (MaRhyThe©) along with conventional physiotherapy in asymptomatic subjects with forward head posture (FHP) on a craniovertebral angle (CVA), strength, pain, and quality of life (QoL) using CVA, pressure biofeedback unit, pain algometer, and short form (SF-36), respectively. Methodology: Sixty-five people were screened for the study, of which 30 were included (18 females and 12 males) who participated in the study. The study participants were randomly allocated to Group A (DEP) or Group B (MaRhyThe©). Preintervention outcome measures used were CVA for the neck position, a craniocervical flexion endurance test for strength, a pain algometer for pain pressure threshold, and SF-36 for QoL. Postintervention outcome measures were recorded on the 6th day after intervention. Results: Data were analyzed descriptively with a priori establishment of success criteria of P < 0.05. Within-group analysis of both groups demonstrated statistically significant parameters of CVA, strength, and pain as P < 0.05. Between groups analysis demonstrated Group B to be statistically significant in all the outcome measures CVA (P < 0.0001), strength (P < 0.0001), and pain (P < 0.0001). SF-36 showed a positive effect on some subdomains as to emotional well-being (0.0320) and pain (0.0047*). Conclusion: It was determined that both deep exercise programs and MaRhyThe© when combined with conventional physiotherapy are effective in treating FHP. However, MaRhyThe© with conventional physiotherapy was found to be superior in reducing pain and improving range of motion, strength, and QoL. [ABSTRACT FROM AUTHOR]

Objective: This meta-analysis compared pressure pain sensitivity in trigeminal, cervical spine and remote pain-free areas between migraine patients and headache-free controls considering diagnosis (episodic versus chronic) and sex. Databases and data treatment: Electronic databases were searched for cross-sectional or prospective case-control studies comparing pressure pain thresholds between migraine and headache-free controls. Data were extracted by two reviewers. The risk of bias and methodological quality was assessed by Newcastle-Ottawa Quality Assessment Scale. Meta-analyses of trigeminal, extra-trigeminal (cervical spine) and remote pain-free areas were compared. Frequency of migraine and sex were taken into account. Mean differences (MD) and random effects were calculated. Results: Eighteen studies were included. Patients with migraine showed lower pressure pain thresholds than headache-free controls: trigeminal (MD −71.33 kPa, 95%CI −92.14 to −50.53), cervical spine (MD −68.50 kPa, 95%CI −84.67 to −52.33), and remote pain-free (MD −62.49 kPa, 95%CI −99.52 to −25.45) areas. Differences were consistently significant for episodic migraine in all locations, but only significant in the trigeminal area for chronic migraine (MD −67.36 kOPa, 95%CI −101.31 to −33.42). Overall, women had lower pressure pain thresholds than men. The methodological quality of most studies (66.7%) was good. The results showed a high heterogeneity. Conclusion: This meta-analysis found low to high quality evidence showing lower pressure pain thresholds in trigeminal, extra-trigeminal, and remote pain-free areas in migraine sufferers when compared with headache-free controls. Hypersensitivity to pressure pain locally and widespread was consistently observed in episodic migraine, but locally in chronic migraine as compared to headache-free controls. Women with migraine were more sensitive than men. Registration number: https://doi.org/10.17605/OSF.IO/YJTAK [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the pain relief effects of chewing gum and mechanical vibration methods on orthodontic pain caused by the initial archwire. Methods: In this study, 57 patients, having a 3-6 mm maxillary dental crowding and non-extraction treatment modality were included. The pressure pain thresholds of the subjects were measured. Patients were distributed equally by sex and randomly allocated into 3 groups: mechanical vibration, chewing gum, and control. The fixed orthodontic treatment was started in the upper jaw only. In the first and second groups, mechanical vibration was applied and sugar-free gum was chewed, respectively. The third group was used as the control. The pain perceptions were measured using the Visual Analog Scale. Kruskal-Wallis and Friedman tests were used for statistical analysis. Results: The groups were similar at the beginning of the study in terms of age and algometer scores (P = .138 and P =.155, respectively). Statistical significant differences in the Visual Analog Scale scores among the groups could not be detected at any time point. The highest pain scores were detected at the 24th hour of treatment in all 3 groups. There was no statistically significant difference in the highest pain level among the groups (P = .279). Conclusion: Although the average pain values were perceived as lower, particularly in the mechanical vibration group, the temporary displacement of the teeth has no clinically significant pain relief effect on orthodontic pain. [ABSTRACT FROM AUTHOR]

Abstract Assessing the responses of body tissue subjected to mechanical load is a fundamental component of the clinical examination, psychophysical assessments and bioengineering research. The forces applied during such assessments are usually generated manually, via the hands of the tester, and aimed at discreet tissue sites. It is therefore desirable to objectively quantify and optimise the control of manually applied force. However, current laboratory-grade manual devices and commercial software packages, in particular pressure algometer systems, are generally inflexible and expensive. This paper introduces and discusses several principles that should be implemented as design goals within a flexible, generic software application, given currently available force measurement hardware. We also discuss pitfalls that clinicians and researchers might face when using current pressure algometer systems and provide examples of these. Finally, we present our implementation of a pressure algometer system that achieves these goals in an efficient and affordable way for researchers and clinicians. As part of this effort, we will be sharing our configurable software application via a software repository.

Background: Abdominal examination (AE), one of the primary diagnostic tools used in traditional Korean medicine (TKM), has a limitation of being subjective due to depending on individual practitioner's experience. Therefore, we devised a novel patient-report pressure algometer (PA) and performed a clinical trial to investigate its validity. Methods: In total, 44 participants with functional dyspepsia and 44 healthy participants completed the study. The participants were allocated into one of two groups according to the existence of abdominal stiffness at 5 acupoints or abdominal tenderness at 12 acupoints diagnosed by TKM doctors. The pressure depth and pressure pain threshold (PPT) were evaluated using the PA at the same acupoints. We assessed the validity (sensitivity and specificity) of PA and calculated the area under the curve (AUC) and optimal cutoff value of the test variables (pressure depth and PPT) to criterion standards (abdominal stiffness and tenderness). Results: Pressure depth and PPT assessed by PA showed high sensitivity and specificity in diagnosing abdominal stiffness and tenderness. The validity at CV-14 of diagnosing abdominal tenderness with PPT by PA had a sensitivity of 73.1%, specificity of 77.8%, and an AUC of 0.807 with a P value of < 0.001. Conclusion: This study may provide evidence of standardization and quantification of AE through PA.

Objective The presence of altered nociceptive pain processing in patients with upper extremity tendinopathy/overuse injury is conflicting. Our aim was to compare pressure pain thresholds (PPTs) in symptomatic and distant pain-free areas between patients with upper extremity tendinopathy/overuse injury and controls. Methods Five databases were searched from inception to October 15, 2020. The authors selected case-control studies comparing PPTs between individuals with upper extremity tendinopathy/overuse injury and pain-free controls. Data were extracted for population, diagnosis, sample size, outcome, and type of algometer. Results were extracted by 3 reviewers. The methodological quality/risk of bias (Newcastle-Ottawa Quality Assessment Scale) and evidence level (Grading of Recommendations Assessment, Development and Evaluation approach) were assessed. Meta-analyses of symptomatic, segment-related, and distant pain-free areas were compared. Results The search identified 807 publications with 19 studies (6 shoulder, 13 elbow) eligible for inclusion. The methodological quality ranged from fair (48%) to good (37%). Patients exhibited lower bilateral PPTs than controls at the symptomatic area (affected side: MD = −175.89 kPa [95% CI = −220.30 to −131.48 kPa]; nonaffected side: MD = −104.50 kPa [95% CI = −142.72 to −66.28 kPa]) and the segment-related area (affected side: MD = −150.63 kPa [95% CI = −212.05 to −89.21 kPa]; nonaffected side: MD = −170.34 kPa [95% CI = − 248.43 to −92.25]) than controls. No significant differences in PPTs over distant pain-free areas were observed. Conclusion Low to moderate quality evidence suggests bilateral hypersensitivity to pressure pain at the symptomatic and contralateral/mirror areas in patients with upper extremity tendinopathies/overuse injury. Moderate quality of evidence supports bilateral pressure pain sensitivity in the segment-related area (neck) in lateral epicondylalgia, but not in subacromial impingement syndrome. No evidence of widespread pressure pain hyperalgesia was reported. Impact Early identification of people with altered pain modulation could guide clinicians in treatment strategies. This review shows that there is a complex interplay between peripheral and central pain mechanisms in upper extremity tendinopathies/overuse injuries and that there likely are different subgroups of patients with upper extremity conditions. [ABSTRACT FROM AUTHOR]

Purpose: Pain is considered a stressful experience, related to real or possible tissue damage with emotional, sensory, social and cognitive components. The aim of the study was to evaluate and compare, using a digital algometer, the pressure pain threshold of temporal and masseter muscles of children and adolescents with and without intellectual disability. Methods: A cross-sectional study was conducted. Data regarding gender and age were collected from the caregiver of children and adolescents with and without intellectual disability. The evaluations followed this sequence: pressure pain threshold of the masseter and temporal muscles, evaluation of pain on touch using the visual analog scale and signs and symptoms of Temporomandibular disorder. The χ2 test, the Kolgomorov–Smirnov test, Student t test and Mann–Whitney test were performed. The significance level was set at 5%. Results: Two homogeneous groups by gender (P = 0.258) and age (P = 0.727) were evaluated, of which 25 children and adolescents presented intellectual disability and another 25 did not have intellectual disability. No significant difference was observed between groups on the pressure pain threshold of the masseter and temporal muscles, nor pressure average or exam time (P > 0.05). Regarding Temporomandibular dysfunction, no difference in signs or symptoms frequency was found (P > 0.05). However, the range of maximum mouth opening was smaller in the intellectual disability group (P = 0.006). Conclusion: Children and adolescents with intellectual disability and preserved basic functionalities do not present alterations in pain perception when evaluated with computerized pressure algometer and visual analog scale. They present similar threshold of pain to pressure as those reported by normative children and adolescents. These results emphasize the importance to treat these children and adolescents with intellectual disability with respect to their pain threshold. [ABSTRACT FROM AUTHOR]

Introduction/Objective. The most frequent clinical presentation of myofascial pain (MFP) includes the presence of a deep local muscle pain, limited level of movements, heterotopic pain of trigger points in the referent zones, and the loss of the major symptoms by anesthetizing these points. The only manner to objectively and comprehensively evaluate pain, as a multidimensional experience, is by applying multiple methods in its diagnostics. The objective of this paper was to corelate diagnostic possibilities of different quantification instruments for the assessment of pain intensity in persons with masticatory MFP. Methods. The study involved 60 subjects, divided into two groups stratified according to their sex and age. The Research Diagnostic Criteria for Temporomandibular Disorders diagnostic protocol was applied, within which the numeric scale of pain, digital palpation, graded chronic pain scale, the Visual Analogue Scale (VAS), and algometry were used. Results. The cardiac power index values are statistically significant and in negative correlation with the algometric measurements (from -0.48 to -0.59) and in positive, statistically significant, correlation with the VAS values (0.71). Conclusion. The results of studies we obtained lead us to the conclusion that there is an interdependence of these instruments for the measurement of pain intensity in persons with masticatory MFP and that the VAS and algometry are more objective and precise methods than the manual palpation.

ObjectiveOpioid-induced hyperalgesia (OIH), increased sensitivity to noxious stimuli after repeated opioid exposures, has been demonstrated in preclinical studies. However, there is no accepted, prospective model of OIH after repeated opioid exposures currently available in humans. This study assessed a potential prospective OIH model.MethodsDouble-blind intramuscular injections of a short-acting opioid (alfentanil 15 mcg/kg; N=8) were compared to active placebo (diphenhydramine 25 mg; N=3) on cold and pressure pain testing and standard abuse liability measures in eight 10-hour sessions (1 injection/session) over 4 to 5 weeks in healthy, pain-free males. Decreases from session baseline pain threshold (PThr) and tolerance (PTol) were calculated to represent hyperalgesia, and were assessed both within and across sessions.ResultsMean decreases in cold PTol were seen in the alfentanil group at 180 minutes (-3.8 s, ±26.5) and 480 minutes (-1.63 s, ±31.5) after drug administration. There was a trend for differences between conditions on cold PThr hyperalgesia but not for pressure PThr. Alfentanil participants had greater mean ratings on Liking and High visual analog scales at peak effects (30 min), but these scores did not change across sessions.DiscussionRepeated alfentanil exposures over 4 to 5 weeks resulted in within session decreases in cold pain tolerance from baseline but these differences were not substantially different from diphenhydramine controls. The results did not support the phenomenon of OIH in this model, although definitive conclusions regarding the existence of OIH in humans likely requires a larger sample size or an alternative model.

Objective: Vaginismus and dyspareunia are together categorized as a genito-pelvic pain and penetration disorder. We aimed to evaluate the threshold of pain and the pain sensitivity in women with vaginismus.Study Design: In this prospective case-control study; 32 women with vaginismus and 29 healthy women were enrolled. Sociodemographic Information Form, Female Sexual Function Index (FSFI), Pain Beliefs Questionnaire (PBQ), Revised Fibromyalgia Impact Questionnaire (FIQR), The Lamont Scale of Vaginismus were applied. Threshold of pain was measured with algometer in terms of Newton (N).Results: The pain thresholds vaginismus and control group were as follows; left posterior superior iliac crest (40.3 N, 84.9 N respectively;p < 0.001), right posterior superior iliac crest (42.9 N, 76.1 N respectively;p = 0.007), left lateral trochanter (42.0 N, 69.8 N respectively; p = 0.015), right lateral trochanter (43.8 N, 75.3 N respectively; p = 0.003), left anterior superior iliac spine (29.2 N, 51.2 N respectively; p = 0.003), left insertion of gracilis muscle (27.3 N, 45.2 N respectively; p = 0.038), left medial vastus muscle (37.0 N, 52.4 N respectively; p = 0.025) and the pain thresholds were significantly lower in the vaginismus patients.Conclusion: Women with vaginismus have a lower threshold of pain, and the pain threshold decreases in higher grades of vaginismus. The pain may aggravate the avoiding behavior of women from sexual intercourse. [ABSTRACT FROM AUTHOR]

Objective: This meta-analysis evaluates pressure pain sensitivity values in symptomatic and distant pain-free areas comparing individuals with tension-type headache to controls. Databases and data treatment: Electronic databases were searched for cross-sectional or prospective case-control studies comparing pressure pain thresholds in patients with tension-type headache to headache-free controls. Data were extracted by three reviewers. The methodological quality was assessed by the Newcastle-Ottawa Quality Assessment Scale. Meta-analyses of trigeminal, extra-trigeminal (neck) and distant pain-free areas in tension-type headache were compared to headache-free controls. Frequency of tension-type headache and gender were taken into account. Results: Twenty studies were included. Patients with tension-type headache exhibited lower pressure pain thresholds than headache-free controls: Trigeminal (MD −49.11 kPa, 95% CI −66.05 to −32.17), cervical spine (MD −88.17 kPa, 95% CI −108.43 to −67.92) and distant pain-free areas (MD −98.43 kPa, 95% CI −136.78 to −60.09). Differences were significant for chronic, episodic, and mixed episodic and chronic tension-type headache within the trigeminal and neck (symptomatic areas), but only significant for chronic tension-type headache (MD −102.86, 95% CI −139.47 to −66.25 kPa) for distant pain-free areas. In general, women had lower pressure pain thresholds than men. The methodological quality ranged from fair (45%) to good (40%). The results showed a high heterogeneity and publication bias. Conclusion: This first meta-analysis addressing pressure pain thresholds differences in symptomatic and distant pain-free areas between patients with tension-type headache and controls found low to moderate evidence supporting the presence of pressure pain hypersensitivity in the trigeminal and neck areas in tension-type headache in comparison with headache-free controls. Sensitivity to pressure pain was widespread only in chronic, not episodic, tension-type headache (moderate evidence). Registration number: https://doi.org/10.17605/OSF.IO/R29HY [ABSTRACT FROM AUTHOR]

Background: The aim of this article is to study the correlation between preoperative pain sensitivity and postoperative pain and analgesic requirements for patients undergoing primary total knee arthroplasty.Methods: Between December 2018 and April 2019, the pain sensitivity of 178 consecutive patients undergoing primary total knee arthroplasty was assessed preoperatively with a digital algometer. The patients reported the VAS (visual analog scale) score at 3 instances of needle prick (phlebotomy, glucometer blood sugar, intradermal antibiotic test dose), during the range of movements and completed the Depression Anxiety Stress Scale score. Postoperative VAS score, analgesic requirement, and physiotherapy milestones were recorded in all these patients on day 0 to day 4.Results: The average age of the patients was 64.13 years and 69.1% were females. Females had lower mean algometry values (56.12 ± 12.77 [standard deviation]) compared to males (71.09 ± 18.78 [standard deviation]) (P < .001). Higher Depression Anxiety Stress Scale correlated with lower algometry values (P < .001). The postoperative VAS score was 2.54 ± 0.59 on the day of surgery which increased to 3.27 ± 0.69 on day 1 after mobilization (P < .001) and reduced to 1.67 ± 0.62 on day 4. Low algometer score correlated with higher postoperative VAS score (P < .05), increased analgesic requirement, and opioid utilization (P < .001), delay in achieving an optimum range of movements (P < .001) and independent ambulation (P < .001).Conclusion: Preoperative assessment of pain sensitivity predicts postoperative analgesic requirements and recovery. Patients with a lower pain threshold should be counseled preoperatively and also receive a better titration of analgesics perioperatively and prolonged physiotherapy. [ABSTRACT FROM AUTHOR]

Background Ankle sprain is one of the most common musculoskeletal injuries in sports, at work, and at home. Subjects who suffer from this injury may develop ankle instability. Functional instability has been associated with a high rate of resprain and impaired neuromuscular control in patients with ankle instability. Objective Measurement of neural and muscular mechanosensitivity after ankle sprain injury and establishment of the relationship between these variables. Methods A cross-sectional case-control study was performed with a sample of 58 students from Alcalá de Henares University (21 males and 37 females, mean age ± SD = 21 ± 3.7 years). Subjects were divided into two groups: a case group (N = 29, subjects with unstable ankle) and a control group (N = 29, healthy subjects). The pressure pain threshold (PPT) of the tibialis anterior, peroneus longus, and peroneus brevis muscles and mechanosensitivity of the common peroneus and tibial nerves were evaluated in all subjects through a manual mechanical algometer. Results Neuromuscular PPTs showed significant differences (P  < 0.05) between both groups, such that, compared with the control group, the case group exhibited significantly lower PPT levels. In the case group, a strong positive correlation was observed between neural and muscular homolateral mechanosensitivity in both lower limbs. Conclusions Participants with chronic ankle instability showed higher neuromuscular mechanosensitivity in muscles and nerves surrounding the ankle joint than healthy subjects. These findings indicate that low PPT values may be associated with symptoms that characterize this disease. [ABSTRACT FROM AUTHOR]

Sacroiliac joint dysfunction (SIJD) is a prominent source of pain in low back pain (LBP) patients. Tenderness inferior to the posterior superior iliac spine (PSIS) is an important sign presented in SIJD. Techniques including muscle energy technique (MET) and mechanical diagnosis and therapy (MDT) have shown benefits in SIJD. However, the effects of these treatments on tenderness and pain around the PSIS are yet to be determined. Compare and examine the preliminary short-term effect of MET and MDT on tenderness and pain around the PSIS in SIJD. Twenty patients, aged between 20 and 65 years and diagnosed with unilateral, sub-acute, or chronic SIJD, were screened for the inclusion criteria and were randomly allocated to the MET or the MDT group. Both the groups received treatment for four sessions over one week. Pain pressure threshold (PPT) and visual analogue scale (VAS) were determined by a blinded assessor on pre- and post-treatment basis. Although no significant differences were observed following the treatment between the groups, some statistically significant (p < 0.05) improvements were observed within each of the groups. No drop-outs and no adverse events were reported. The findings of the study suggest that both interventions may be equally effective in reducing symptoms around the PSIS. However, due to the small sample size, the results need to be interpreted cautiously. Future studies on larger sample size and long-term follow up are warranted. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the inter- and intra-observer reliability of quantitative sensory testing performed with the SMall animal ALGOmeter (SMALGO) in healthy cats and in cats with chronic gingivostomatitis (CGS), and to evaluate the SMALGO as a tool to detect and quantify pain in cats with CGS. Methods: Thirty cats from a private shelter were included and assigned to one of two groups: group C (healthy cats; n = 15) or group CGS (cats with CGS; n = 15). In all cats the mechanical thresholds were measured with the SMALGO, with the sensor tip applied to the superior lip above the canine root, by two independent investigators (A, experienced; B, unexperienced), on two different occasions (day 1 and day 2) with a 24 h interval. A CGS scale was used in the diseased cats to assess the severity of the condition. For the reliability analysis, intra-class correlation coefficients (ICCs) were calculated. Other statistical tests used were Pearson correlation coefficient and a paired t -test. Results: The inter- and intra-observer levels of agreement were fair (ICC = 0.50) and good, respectively (ICC = 0.73 for investigator A; ICC = 0.60 for investigator B). However, the thresholds measured in healthy cats (169 ± 59 g) did not differ from those obtained from diseased cats (156 ± 82 g; P = 0.35). There was no correlation between the scores of the CGS scale and the thresholds measured in diseased cats (Pearson correlation coefficient = 0.047; P = 0.87). Conclusions and relevance: Quantitative sensory testing performed with the SMALGO in cats is repeatable and reliable, regardless of the expertise of the investigator. However, the findings of this study suggest that the mechanical thresholds measured with the SMALGO may not be a valuable indicator of pain in cats with CGS. [ABSTRACT FROM AUTHOR]

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Aims: To determine whether a new palpometer and manual palpation can detect site-to-site differences in human craniofacial pain sensitivity in a similar pattern to that of an electronic pressure algometer and subsequently to compare between-session and within-session variability of palpometer and manual palpation. Methods: Sixteen volunteers participated. Experiment 1 was carried out in two sessions. In session 1, pressure pain thresholds (PPT) were determined with a pressure algometer at nine craniofacial sites. Manual palpation and the palpometer were then applied to all sites, and subjects scored perceived pressure/pain on a 0 to 100 numerical rating scale (NRS). Mean scores were compared using analysis of variance (ANOVA). Ten of the volunteers were recalled for a second session and the same protocol was carried out except for assessment of PPTs to establish between-session variability. In experiment 2, three craniofacial sites were examined using the palpometer and manual palpation. Both techniques were repeated 10 times at each site and coefficient of variation (CV) was compared to determine within-session variability. Results: There were no significant differences in NRS scores evoked by manual palpation or palpometer at any test site between repeated sessions. The CV varied between techniques, with lower within-session variability for the palpometer compared with manual palpation (P = .03). Conclusion: The palpometer and manual palpation could detect differences in craniofacial sensitivity in healthy subjects, with no significant differences between repeated sessions. All techniques showed the highest sensitivity at the retromandibular site and the lowest at the temporalis muscle site. The palpometer had lower within-session variability compared with manual palpation. [ABSTRACT FROM AUTHOR]

Serious stretching in many sports involves discomfort and is often an early ceiling on improvements. Purpose: To continue investigation of the use of vibration to enhance acute range of motion while assessing the influence of vibration and stretching on pressure-to-pain threshold perception. Methods: Ten young male gymnasts were assessed for split range of motion. One side split was randomly assigned as the experimental condition, and the other side split was assigned as the control. Both side splits were performed on a vibration device; the experimental condition had the device turned on and the control condition was performed with the device turned off. In addition, the athletes were assessed for pressure-to-pain transition using an algometer on the biceps femoris (stretched muscle) and vastus lateralis (nonstretched muscle) bilaterally. Results: Pre-post difference scores between the vibrated split (most improved) and the nonvibrated split were statistically different (P = .001, 95% confidence interval of the difference 2.3 to 5.8 cm). Following the stretching protocol, the force values for the pressure-to-pain threshold comparing the vibrated and nonvibrated biceps femoris muscle were not statistically different. The nonstretched vastus lateralis muscle also showed no statistical difference in pressure-to-pain threshold between the vibration and nonvibration conditions. Conclusion: This study showed that vibration improved split range of motion over stretching alone, but did not show a difference in pressure-to-pain perception in either the stretched or nonstretched muscles. [ABSTRACT FROM AUTHOR]

Introduction. Pressure pain threshold has been quantified by using a gold standard algometer in patients with bruxism. However, the expense associated with quantifying pressure pain threshold to detect trigger points with a gold standard algometer precludes its use in the clinic. This study aimed to measure the reliability and validity of the more accessible Egyptian algometer for pressure pain threshold evaluation in patients with bruxism. Methods. A descriptive repeated-measures study was performed among 100 participants with bruxism. Pressure pain threshold values were collected from the left temporalis, right temporalis, left masseter, and right masseter muscles with the participants sitting. Pressure pain thresholds were assessed over 2 sessions separated by a 1-week interval. Results. Intraclass correlation coefficient (ICC) determined the intra-rater reliability and Pearson correlation analysis determined the validity of the Egyptian algometer. ICC equalled 0.878, 0.785, 0.896, and 0.903 for the right masseter, left masseter, right temporalis, and left temporalis muscles, respectively. The standard error of measurement ranged from 0.24 to 0.5, the minimal detectable difference ranged from 0.66 to 1.41, ICC ranged from 0.785 to 0.903. Pearson correlation values were 0.673, 0.670, 0.408, and 0.705 for the right masseter, left masseter, right temporalis, and left temporalis muscles, respectively. Conclusions. High ICCs indicated a strong agreement between the measurement systems, suggesting that the Egyptian algometer is a reliable and valid device for quantification of pressure pain threshold in patients with bruxism. [ABSTRACT FROM AUTHOR]

This study tested the reproducibility of visual analog scale (VAS) pain scores to measure changes in masseter muscle pain evoked by maximally tolerable mechanical stimulation over a short time period in healthy subjects. This study also evaluated gender differences in reproducibility of VAS scores to mechanical stimulation. Ten healthy female and eight healthy male individuals participated in this study. The recordings of VAS pain scores to an identical mechanical pressure on the masseter muscle were performed at three different sessions (T1, T2, and T3). The subjects rated their pain on a VAS to a maximally tolerable stimulus that was recorded on an algometer at the first session. The algometer pressure reading was recorded for each subject and then used to duplicate the same identical mechanical stimulus at each of the three sessions. This identical pressure was repeated in the same marked spot at six minutes and after 30 minutes. The subjects rated the pain on a VAS to this identical stimulus at each session. There was no significant difference in VAS pain scores of all subjects at T1, T2, and T3. There was no significant difference in reproducibility of VAS pain scores in females compared to males. Intraclass correlation coefficients were 0.811 on the right masseter and 0.844 on the left masseter. VAS pain scores to mechanical stimulation were reproducible over a short time period. Gender did not affect the reproducibility. This previously unreported method of measuring pain to repeated identical mechanical stimulation appears to have potential for both clinical and research application.

The pressure pain threshold (PPT) is a useful tool for evaluating mechanical sensitivity in individuals suffering from various musculoskeletal disorders. The aim of this study is to investigate PPT at the heel area in order to assist in the design of orthotic shoes for sufferers of heel pain due to a calcaneal spur. The size and location of the calcaneal spur was determined by x-ray images, with PPT data measured around the spur at five points by using algometer FDIX 25. The pain test experiment was conducted by pressing each point to obtain the pain minimum compressive pressure (PMCP) and its location. The information of shoe size, spur location and dimensions, and the PMCP location for each individual is used to obtain the exact point location for applying a softer material to the shoe in-sole, in order to reduce heel pain. The results are significant as it can be used by designers to design appropriate shoe in-soles for individuals suffering from heel pain.

A protocol for a prospective single-blind parallel four-arm randomized placebo-controlled trial with repeated measures was designed to test the effects of various acupuncture methods compared with sham. Eighty self-selected participants with myofascial pain in the upper trapezius muscle were randomized into four groups. Group 1 received acupuncture to a myofascial trigger point (MTrP) in the upper trapezius. Group 2 received acupuncture to the MTrP in addition to relevant distal points. Group 3 received acupuncture to the relevant distal points only. Group 4 received a sham treatment to both the MTrP and distal points using a deactivated acupuncture laser device. Treatment was applied four times within 2 weeks with outcomes measured throughout the trial and at 2 weeks and 4 weeks posttreatment. Outcome measurements were a 100-mm visual analog pain scale, SF-36, pressure pain threshold, Neck Disability Index, the Upper Extremity Functional Index, lateral flexion in the neck, McGill Pain Questionnaire, Massachusetts General Hospital Acupuncture Sensation Scale, Working Alliance Inventory (short form), and the Credibility Expectance Questionnaire. Two-way analysis of variance (ANOVA) with repeated measures were used to assess the differences between groups.