Hand-held dynamometer to measure pressure pain thresholds: A double-blinded reliability and validity study

• Published in: Musculoskeletal science & practice Vol. 51; no. NA; p. 102268
• Main Authors: Jayaseelan, Dhinu J., Cole, Keith R., Courtney, Carol A.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2021
• Subjects: Adult; Algometry; Healthy Volunteers; Humans; Pain; Pain Measurement; Pain mechanisms; Pain Threshold; Physical Medicine and Rehabilitation; Quantitative sensory testing; Reproducibility of Results; Spatial summation; Algometry; Pain mechanisms; Quantitative sensory testing; Spatial summation
• DOI: 10.1016/j.msksp.2020.102268
• ISSN: 2468-7812; 2468-8630

Pain is the most common complaint reported in the musculoskeletal setting. Quantitative sensory testing (QST) assists with pain mechanism identification, although QST is typically performed in research settings. It is possible that clinical utilization of QST may improve if clinically accessible tools can be reliably and validly used. To determine if a hand-held dynamometer (HHD) can be a valid and reliable assessment of pressure pain threshold (PPT). Double-blinded validation study. Eighteen healthy subjects (25.6 ± 3.4 years old) participated in this study. Two testers independently assessed PPT using a HHD and a digital algometer. Assessments followed previously described pressure algometry protocols. Testers and subjects were each blinded to data during assessments. Intra- and inter-rater reliability were excellent for the foot and face for both devices (ICC's > 0.9). Bland-Altman plots and intraclass correlation coefficients revealed good-excellent agreement with minimal proportional bias when normalizing device force at pain threshold to the circumference of the device applicator (ICC 95%CI: 0.56–0.95). Only poor-good agreement (ICC 95% CI: 0.30–0.76) and significant proportional bias was observed when normalizing to area (pressure). Based on the results of this study, when force is normalized by circumference of the applicator, a HHD was found to be a valid and reliable tool for measuring PPT. Clinicians may use HHD to detect relevant pain mechanisms at fault in their evaluation and treatment of pain. Additional research in various pathologic populations is warranted. •A good-excellent correlation between the algometer and dynamometer was found.•Inter-rater and intra-rater reliability of both devices was excellent (ICC > 0.9).•A young asymptomatic sample was used, additional investigation is warranted.•Hand-held dynamometers can validly and reliably assess pressure pain thresholds.