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Dynamic mechanical assessment of muscle hyperalgesia in humans: the dynamic algometer.

Finocchietti S, Graven-Nielsen T, Arendt-Nielsen L - Pain Res Manag (2015 Jan-Feb)

Bottom Line: Musculoskeletal pain is often associated with a nonhomogeneous distribution of mechanical hyperalgesia.The dynamic pressure algometer was tested bilaterally on the tibialis anterior muscle in 15 healthy subjects and compared with static pressure algometry.It can be applied as a simple clinical bed-side test and as a quantitative tool in pharmacological profiling studies.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Musculoskeletal pain is often associated with a nonhomogeneous distribution of mechanical hyperalgesia. Consequently, new methods able to detect this distribution are needed.

Objective: To develop and test a new method for assessing muscle hyperalgesia with high temporal and spatial resolution that provides complementary information compared with information obtained by traditional static pressure algometry.

Methods: The dynamic pressure algometer was tested bilaterally on the tibialis anterior muscle in 15 healthy subjects and compared with static pressure algometry. The device consisted of a wheel that was rolled over the muscle tissue with a fixed velocity and different predefined forces. The pain threshold force was determined and pain intensity to a fixed-force stimulation was continuously rated on a visual analogue scale while the wheel was rolling over the muscle. The pressure pain sensitivity was evaluated before, during, and after muscle pain and hyperalgesia induced unilaterally by either injection of hypertonic saline (0.5 mL, 6%) into the tibialis anterior or eccentric exercise evoking delayed-onset muscle soreness (DOMS).

Results: The intraclass correlation coefficient was >0.88 for the dynamic thresholds; thus, the method was reliable. Compared with baseline, both techniques detected hyperalgesia at the saline injection site and during DOMS (P<0.05). The dynamic algometer also detected the widespread, patchy distribution of sensitive loci during DOMS, which was difficult to evaluate using static pressure algometry.

Discussion and conclusion: The present study showed that dynamic pressure algometry is a reliable tool for evaluating muscle hyperalgesia (threshold and pain rating) with high temporal and spatial resolution. It can be applied as a simple clinical bed-side test and as a quantitative tool in pharmacological profiling studies.

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Related in: MedlinePlus

Distribution of pressure pain threshold (n=15) changes assessed by the computer-controlled pressure algometer at the nine sites on the tibialis anterior muscle during delayed-onset muscle soreness. Open circles represent decreased sensitivity (15% increase of pressure pain threshold compared with baseline) and filled circles represent increased sensitivity (15% reduction of pressure pain threshold compared with baseline). × indicates the site of maximal sensitivity (ie, the pressure pain threshold with the largest reduction) for each subject
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f6-prm-20-29: Distribution of pressure pain threshold (n=15) changes assessed by the computer-controlled pressure algometer at the nine sites on the tibialis anterior muscle during delayed-onset muscle soreness. Open circles represent decreased sensitivity (15% increase of pressure pain threshold compared with baseline) and filled circles represent increased sensitivity (15% reduction of pressure pain threshold compared with baseline). × indicates the site of maximal sensitivity (ie, the pressure pain threshold with the largest reduction) for each subject

Mentions: At baseline, the VAS score after rolling stimulation meaured at the sites for PPT assessments correlated with the PPTs for all nine points (R=0.86, P<0.05). Five minutes after saline-induced pain, the most sensitive site was point 5 (the muscle belly) while the least sensitive site was point 9 (the most distal point from the tibial tuberosity). In the DOMS leg, PPTs and corresponding VAS scores after rolling stimulation did not correlate for any assessment points (P>0.10). The most sensitive site was point 5 for both the pressure algometry (Figure 6) and dynamic algometry (Figure 7) assessments. However, the VAS related to dynamic pain assessment showed the presence of sensitive loci, non-visible with the pressure algometry measurement (Figure 7).


Dynamic mechanical assessment of muscle hyperalgesia in humans: the dynamic algometer.

Finocchietti S, Graven-Nielsen T, Arendt-Nielsen L - Pain Res Manag (2015 Jan-Feb)

Distribution of pressure pain threshold (n=15) changes assessed by the computer-controlled pressure algometer at the nine sites on the tibialis anterior muscle during delayed-onset muscle soreness. Open circles represent decreased sensitivity (15% increase of pressure pain threshold compared with baseline) and filled circles represent increased sensitivity (15% reduction of pressure pain threshold compared with baseline). × indicates the site of maximal sensitivity (ie, the pressure pain threshold with the largest reduction) for each subject
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325887&req=5

f6-prm-20-29: Distribution of pressure pain threshold (n=15) changes assessed by the computer-controlled pressure algometer at the nine sites on the tibialis anterior muscle during delayed-onset muscle soreness. Open circles represent decreased sensitivity (15% increase of pressure pain threshold compared with baseline) and filled circles represent increased sensitivity (15% reduction of pressure pain threshold compared with baseline). × indicates the site of maximal sensitivity (ie, the pressure pain threshold with the largest reduction) for each subject
Mentions: At baseline, the VAS score after rolling stimulation meaured at the sites for PPT assessments correlated with the PPTs for all nine points (R=0.86, P<0.05). Five minutes after saline-induced pain, the most sensitive site was point 5 (the muscle belly) while the least sensitive site was point 9 (the most distal point from the tibial tuberosity). In the DOMS leg, PPTs and corresponding VAS scores after rolling stimulation did not correlate for any assessment points (P>0.10). The most sensitive site was point 5 for both the pressure algometry (Figure 6) and dynamic algometry (Figure 7) assessments. However, the VAS related to dynamic pain assessment showed the presence of sensitive loci, non-visible with the pressure algometry measurement (Figure 7).

Bottom Line: Musculoskeletal pain is often associated with a nonhomogeneous distribution of mechanical hyperalgesia.The dynamic pressure algometer was tested bilaterally on the tibialis anterior muscle in 15 healthy subjects and compared with static pressure algometry.It can be applied as a simple clinical bed-side test and as a quantitative tool in pharmacological profiling studies.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Musculoskeletal pain is often associated with a nonhomogeneous distribution of mechanical hyperalgesia. Consequently, new methods able to detect this distribution are needed.

Objective: To develop and test a new method for assessing muscle hyperalgesia with high temporal and spatial resolution that provides complementary information compared with information obtained by traditional static pressure algometry.

Methods: The dynamic pressure algometer was tested bilaterally on the tibialis anterior muscle in 15 healthy subjects and compared with static pressure algometry. The device consisted of a wheel that was rolled over the muscle tissue with a fixed velocity and different predefined forces. The pain threshold force was determined and pain intensity to a fixed-force stimulation was continuously rated on a visual analogue scale while the wheel was rolling over the muscle. The pressure pain sensitivity was evaluated before, during, and after muscle pain and hyperalgesia induced unilaterally by either injection of hypertonic saline (0.5 mL, 6%) into the tibialis anterior or eccentric exercise evoking delayed-onset muscle soreness (DOMS).

Results: The intraclass correlation coefficient was >0.88 for the dynamic thresholds; thus, the method was reliable. Compared with baseline, both techniques detected hyperalgesia at the saline injection site and during DOMS (P<0.05). The dynamic algometer also detected the widespread, patchy distribution of sensitive loci during DOMS, which was difficult to evaluate using static pressure algometry.

Discussion and conclusion: The present study showed that dynamic pressure algometry is a reliable tool for evaluating muscle hyperalgesia (threshold and pain rating) with high temporal and spatial resolution. It can be applied as a simple clinical bed-side test and as a quantitative tool in pharmacological profiling studies.

Show MeSH
Related in: MedlinePlus