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A Novel Quantitative Pain Assessment Instrument That Provides Means of Comparing Patient's Pain Magnitude With a Measurement of Their Pain Tolerance.

Johnson LL, Pittsley A, Becker R, Young AD - J Clin Med Res (2015)

Bottom Line: The database included quantitative measures providing the opportunity to confirm, validate or refute the patient's assertions concerning pain magnitude and tolerance.This method is best described as a patient pain profile.It has the potential to give both the patient and the physician quantified objective information rendering insight not otherwise available.

View Article: PubMed Central - PubMed

Affiliation: 314 East Crystal Downs Drive, Frankfort, MI 49635, USA.

ABSTRACT

Background: Traditional pain assessment instruments are subjective in nature. They are limited to subjective reporting of the presence and magnitude of pain. There is no means of validating their response or assessing their pain tolerance. The objective of this study was to determine the potential value of a novel addition to the traditional physical examination concerning a patient's pain and more importantly their pain tolerance.

Methods: Extensive preliminary data were collected on 359 consecutive private practice knee patients referable the subject's pain, including the magnitude, the most pain ever experienced, and their opinion of personal pain tolerance. The novel evaluation included physical testing of a series of small ball drops through a vertical tube from various fixed levels on the index finger and patella. The patient's response to this impact testing provided quantitative information, from which a comparison was made to their pain opinion and also to that of other patients with similar demographics.

Results: Nine percent of the patients rated their pain tolerance below the midpoint on the visual analog scale. Seventy-one percent thought they were above the midpoint on the scale in regards to pain tolerance. There were discrepancies in both directions between the subject's opinion on pain tolerance and their rating of their pain experience to the ball drop testing. Twenty-eight percent of the entire patient group rated themselves above 5 on tolerance, but experienced above the average discomfort compared to other subjects reporting on the finger impact testing.

Conclusions: This report introduces a novel method for collecting data concerning pain that can be subjected to quantification. The database included quantitative measures providing the opportunity to confirm, validate or refute the patient's assertions concerning pain magnitude and tolerance. This method is best described as a patient pain profile. It has the potential to give both the patient and the physician quantified objective information rendering insight not otherwise available.

No MeSH data available.


Related in: MedlinePlus

Photograph of the 3-feet long tube used for knee patellar impact testing. (a) Examiner is placing the ball at the highest of the three 1-foot openings in the 3-feet tube. The subject’s eyes are closed so as to isolate the experience to the physical impact of the ball drop. All subjects and patients permitted the ball drop at this highest level. There are openings at 1 and 2 feet and the top. (b) Close up of examiner placing ball in top portal.
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Figure 2: Photograph of the 3-feet long tube used for knee patellar impact testing. (a) Examiner is placing the ball at the highest of the three 1-foot openings in the 3-feet tube. The subject’s eyes are closed so as to isolate the experience to the physical impact of the ball drop. All subjects and patients permitted the ball drop at this highest level. There are openings at 1 and 2 feet and the top. (b) Close up of examiner placing ball in top portal.

Mentions: This report introduces a novel, simple, practical, inexpensive, efficient, validated clinical method of expanding the concept of pain assessment, so that it joins the list of other quantifying clinical measures. The method is initiated by recording three subjective factors. There is the patient’s perception of their present pain intensity. The second factor is unique: the recording of the patient’s opinion of their personal pain tolerance. The third factor is the patient’s response to a validating physical impact test. This test is performed with an instrument consisting of a tube into which a small lead ball is dropped from measured distances upon the affected body part (Fig. 1, Fig. 2). The physical impact testing provides an opportunity for validating what the patient perceives about their pain intensity and tolerance. The responses to these three factors plus the medical history and clinical diagnosis are entered into a computerized database for subsequent quantitative analysis.


A Novel Quantitative Pain Assessment Instrument That Provides Means of Comparing Patient's Pain Magnitude With a Measurement of Their Pain Tolerance.

Johnson LL, Pittsley A, Becker R, Young AD - J Clin Med Res (2015)

Photograph of the 3-feet long tube used for knee patellar impact testing. (a) Examiner is placing the ball at the highest of the three 1-foot openings in the 3-feet tube. The subject’s eyes are closed so as to isolate the experience to the physical impact of the ball drop. All subjects and patients permitted the ball drop at this highest level. There are openings at 1 and 2 feet and the top. (b) Close up of examiner placing ball in top portal.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554218&req=5

Figure 2: Photograph of the 3-feet long tube used for knee patellar impact testing. (a) Examiner is placing the ball at the highest of the three 1-foot openings in the 3-feet tube. The subject’s eyes are closed so as to isolate the experience to the physical impact of the ball drop. All subjects and patients permitted the ball drop at this highest level. There are openings at 1 and 2 feet and the top. (b) Close up of examiner placing ball in top portal.
Mentions: This report introduces a novel, simple, practical, inexpensive, efficient, validated clinical method of expanding the concept of pain assessment, so that it joins the list of other quantifying clinical measures. The method is initiated by recording three subjective factors. There is the patient’s perception of their present pain intensity. The second factor is unique: the recording of the patient’s opinion of their personal pain tolerance. The third factor is the patient’s response to a validating physical impact test. This test is performed with an instrument consisting of a tube into which a small lead ball is dropped from measured distances upon the affected body part (Fig. 1, Fig. 2). The physical impact testing provides an opportunity for validating what the patient perceives about their pain intensity and tolerance. The responses to these three factors plus the medical history and clinical diagnosis are entered into a computerized database for subsequent quantitative analysis.

Bottom Line: The database included quantitative measures providing the opportunity to confirm, validate or refute the patient's assertions concerning pain magnitude and tolerance.This method is best described as a patient pain profile.It has the potential to give both the patient and the physician quantified objective information rendering insight not otherwise available.

View Article: PubMed Central - PubMed

Affiliation: 314 East Crystal Downs Drive, Frankfort, MI 49635, USA.

ABSTRACT

Background: Traditional pain assessment instruments are subjective in nature. They are limited to subjective reporting of the presence and magnitude of pain. There is no means of validating their response or assessing their pain tolerance. The objective of this study was to determine the potential value of a novel addition to the traditional physical examination concerning a patient's pain and more importantly their pain tolerance.

Methods: Extensive preliminary data were collected on 359 consecutive private practice knee patients referable the subject's pain, including the magnitude, the most pain ever experienced, and their opinion of personal pain tolerance. The novel evaluation included physical testing of a series of small ball drops through a vertical tube from various fixed levels on the index finger and patella. The patient's response to this impact testing provided quantitative information, from which a comparison was made to their pain opinion and also to that of other patients with similar demographics.

Results: Nine percent of the patients rated their pain tolerance below the midpoint on the visual analog scale. Seventy-one percent thought they were above the midpoint on the scale in regards to pain tolerance. There were discrepancies in both directions between the subject's opinion on pain tolerance and their rating of their pain experience to the ball drop testing. Twenty-eight percent of the entire patient group rated themselves above 5 on tolerance, but experienced above the average discomfort compared to other subjects reporting on the finger impact testing.

Conclusions: This report introduces a novel method for collecting data concerning pain that can be subjected to quantification. The database included quantitative measures providing the opportunity to confirm, validate or refute the patient's assertions concerning pain magnitude and tolerance. This method is best described as a patient pain profile. It has the potential to give both the patient and the physician quantified objective information rendering insight not otherwise available.

No MeSH data available.


Related in: MedlinePlus