Two pressure pain threshold testing trials using a handheld pressure algometer (Wagner Instruments; Greenwich, CT) were conducted over the L4 spinous process (local pain sensitivity) and the right tibialis anterior (remote pain sensitivity); average pressure pain threshold values were generated. Lower pressure pain threshold values indicate higher pain sensitivity and are associated with increased risk for poor clinical outcomes [15 (link),16 (link)].
Handheld pressure algometer
Manufactured by Wagner Instruments
Sourced in United Kingdom, United States
The Wagner Instruments Handheld Pressure Algometer is a compact, portable device designed to measure pressure pain thresholds. It features a pressure sensor and digital display to quantify the amount of pressure applied to a specific area of the body.
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5 protocols using handheld pressure algometer
1
Pressure Pain Threshold Testing
2
Conditioned Pain Modulation in Humans
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The CPM paradigm was designed following international recommendations72 (link): In a counterbalanced manner, the secondary outcome CPM was performed by an assessor blinded to the group allocation. Test stimuli were applied to the nondominant forearm in a supine position and at the nondominant side of the back in prone on a therapy plinth. The same test areas were used as for the OA paradigm. A handheld pressure algometer (Wagner Instruments, Greenwich, United Kingdom) with a stimulation area of 1 cm2 was used as the test stimulus by increasing the pressure (250 g per second62 (link)) to a pain intensity of Pain40 (40 out of 100 on a VAS). Participants were informed to say “stop” as soon as they perceived a pain intensity of 40 out of 100 (Pain40). The test stimulus procedure was repeated twice on each side of the body before and immediately after the conditioning stimulus. For the conditioning stimulus, a 60-second cold-water immersion (approx. 8°C: exercise group 8.1°C [SD 0.08]; rest group: 8.0°C [SD 0.9]) of the dominant hand to wrist level was used as the conditioning stimulus. Immediately at the end of this cold pressor task, subjects reassessed the painfulness (VAS) induced by the conditioning stimulus.
3
Measuring Mechanical Nociceptive Threshold in Sheep
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The mechanical nociceptive threshold refers to the lowest amount of pressure an animal can tolerate before a behavioral response indicative of pain occurs [32 (link)]. The MNT was determined on the lower abdomen of sheep pre-procedure (baseline) and at 4, 6, 24, 30, and 48 h post-surgery around the site of incision (or the lower abdomen for CON sheep, in the area where the incision was made in MEL and FLU sheep) using a hand-held pressure algometer (Wagner Instruments, Greenwich, CT, USA). A withdrawal (pain) response in sheep was indicated by any overt movement away from the applied pressure algometer. Four sites around the incision (left cranial, left caudal, right cranial, right caudal) and one control site on the upper abdomen of the ewe, approximately 15 cm away from the incision, were measured at each time point. For the CON sheep, these four sites were estimated based on where the incision would have been made. The location of the test sites, the order of data collection from each test site, and the individual measuring MNT did not change for the duration of the study.
4
Pressure Pain Threshold Assessment at Lumbar Spine
5
Quantifying Calf Muscle Sensitivity
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A total of 208 MNT measures made up the data set. Using a hand held pressure algometer (Wagner Instruments, Greenwich, CT), force was applied perpendicularly at a rate of approximately 1 kg of force per second at one location on each side of the ribs of each calf over the sixth intercostal space for a total of two locations, as described in (Williams et al., 2020 (link)). A withdrawal response was indicated by an overt movement away from the applied pressure algometer and values were recorded by a second investigator to prevent bias. Locations were tested three times in sequential order, and the values were averaged for statistical analysis.
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