Cuff algometry: Positioning and inflation pattern
Author
Lindskou, Tim Alex
Term
4. term
Education
Publication year
2014
Submitted on
2014-06-03
Pages
37
Abstract
Central sensibilisering spiller en rolle i flere smertetilstande og kan vurderes med trykalgometri. Dette studie undersøgte, om placeringen af en computerstyret trykmanchet og valg af inflationsmønster påvirker målinger af smerte ved tryk. I et enkeltsessions, randomiseret cross-over design deltog 20 raske frivillige (10 mænd, 10 kvinder; medianalder 26 år). Trykmanchet-målinger blev udført fire steder på det dominante ben med inflationsmålinger i det distale, proksimale og begge manchet-kamre. Udfaldsmålene omfattede tryksmertetærskel, tryksmerte-tolerance, spatial summation samt temporal summation (målt ét sted). To inflationsmønstre blev sammenlignet: ramp (kontinuerlig stigning) og staircase (trinvise stigninger). Derudover blev håndholdt trykalgometri anvendt til at måle tryksmertetærskel. Der sås forskelle mellem de fire positioner, mellem distale og proksimale kamre samt mellem køn. Ved brug af det distale kammer var tryksmertetærsklen højere ved position 1, og graden af spatial summation lavere ved position 2. Staircase-inflation gav højere tærskler end ramp-inflation for alle mål undtagen temporal summation. Fundene tyder på, at ramp-mønsteret kan fremme smertesummering og dermed lavere tærskler, og at visse positioner/kamre (position 1 og det distale kammer) kan være mindre egnede til standardiserede manchetmålinger. Resultaterne bør tolkes med forsigtighed på grund af den begrænsede stikprøvestørrelse, og større studier anbefales.
Central sensitization contributes to several pain syndromes and can be assessed with pressure algometry. This study examined whether the positioning of a computer-controlled cuff and the chosen inflation pattern affect pressure pain measurements. In a single-session, randomized crossover design, 20 healthy volunteers (10 men, 10 women; median age 26) underwent cuff algometry at four locations on the dominant leg, with inflation applied to the distal chamber, proximal chamber, and both chambers. Outcomes included pressure pain threshold, pressure pain tolerance, spatial summation, and temporal summation (assessed at one location). Two inflation patterns were compared: ramp (continuous increase) and staircase (stepwise increases). Hand-held algometry was also used to obtain pressure pain thresholds. Differences were observed across positions, between distal and proximal chambers, and between genders. With the distal chamber, thresholds were higher at position 1 and spatial summation was lower at position 2. The staircase pattern yielded higher thresholds than the ramp pattern for all measures except temporal summation. These findings suggest ramp inflation may promote pain summation and reduce thresholds, and that certain positions/chambers (position 1 and the distal chamber) may be less suitable for standardized cuff measurements. The small sample size warrants caution, and larger studies are recommended.
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