Reproducibility and reliability of pressure algometry: are digital and analogue devices comparable?

Oliveira, Natália Cristina de; Silva, Klara Reis; Santos, Adna Costa; Alfieri, Fábio Marcon

doi:10.5935/2595-0118.20240055-en

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ORIGINAL ARTICLE • BrJP 7 • 2024 • https://doi.org/10.5935/2595-0118.20240055-en copy

Reproducibility and reliability of pressure algometry: are digital and analogue devices comparable?

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Digital and analogue algometry have been widely employed in clinical studies, but a recent investigation observed a systematic error between devices, which may hinder comparison of data from different studies. The objective of this study was to evaluate the reproducibility and reliability of analogue and digital algometers.

METHODS:

This was an observational transversal study involving 40 healthy adults. They had preserved cognitive capacity and no chronic or acute pain. Participants were submitted to pressure pain threshold (PPT) assessment by two different algometers, 15 minutes apart: a digital device (Wagner Pain Test FPX) and an analogue one (Wagner Force Dial). Data collection involved 2 evaluators and occurred once a week. The muscles evaluated were teres major, upper trapezius, elevator scapulae, supraspinatus, infraspinatus, pectoralis, middle gluteus, paraspinal and deltoid.

RESULTS:

Reliability between the measurements taken by the same evaluator (intra-rater reliability) or with the same device (inter-rater reliability) on different days was analyzed using the Intraclass Correlation Coefficient (ICC). When comparing the intra-rater reliability (evaluator 1, weeks 1 and 3), good or excellent reproducibility was observed in most of the sites, with both analogue and digital algometers, with statistical significance. The inter-device reliability (digital and analogue algometers) showed a significant and excellent correlation (r > 0.75) in all evaluated sites for both evaluators. The analysis of inter-rater reliability (2 different evaluators) for the digital algometer revealed good or excellent significant correlation in almost all sites, except for the left pectoralis major. For the analogue algometer, all evaluated sites exhibited good or excellent correlation with statistical significance.

CONCLUSION:

The data highlight that digital and analogue algometry have good intra-rater reliability (reproducibility), inter-device reliability and inter-rater reliability in a sample of healthy young individuals.

Keywords:
Evaluation study; Pain; Pain threshold; Reproducibility of results

HIGHLIGHTS

Digital and analogue algometry have good intra-rater reliability (reproducibility)

Digital and analogue algometry presented good inter-device reliability

Digital and analogue algometry exhibited good inter-rater reliability

	n (%)	Mean ± SD
Gender (F)	20 (50)
Dominant side (R)	36 (90)
Physically active	26 (65)
Exercise days/week*		4.2 ± 1.2
Body mass index		23.9 ± 4.9

	Analogue		Digital
	ICC (r)	p-value	ICC (r)	p-value
R teres major	0.645	0.001	0.743	<0.001
L teres major	0.630	0.001	0.617	0.002
R upper trapezius	0.668	<0.001	0.703	<0.001
L upper trapezius	0.655	<0.001	0.683	<0.001
R levator scapulae	0.678	<0.001	0.635	0.001
L levator scapulae	0.558	0.004	0.613	0.002
R supraspinatus	0.553	0.006	0.573	0.004
L supraspinatus	0.628	0.001	0.552	0.007
R infraspinatus	0.606	0.001	0.635	0.001
L infraspinatus	0.645	<0.001	0.652	<0.001
R pectoralis major	0.588	0.003	0.645	0.001
L pectoralis major	0.688	<0.001	0.575	0.005
R gluteus medius	0.695	<0.001	0.634	0.001
L gluteus medius	0.689	<0.001	0.592	0.004
R paraspinal at 2cm*	0.642	<0.001	0.671	<0.001
L paraspinal at 2cm*	0.643	<0.001	0.687	<0.001
R paraspinal at 4cm*	0.602	0.001	0.530	0.012
L paraspinal at 4cm*	0.621	0.001	0.583	0.001
R deltoid	0.613	0.002	0.776	<0.001
L deltoid	0.601	0.002	0.751	<0.001

	Rater 1		Rater 2
	ICC (r)	p-value	ICC (r)	p-value
R teres major	0.858	<0.001	0.910	<0.001
L teres major	0.829	<0.001	0.882	<0.001
R upper trapezius	0.915	<0.001	0.897	<0.001
L upper trapezius	0.912	<0.001	0.914	<0.001
R levator scapulae	0.908	<0.001	0.952	<0.001
L levator scapulae	0.912	<0.001	0.944	<0.001
R supraspinatus	0.939	<0.001	0.904	<0.001
L supraspinatus	0.945	<0.001	0.902	<0.001
R infraspinatus	0.952	<0.001	0.921	<0.001
L infraspinatus	0.934	<0.001	0.909	<0.001
R pectoralis major	0.912	<0.001	0.817	<0.001
L pectoralis major	0.864	<0.001	0.845	<0.001
R gluteus medius	0.908	<0.001	0.872	<0.001
L gluteus medius	0.916	<0.001	0.859	<0.001
R paraspinal at 2cm*	0.897	<0.001	0.826	<0.001
L paraspinal at 2cm*	0.914	<0.001	0.837	<0.001
R paraspinal at 4cm*	0.944	<0.001	0.878	<0.001
L paraspinal at 4cm*	0.922	<0.001	0.853	<0.001
R deltoid	0.884	<0.001	0.773	<0.001
L deltoid	0.873	<0.001	0.858	<0.001

	Analogue		Digital
	ICC (r)	p-value	ICC (r)	p-value
R teres major	0.754	<0.001	0.806	<0.001
L teres major	0.743	<0.001	0.790	<0.001
R upper trapezius	0.700	<0.001	0.729	<0.001
L upper trapezius	0.690	<0.001	0.651	0.001
R levator scapulae	0.786	<0.001	0.734	<0.001
L levator scapulae	0.783	<0.001	0.648	0.001
R supraspinatus	0.790	<0.001	0.766	<0.001
L supraspinatus	0.728	<0.001	0.752	<0.001
R infraspinatus	0.775	<0.001	0.795	<0.001
L infraspinatus	0.771	<0.001	0.734	<0.001
R pectoralis major	0.640	<0.001	0.729	<0.001
L pectoralis major	0.698	<0.001	0.585	0.001
R gluteus medius	0.798	<0.001	0.737	<0.001
L gluteus medius	0.794	<0.001	0.745	<0.001
R paraspinal at 2cm*	0.675	<0.001	0.705	<0.001
L paraspinal at 2cm*	0.695	<0.001	0.702	<0.001
R paraspinal at 4cm*	0.778	<0.001	0.735	<0.001
L paraspinal at 4cm*	0.749	<0.001	0.673	<0.001
R deltoid	0.699	<0.001	0.622	<0.001
L deltoid	0.664	0.001	0.609	0.001

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[1] Correspondence to
: Fábio Marcon Alfieri E-mail: fabiomarcon@bol.com.br