Skip to main content
Erschienen in: Journal of Children's Orthopaedics 3/2011

01.06.2011 | Original Clinical Article

Intra- and interrater agreement of pressure pain thresholds in children with orthopedic disorders

verfasst von: Lone Nikolajsen, Anders D. Kristensen, Line K. Pedersen, Ole Rahbek, Troels S. Jensen, Bjarne Møller-Madsen

Erschienen in: Journal of Children's Orthopaedics | Ausgabe 3/2011

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Pressure algometry is widely used to obtain measures of mechanical pain sensitivity in adults, both in experimental and clinical pain conditions. Only very few studies describe the use of pressure algometry in children. The purpose of this study was to produce reference values of pressure pain thresholds and to determine the intra- and interrater agreement, in order to introduce pressure algometry as a standardized method for the assessment of pain thresholds in children with orthopedic disorders.

Methods

Pressure pain thresholds were determined at the leg and at the thenar in 50 children aged 4–12 years. All were scheduled for physical examination at the outpatient Orthopedic Clinic at Aarhus University Hospital, Denmark, because of various orthopedic disorders such as clubfoot and Baker’s cyst. Pressure pain thresholds were determined by two different raters: 20 children were examined twice by rater 1 (intrarater agreement), and another 20 children were examined by both rater 1 and rater 2 (interrater agreement). An additional ten children were examined once by rater 1 to increase the number of children used to determine the reference values.

Results

The pressure pain threshold was 183.1 kPa (mean, SD: 90.7) at the leg and 179.1 kPa (mean, SD: 97.4 kPa) at the thenar (n = 50). Pressure pain thresholds were similar in boys (n = 27) and girls (n = 23). Also, pressure pain thresholds were not affected by age. Bland–Altman plots showed excellent intrarater agreement and satisfactory interrater agreement.

Conclusion

Pressure algometry has excellent intrarater agreement and satisfactory interrater agreement. Pressure algometry was well-tolerated even by very young children. The method deserves more widespread use both in clinical and experimental settings.
Literatur
1.
Zurück zum Zitat Rolke R, Baron R, Maier C, Tolle TR, Treede RD, Beyer A, Binder A, Birbaumer N, Birklein F, Botefur IC, Braune S, Flor H, Huge V, Klug R, Landwehrmeyer GB, Magerl W, Maihofner C, Rolko C, Schaub C, Scherens A, Sprenger T, Valet M, Wasserka B (2006) Quantitative sensory testing in the German research network on neuropathic pain (DFNS): standardized protocol and reference values. Pain 123:231–243CrossRef Rolke R, Baron R, Maier C, Tolle TR, Treede RD, Beyer A, Binder A, Birbaumer N, Birklein F, Botefur IC, Braune S, Flor H, Huge V, Klug R, Landwehrmeyer GB, Magerl W, Maihofner C, Rolko C, Schaub C, Scherens A, Sprenger T, Valet M, Wasserka B (2006) Quantitative sensory testing in the German research network on neuropathic pain (DFNS): standardized protocol and reference values. Pain 123:231–243CrossRef
2.
Zurück zum Zitat Arendt-Nielsen L, Nie H, Laursen MB, Laursen BS, Madeleine P, Simonsen OH, Graven-Nielsen T (2010) Sensitization in patients with painful knee osteoarthritis. Pain 149:573–581CrossRef Arendt-Nielsen L, Nie H, Laursen MB, Laursen BS, Madeleine P, Simonsen OH, Graven-Nielsen T (2010) Sensitization in patients with painful knee osteoarthritis. Pain 149:573–581CrossRef
3.
Zurück zum Zitat Kosek E, Ekholm J, Hansson P (1996) Sensory dysfunction in fibromyalgia patients with implications for pathogenic mechanisms. Pain 68:375–383CrossRef Kosek E, Ekholm J, Hansson P (1996) Sensory dysfunction in fibromyalgia patients with implications for pathogenic mechanisms. Pain 68:375–383CrossRef
4.
Zurück zum Zitat Baad-Hansen L, Leijon G, Svensson P, List T (2008) Comparison of clinical findings and psychosocial factors in patients with atypical odontalgia and temporomandibular disorders. J Orofac Pain 22:7–14 Baad-Hansen L, Leijon G, Svensson P, List T (2008) Comparison of clinical findings and psychosocial factors in patients with atypical odontalgia and temporomandibular disorders. J Orofac Pain 22:7–14
5.
Zurück zum Zitat Kasch H, Qerama E, Kongsted A, Bach FW, Bendix T, Jensen TS (2008) Deep muscle pain, tender points and recovery in acute whiplash patients: a 1-year follow-up study. Pain 140:65–73CrossRef Kasch H, Qerama E, Kongsted A, Bach FW, Bendix T, Jensen TS (2008) Deep muscle pain, tender points and recovery in acute whiplash patients: a 1-year follow-up study. Pain 140:65–73CrossRef
6.
Zurück zum Zitat Hashkes PJ, Friedland O, Jaber L, Cohen HA, Wolach B, Uziel Y (2004) Decreased pain threshold in children with growing pains. J Rheumatol 31:610–613 Hashkes PJ, Friedland O, Jaber L, Cohen HA, Wolach B, Uziel Y (2004) Decreased pain threshold in children with growing pains. J Rheumatol 31:610–613
7.
Zurück zum Zitat Uziel Y, Chapnick G, Jaber L, Nemet D, Hashkes PJ (2010) Five-year outcome of children with “growing pains”: correlations with pain threshold. J Pediatr 156:838–840CrossRef Uziel Y, Chapnick G, Jaber L, Nemet D, Hashkes PJ (2010) Five-year outcome of children with “growing pains”: correlations with pain threshold. J Pediatr 156:838–840CrossRef
8.
Zurück zum Zitat Fernandez-Mayoralas DM, Fernandez-de-las-Penas C, Ortega-Santiago R, Ambite-Quesada S, Jimenez-Garcia R, Fernandez-Jaen A (2010) Generalized mechanical nerve pain hypersensitivity in children with episodic tension-type headache. Pediatrics 126:187–194CrossRef Fernandez-Mayoralas DM, Fernandez-de-las-Penas C, Ortega-Santiago R, Ambite-Quesada S, Jimenez-Garcia R, Fernandez-Jaen A (2010) Generalized mechanical nerve pain hypersensitivity in children with episodic tension-type headache. Pediatrics 126:187–194CrossRef
9.
Zurück zum Zitat Hogeweg JA, Kuis W, Oostendorp RA, Helders PJ (1996) The influence of site of stimulation, age, and gender on pain threshold in healthy children. Phys Ther 76:1331–1339 Hogeweg JA, Kuis W, Oostendorp RA, Helders PJ (1996) The influence of site of stimulation, age, and gender on pain threshold in healthy children. Phys Ther 76:1331–1339
10.
Zurück zum Zitat Chaves TC, Nagamine HM, de Sousa LM, de Oliveira AS, Grossi DB (2007) Intra- and interrater agreement of pressure pain threshold for masticatory structures in children reporting orofacial pain related to temporomandibular disorders and symptom-free children. J Orofac Pain 21:133–142 Chaves TC, Nagamine HM, de Sousa LM, de Oliveira AS, Grossi DB (2007) Intra- and interrater agreement of pressure pain threshold for masticatory structures in children reporting orofacial pain related to temporomandibular disorders and symptom-free children. J Orofac Pain 21:133–142
11.
Zurück zum Zitat Chaves TC, Nagamine HM, de Sousa LM, de Oliveira AS, Grossi DB (2010) Comparison between the reliability levels of manual palpation and pressure pain threshold in children who reported orofacial pain. Manual therapy 15:508–512CrossRef Chaves TC, Nagamine HM, de Sousa LM, de Oliveira AS, Grossi DB (2010) Comparison between the reliability levels of manual palpation and pressure pain threshold in children who reported orofacial pain. Manual therapy 15:508–512CrossRef
12.
Zurück zum Zitat Ohrbach R, Gale EN (1989) Pressure pain thresholds, clinical assessment, and differential diagnosis: reliability and validity in patients with myogenic pain. Pain 39:157–169CrossRef Ohrbach R, Gale EN (1989) Pressure pain thresholds, clinical assessment, and differential diagnosis: reliability and validity in patients with myogenic pain. Pain 39:157–169CrossRef
13.
Zurück zum Zitat Chung SC, Kim JH, Kim HS (1993) Reliability and validity of the pressure pain thresholds (PPT) in the TMJ capsules by electronic algometer. Cranio 11:171–176 Chung SC, Kim JH, Kim HS (1993) Reliability and validity of the pressure pain thresholds (PPT) in the TMJ capsules by electronic algometer. Cranio 11:171–176
14.
Zurück zum Zitat Antonaci F, Sand T, Lucas GA (1998) Pressure algometry in healthy subjects: inter-examiner variability. Scand J Rehabil Med 30:3–8CrossRef Antonaci F, Sand T, Lucas GA (1998) Pressure algometry in healthy subjects: inter-examiner variability. Scand J Rehabil Med 30:3–8CrossRef
15.
Zurück zum Zitat Chesterton LS, Sim J, Wright CC, Foster NE, Chesterton LS, Barlas P, Foster NE, Baxter GD, Wright CC (2007) Interrater reliability of algometry in measuring pressure pain thresholds in healthy humans, using multiple raters. Clin J Pain 23:760–766CrossRef Chesterton LS, Sim J, Wright CC, Foster NE, Chesterton LS, Barlas P, Foster NE, Baxter GD, Wright CC (2007) Interrater reliability of algometry in measuring pressure pain thresholds in healthy humans, using multiple raters. Clin J Pain 23:760–766CrossRef
16.
Zurück zum Zitat Meeus M, Roussel NA, Truijen S et al (2010) Reduced pressure pain threshold in response to exercise in chronic fatigue syndrome but not in chronic low back pain: An experimental study. J Rehabil Med 42:884–890CrossRef Meeus M, Roussel NA, Truijen S et al (2010) Reduced pressure pain threshold in response to exercise in chronic fatigue syndrome but not in chronic low back pain: An experimental study. J Rehabil Med 42:884–890CrossRef
17.
Zurück zum Zitat Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310CrossRef Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310CrossRef
18.
Zurück zum Zitat Persson AL, Brogardh C, Sjolund BH (2004) Tender or not tender: test–retest repeatability of pressure pain thresholds in the trapezius and deltoid muscles of healthy women. J Rehabil Med 36:17–27CrossRef Persson AL, Brogardh C, Sjolund BH (2004) Tender or not tender: test–retest repeatability of pressure pain thresholds in the trapezius and deltoid muscles of healthy women. J Rehabil Med 36:17–27CrossRef
19.
Zurück zum Zitat Kallai I, Barke A, Voss U (2004) The effects of experimenter characteristics on pain reports in women and men. Pain 112:142–147CrossRef Kallai I, Barke A, Voss U (2004) The effects of experimenter characteristics on pain reports in women and men. Pain 112:142–147CrossRef
20.
Zurück zum Zitat Aslaksen PM, Myrbakk IN, Hoifodt RS, Flaten MA (2007) The effect of experimenter gender on autonomic and subjective responses to pain stimuli. Pain 129:260–268CrossRef Aslaksen PM, Myrbakk IN, Hoifodt RS, Flaten MA (2007) The effect of experimenter gender on autonomic and subjective responses to pain stimuli. Pain 129:260–268CrossRef
21.
Zurück zum Zitat Lautenbacher S, Kunz M, Strate P, Nielsen J, Arendt-Nielsen L (2005) Age effects on pain thresholds, temporal summation and spatial summation of heat and pressure pain. Pain 115:410–418CrossRef Lautenbacher S, Kunz M, Strate P, Nielsen J, Arendt-Nielsen L (2005) Age effects on pain thresholds, temporal summation and spatial summation of heat and pressure pain. Pain 115:410–418CrossRef
22.
Zurück zum Zitat Chesterton LS, Barlas P, Foster NE, Baxter GD, Wright CC (2003) Gender differences in pressure pain threshold in healthy humans. Pain 101:259–266CrossRef Chesterton LS, Barlas P, Foster NE, Baxter GD, Wright CC (2003) Gender differences in pressure pain threshold in healthy humans. Pain 101:259–266CrossRef
23.
Zurück zum Zitat Goubert L, Vervoort T, Cano A, Crombez G (2009) Catastrophizing about their children`s pain is related to higher parent–child congruency in pain ratings: an experimental investigation. Eur J Pain 13:196–201CrossRef Goubert L, Vervoort T, Cano A, Crombez G (2009) Catastrophizing about their children`s pain is related to higher parent–child congruency in pain ratings: an experimental investigation. Eur J Pain 13:196–201CrossRef
Metadaten
Titel
Intra- and interrater agreement of pressure pain thresholds in children with orthopedic disorders
verfasst von
Lone Nikolajsen
Anders D. Kristensen
Line K. Pedersen
Ole Rahbek
Troels S. Jensen
Bjarne Møller-Madsen
Publikationsdatum
01.06.2011
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Children's Orthopaedics / Ausgabe 3/2011
Print ISSN: 1863-2521
Elektronische ISSN: 1863-2548
DOI
https://doi.org/10.1007/s11832-011-0336-4

Weitere Artikel der Ausgabe 3/2011

Journal of Children's Orthopaedics 3/2011 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.