Published Paper


Comparitive Study of Vas Scores and Pressure Algometry to Quantify Pain in Healthy Subjects

Harini.D Ravi Madhusudhana Dr Ankitha.S Dr. Nagaseshu kumari vasantha
India
Page: 1291-1302
Published on: 2023 December

Abstract

Introduction : Pain quantification is essential for diagnostic and monitoring purposes where it is inherently subjective, and pain measurement in patients relies primarily on self-reports. The most common approaches to self-reported pain measurement are the use of a visual analog scale (VAS), numeric pain rating scales, and the Western Ontario and McMaster osteoarthritis Index pain scale. Objective pain measures are invaluable as they reflect different perspectives of the health condition like the physiological and psychological features of the patient making it difficult to interpret responses. Pain threshold is evaluated by methods including cuff algometry, pressure algometry, and algometry with electric stimulation. Pressure algometers(PA) are inexpensive, more convenient and widely available. Objectives : Primary: Is to determine in healthy volunteers the reliability of PA when it is applied on the medial part of the proximal tibia metaphysis along with VAS Scores Secondary: Is to evaluate if there were differences inpressure pain threshold(PPT) at the medial side of the knee between men and women. Methodology: After receiving the approval of the Institutional Ethics Committee 40 healthy volunteers under ASA 1 and 2 were included in a study using a randomized comparative study. All healthy volunteers both males and females age group between 15 to 65 years were the inclusion criteria in this study after obtaining written informed consent from healthy volunteers. Exclusion criteria for this includes those with a healthy subject with no history of lower limb, spine or pelvic fractures, with the absence of skin disorders, peripheral neuropathies or vascular diseases and those who took painkillers for any reason in the previous week will be excluded. PPT is determined using a handheld pressure algometer device with an increasing of the pressure of 20Kpa/s, all the measurements were performed from the medial knee joint line with the knee flexed at 90 degree, by pushing the algometer the force applied to the tibia gradually increased. The participants were not allowed to see the algometer display in any moment, and, as soon as they experienced a painful sensation, they said “stop”, the algometer is immediately released and the force (in Kpa) is read from the display and they were also asked to indicate their pain intensity on a 10 cm line by using the VAS score simultaneously, based on both scores they were graded into mild, moderate and severe. Results: No significant demographic differences in age, gender or ASA classification have been observed in my study. PA AND VAS- Frequency distribution of patients studied. In our study, when quantifying the pain threshold in healthy volunteers using Pressure algometry and VAS, we obtained similar results with p value of 0.397 and p value of 0.366 respectively but were unable to detect any statistical significance and as observed males have high pain threshold compared to females based on the standard deviation of 1.55±0.43 and 1.43±0.49 respectively measured in our study. Conclusion: Both Pressure algometry and VAS is a reliable tool to quantify the pain threshold in a healthy volunteer and males have a high-pressure pain threshold compared to females.

 

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