Work

Reliability and standard error of measurement of pressure pain thresholds at articular landmarks

Year: 2026

Type: article

Abstract: Background: Pressure pain threshold (PPT) testing is a widely used quantitative sensory testing method to assess mechanical pain sensitivity. While reference values for PPT at articular-/joint-related and osseous landmarks are available, data on measurement reliability remain limited. This study aimed to determine the intra- and inter-rater reliability of PPT measurements and to report the standard error of measurement (SEM) for joint PPT. Methods: = 40), inter-rater reliability was evaluated with two different examiners. PPT was measured at joints (elbow, knee, ankle) and reference landmarks (sternum, forehead) using a digital algometer. ICCs (2,k model) and SEM were calculated for each landmark. Results: Intra-rater reliability was excellent at all landmarks (ICCs ≥ 0.926) except the elbow with a good reliability (ICC = 0.848). Inter-rater reliability was excellent at the sternum (ICC = 0.950) and good at the ankle, knee, elbow, and forehead (ICCs ≥ 0.813). SEM values varied across landmarks, with lowest values observed at reference landmarks sites (e.g., sternum and forehead). ICCs are similar between sexes. Conclusions: PPT measurements at articular (joints) and bony reference landmarks show good to excellent reliability. These findings support the use of joint PPT in standardized pain sensitivity assessments and provide a basis for clinical and research applications. However, findings are limited to pain-free participants and should be replicated in broader populations.

Source: British Journal of Pain

DOI: 10.1177/20494637261463704

Authors: Fabian Tomschi, Thomas Hilberg

Institution: University of Wuppertal

Language: English

Topic: Pain Mechanisms and Treatments

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,150