Controlled manual loading of body tissues: towards the next generation of pressure algometer
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(2020) 28:51
REVIEW
Open Access
Controlled manual loading of body tissues: towards the next generation of pressure algometer Davidk W. Evans1,2*
and Alessandro Marco De Nunzio3
Abstract Assessing the responses of body tissue subjected to mechanical load is a fundamental component of the clinical examination, psychophysical assessments and bioengineering research. The forces applied during such assessments are usually generated manually, via the hands of the tester, and aimed at discreet tissue sites. It is therefore desirable to objectively quantify and optimise the control of manually applied force. However, current laboratorygrade manual devices and commercial software packages, in particular pressure algometer systems, are generally inflexible and expensive. This paper introduces and discusses several principles that should be implemented as design goals within a flexible, generic software application, given currently available force measurement hardware. We also discuss pitfalls that clinicians and researchers might face when using current pressure algometer systems and provide examples of these. Finally, we present our implementation of a pressure algometer system that achieves these goals in an efficient and affordable way for researchers and clinicians. As part of this effort, we will be sharing our configurable software application via a software repository. Keywords: Clinical examination, Psychophysical, Force, Pressure, Algometer, Pain threshold, Temporal summation
Introduction Assessing the responses of body tissue subjected to mechanical load is a fundamental component of the clinical examination, psychophysical testing and bioengineering research. The aim of loading may be to measure the mechanical properties of a body tissue: strength, resistance, elasticity or viscosity. Alternatively, the load can act as a stimulus, used to evoke responses from innervated receptors embedded within the tissue. Whatever the aim, accurate force application is essential if inferences are to be drawn from responses to tissue loading. * Correspondence: [email protected] 1 Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK 2 Research Centre, University College of Osteopathy, 275 Borough High Street, London SE1 1JE, UK Full list of author information is available at the end of the article
The forces applied during such assessments are usually generated manually, via the hands of the tester, and aimed at discreet tissue sites. Some testers have utilised computer-controlled, automated force application, via devices comprising pneumatic pumps [39] or force actuators [23, 45]. Whilst such automated devices will undoubtedly improve accuracy of force generation, cost and time constraints leave manual application as the most likely implementation for the foreseeable future. It is therefore desirable to objectively quantify and optimise the control of manually applied force. However, current laboratory-grade manual
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