Novice assessors demonstrate good intra-rater agreement and reliability when determining pressure pain thresholds: a cross-sectional study

Roland Reezigt (First author), Geranda Slager, Michel Coppieters, G.M. Scholten-Peeters

    Research output: Contribution to journalArticleAcademicpeer-review


    Background: Experienced assessors show good intra-rater reproducibility (within-session and between-session agreement and reliability) when using an algometer to determine pressure pain thresholds (PPT). However, it is unknown whether novice assessors perform equally well. This study aimed to determine within and between-session agreement and reliability of PPT measurements performed by novice assessors and explored whether these parameters differed per assessor and algometer type.

    Methods: Ten novice assessors measured PPTs over four test locations (tibialis anterior muscle, rectus femoris muscle, extensor carpi radialis brevis muscle and paraspinal muscles C5-C6) in 178 healthy participants, using either a Somedic Type II digital algometer (10 raters; 88 participants) or a Wagner Force Ten FDX 25 digital algometer (nine raters; 90 participants). Prior to the experiment, the novice assessors practiced PPTs for 3 h per algometer. Each assessor measured a different subsample of ~9 participants. For both the individual assessor and for all assessors combined (i.e., the group representing novice assessors), the standard error of measurement (SEM) and coefficient of variation (CV) were calculated to reflect within and between-session agreement. Reliability was assessed using intraclass correlation coefficients (ICC1,1).

    Results: Within-session agreement expressed as SEM ranged from 42 to 74 kPa, depending on the test location and device. Between-session agreement, expressed as SEM, ranged from 36 to 76 kPa and the CV ranged from 9-16% per body location. Individual assessors differed from the mean group results, ranging from -55 to +32 kPa or from -9.5 to +6.6 percentage points. Reliability was good to excellent (ICC1,1: 0.87 to 0.95). Results were similar for both types of algometers.

    Conclusions: Following 3 h of algometer practice, there were slight differences between assessors, but reproducibility in determining PPTs was overall good.
    Translated title of the contributionOnervaren testleiders tonen een goede intra-beoordelaarsbetrouwbaarheid bij pijndrempelmetingen (PPTs) - een cross-sectionele studie
    Original languageEnglish
    Pages (from-to)e14565
    Number of pages20
    JournalPeerJ – the Journal of Life & Environmental Sciences
    Issue numberpeerj.14565.
    Publication statusPublished - 4 Jan 2023


    • central sensitisation
    • mechanical hyperalgesia
    • novice assessor
    • novice rater
    • pain measurement
    • pain sensitivity
    • pressure pain threshold
    • quantitative sensory testing
    • reproducibility of results


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