A Multi-Modal Biosensor to Measure Soft Tissue Pain and Myofascial Trigger Points (MFTP’s) for Evidence Based Practices
The leading causes of disability in people in their working years are musculoskeletal conditions. [Mense, Simons, (2001) ] Chronic pain afflicts 1/3 of Americans costing up to $635 billion each year. [Reichard (2011)]. Nurses using Pain Questionnaires statistically underestimated the patients’ pain. [Hovi (1999)] We need more objective evidence to support current treatment practices. [Tough, White, Richards, Campbell (2007)].
We will investigate inflammation a cause for pain and MFTP’s. We will use content validity to support the inclusion of algometry, thermography, galvanometers and stethoscopes as valuable assessment tools for measuring attributes of inflammation.
To qualify and quantify pain and Myofascial Trigger Points (MFTPs), we will combine four measurement technologies into one device to be used along with palpation and pain questionnaires. We will use content validity to support the use of these devices (algometry, thermography, galvanometers, and stethoscopes) as tools to measure attributes of inflammation, a complex biological response to injury that sensitizes nociceptors (Figure 1) and induces hyperalgesia. [Dubin, Patapoutian (2010)]. (Figure 2)
Inflammation is a complex biological response to injury that sensitizes nociceptors and induces hyperalgia (pain). [Dubin, Patapoutian (2010)] (Figure 1, 2) Content validity supports the inclusion measuring inflammation using the above validated measurement tools.
Numerous abstract citations substantiate that the above four devices identified above are useful for providing objective data this is associated with inflammatory pain. A Multi-Modal Biosensor that has been developed will display and collect differential comparisons between healthy and inflamed soft tissue using a PC software program.
ABATE Qr combines four individual measurement devices into one multi-modal biosensor to provide concurrent measurement of inflammation or myofascial pain. It increases the overall potential for objective impartiality relieving the practitioner(s) from subjective decision-making during physical examinations. ABATE Qr provides an evidence based practice device for myofascial pain and its management (Figure 3) and a simultaneous measurement that correlates with palpation findings. ABATE Qr shows the improvement of pain therapies through digitized data of the treatment outcomes. It also provides a useful tool for future studies of compression massage devices
ABATE Qr illustrates graphically the differentials between healthy (Graph 1) and damaged tissue or myofascial pain (Graphs 2, 3, 4, 5)
- red illustrates temperature or thermography
- blue illustrates moisture or galvanic skin response
- green illustrates pressure or algometry
- yellow illustrates crepitus level of stethoscope for crepitus sounds
- black illustrates crepitus counts
- purple illustrates patient response module pressure threshold on a scale of 1 to 5 used by the patient to express their level of pain when pressure is applied.
“A self-report is considered the gold standard of pain measurement because it is consistent with the definition of pain. Pain is a subjective experience. But, the dilemma of self-report measures is exactly that subjective nature. They are based on the patient’s perception of her or his pain and that perception may be influenced by other factors.” (Pain assessment and measurement Jenny Strong Jennifer Sturgess Anita M. Unruh Bill Vicenzino)
Evidence based practice (EBP) process is a method that allows the practitioner to assess research, clinical guidelines, and other information resources based on high quality findings and apply the results to practice. EBP is the conscientious use of current best evidence in making decisions about patient care (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000).
- Figure 1. Shows the inflammatory response.
- Figure 2. Shows how inflammations cause pain reception
- Figure 3. Measurement of inflammatory pain using a visual display of data collected in graphical form