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Title: The assessment of sensory threshold levels using physiological pressure algometry for the evaluation of electro-physiological neuromodulation for chronic pain
Author: Raheem, Tarek M. A.
ISNI:       0000 0004 2740 9228
Awarding Body: Birmingham City University
Current Institution: Birmingham City University
Date of Award: 2013
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Background: Chronic pain is a major health problem due to both its prevalence and the difficulties associated with its adequate diagnosis and treatment. The field of medical physiology has offered possible answers to those difficulties, namely; physiological pressure algometry and electro-physiological neuromodulation. Aims: To explore the diagnostic potential of a physiological pressure algometry device in patient populations suffering from hyperalgesia due to chronic pain; and to use this device to, both, assess and quantify the therapeutic response of patients undergoing various electrophysiological neuromodulation therapies for chronic pain. Methods: Five clinical phases, I–V, conducted on a total of two hundred and seven patients suffering from chronic pain. Results: Phase I; there was a highly significant negative correlation between the pressure pain threshold (PPT) values and each of the visual analogue scale (VAS) and numerical rating scale (NRS) scores; for PPT and VAS; ρ= -0.453 and for PPT and NRS; ρ= -0.413 (p<0.0005 in both cases). Phase II; there were clinically and statistically significant improvements in each of the VAS and NRS scores, and PPT following the activation of the spinal cord stimulation equipment (p<0.0005 in all three cases). Phase III; for the active percutaneous electrical nerve stimulation (PENS) treatments, there were clinically and statistically significant improvements in the NRS scores and PPT after therapy (p<0.0005 in both cases). For the sham treatments, there were neither clinically nor statistically significant changes (p=0.317 and p=0.055 respectively). Phase IV; there were clinically and statistically significant reductions in the median NRS scores; from 7.25 before PENS therapy to 3 after therapy (p<0.05). Phase V; there were clinically significant improvements in the PPT and NRS/VAS scores following the activation of the peripheral nerve stimulation equipment. Key Words: chronic pain, medical physiology, physiological pressure algometry, electrophysiological neuromodulation.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available