title: The reliability of a novel magnetic resonance compatible electro-pneumatic device for delivering a painful pressure stimulus over the lumbar spine.
abstract: BACKGROUND
  Chronic lower back pain (CLBP) is a significant public health problem in the USA. The complexity of CLBP necessitates an assessment tool that can objectively evaluate the aspects of CLBP that lead to disability. Here we present a novel means by which to provide pressure stimuli to the lumbar spine through the use of an electro-pneumatic circuit that can be used in conjunction with functional magnetic resonance imaging (fMRI) technology to assess the cortical activity changes associated with CLBP.
  
  
  METHODS
  A test-retest experimental design was used to objectively quantify pressure pain sensitivity of the lumbar spine. Sensitivity was investigated through the identification of pressure pain thresholds of the lumbar spine using a multiple random staircase method (5-s stimuli) and continuous pain intensity rating (25-s stimuli).
  
  
  RESULTS
  Data presented here were consistent and reliable from day to day with an interclass-correlation coefficient (ICC) value of 0.913 for threshold values overall and individual ICC values of 0.652, 0.818, and 0.851 for mild, moderate, and intense thresholds, respectively. Linear regression analysis for longer trials indicated a large variation on day 1, R(2) values ranged from 0.222 to 0.882, however, the number of low correlation values decreased with only three subjects having R(2) < 0.6 for trial 2 on day 2.
  
  
  CONCLUSIONS
  This project has successfully developed a device that can deliver a reliable and reproducible stimulus over the lumbar spine that mimics the palpatory technique used in clinical practice, and can be used in conjunction with fMRI to assess cortical response.
authors.affiliation: New York Chiropractic College , Seneca Falls, NY , USA .
authors.forename: M Owen
authors.initials: MO
authors.lastname: Papuga
authors.forename: Jeanmarie R
authors.initials: JR
authors.lastname: Burke
authors.forename: Paul E
authors.initials: PE
authors.lastname: Dougherty
mesh_terms: D000328:Adult; D005260:Female; D005385:Fingers / Q000294:innervation; D006801:Humans; D007091:Image Processing, Computer-Assisted; D048228:Intermittent Pneumatic Compression Devices; D016014:Linear Models; D017116:Low Back Pain / Q000175:diagnosis* / Q000209:etiology*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement / Q000295:instrumentation* / Q000379:methods*; D017288:Pain Threshold / Q000502:physiology*; D011312:Pressure / Q000009:adverse effects; D015203:Reproducibility of Results; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Lower back pain; MRI compatible devices; fMRI; pain stimulus