Assessment of Pressure Pain Threshold (PPT) and Conditioned Pain Modulation (CPM) After Effect in Patients With and Without Tennis Elbow (TE)
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Physiological/measurement-validation study.
- Who it may be relevant to
- Registry conditions: Tennis Elbow, Health Adult Subjects, Lateral Elbow Tendinopathy (Tennis Elbow), Pressure Pain Threshold (PPT). Basic parameters: up to 60 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Jordan
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Measurement Properties and Temporal Stability of Conditioned Pain Modulation in Individuals With and Without Lateral Epicondylalgia
Overview
This study at Hashemite University looks at how people with and without tennis elbow (AKA lateral elbow tendinopathy) feel pressure pain and how their bodies briefly "turn down" pain after a cold stimulus. Participants complete brief questionnaires (basic demographics without names, a tennis-elbow symptom form, and a physical-activity form) and then have their pressure-pain threshold (PPT) tested with a handheld device that slowly increases pressure on standard spots near the elbow and wrist; they say when it first becomes painful. To test the body's built-in anti-pain system (conditioned pain modulation, CPM), one hand is placed in ice water (the cold-pressor task) and PPT is measured again at set times (before, during, and after the cold stimulus) to see how much pain sensitivity changes and how long that change lasts. Both PPT reliability and CPM after effect are measured in this study. The study findings may help improve future assessment and treatment of musculoskeletal pain conditions.
Detailed description
This is a quasi-experimental reliability and time-course study using digital algometry for PPT and the cold-pressor task for CPM. Primary outcomes include PPT reliability (with intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest detectable change (SDC) and the duration of CPM after-effects (time to return toward baseline). Testing is planned in the Physiotherapy Clinic at the Community Rehabilitation Center, with a minimum sample noted in the application. The protocol emphasizes standardized sites, repeated measures at predefined time points, and storage of coded data on university systems.
Interventions
- Other Physiological/measurement-validation study
Protocols PPT Reliability The assessor measured Pressure Pain Threshold; PPT, using an electronic digital algometer. Measurements will be taken at two test sites wrist at baseline, at 1, 3 and 5 minutes. Three PPT measurements were taken at each time point with a 15-20 seconds interval between each. Mean values will then be used in analysis. Conditioned Pain Modulation In order to assess CPM, PPT was used as a tested stimulus on the painful arm (elbow and wrist). Baseline PPTs will assessed thr
Primary outcome measures
- Pressure Pain Threshold (PPT) [Time frame: The PPT session would take about 30min to be completed in one day.]
- Conditioned Pain Modulation (CPM) [Time frame: 1 and half hours in a separate day (different to the PPT session day)]
Eligibility criteria
TE Group
Inclusion criteria
Patients with Tennis Elbow confirmed at initial assessment by the Primary Investigator (PI)
Unilateral elbow pain > 6 weeks duration reproduced on at least two of the following tests:
- Palpation of the lateral epicondyle
- Isometric testing of the wrist extensors
- Middle finger extension test
- Passive stretch of wrist extensors
- Resisted hand gripping using a dynamometer
- Upper limb neurodynamic test-radial nerve bias (ULNDT-RN)
Exclusion criteria
- History of chronic pain conditions (e.g. fibromyalgia, irritable bowel
- syndrome, temporomandibular dysfunction, migraines)
- Neurological or sensory dysfunction (especially in the upper limbs)
- History of chronic musculoskeletal pain (e.g. arthritis, chronic low back
- pain)
- Contraindications to cold application (i.e. Reynaud's disease, diabetes)
- Current or long-term use of pain medication or anti-depressants
Healthy Group The asymptomatic group included adults (18-65 years) without pain (acute or chronic) at least 3 months before the experimental sessions.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Other
Study locations
Jordan · 1 center
- The Hashemite University, Department of Physical Therapy; Community Rehabilitation Center — Zarqa
Publications
- Oono Y, Nie H, Matos RL, Wang K, Arendt-Nielsen L. The inter- and intra-individual variance in descending pain modulation evoked by different conditioning stimuli in healthy men. Scand J Pain. 2011 Oct 1;2(4):162-169. doi: 10.1016/j.sjpain.2011.05.006. PMID 29913755
- Bilika P, Kalamatas-Mavrikas P, Vasilis N, Strimpakos N, Kapreli E. Reliability of Pressure Pain Threshold (PPT) and Conditioned Pain Modulation (CPM) in Participants with and without Chronic Shoulder Pain. Healthcare (Basel). 2024 Aug 31;12(17):1734. doi: 10.3390/healthcare12171734. PMID 39273758
Identifiers
NCT: NCT07178288 · 32/1/2024/2025