• M Owen Papuga, Jeanmarie R Burke, and Paul E Dougherty.
• New York Chiropractic College , Seneca Falls, NY , USA .
• Somatosens Mot Res. 2015 Jan 1;32(1):51-60.

BackgroundChronic 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.MethodsA 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).ResultsData 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.ConclusionThis 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.

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