OBJECTIVE: To explore 2 potential protocols for provocation testing and assessment of directional preference using padded wedges.
METHODS: Two groups of 20 subjects were examined while lying prone on various positions of padded wedges. In the first group, pain pressure threshold (PPT) was measured at 4 anatomic points; in the second group, tenderness was measured at 1 anatomic point. We investigated whether either method could demonstrate a directional preference response.
RESULTS: When tenderness was measured at 1 anatomic point, 70% of subjects demonstrated a directional response, and only 1 subject exhibited an increase in baseline tenderness at the end of the procedure. When PPT was measured at 4 anatomic points, 40% of subjects demonstrated a directional response, but 12 subjects exhibited decreased PPT at the end of the procedure.
CONCLUSION: Measuring changes in tenderness at 1 anatomic point in response to various padded wedge patterns appears promising as an examination procedure to determine directional preference.
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