INTERNATIONAL CONFERENCE ON APPLIED

TECHNOLOGIES
ICAT - 2019

MECHANICAL PAIN ASSESSMENT THROUGH PARAMETERS

DERIVED FROM PHOTOPLETHYSMOGRAPHIC (PPG) SIGNALS:
A PILOT STUDY.

Type of Job: A PILOT STUDY

Presented by: Andrés David Ramírez Mena; Erick Javier Argüello P, PhD;
Leonardo Antonio Bermeo V, PhD; Rodolfo David Molano V, Dr.
University Santiago Of Cali- Faculty Of Engineering
E-Mail: andres.ramirez18@usc.edu.co
 TABLE OF CONTENTS
• INTRODUCTION
• METHODS
DATA ACQUISITION AND PROCESSING
EXPERIMENTAL PROTOCOL
• RESULTS AND DISCUSSION
• CONCLUSSIONS
• REFERENCES
 INTRODUCTION

The standards of the Joint Commission for the

Accreditation of Healthcare Organizations defended the
consideration of pain as a fifth vital sign and emphasized
the need to register pain
 MECHANICAL PAIN ASSESSMENT THROUGH PARAMETERS DERIVED
FROM PHOTOPLETHYSMOGRAPHIC (PPG) SIGNALS: A PILOT STUDY.

PAIN
(physical and
emotional
experiences)

TOO
PAIN CAN BE
EXPENSIVE
AND COMPLEX/
PHYSIOLOGICAL
PARAMETERS
MEASURED ?
DISCOMFORT (FC, VFC,
AND RISK PPGA)

PREVIOUS
STUDIES
(Loggia et al.,
2011; Treister et
al., 2012; Nickel
et al., 2017)
 PPG SIGNAL

Fig. 3. An example of the PPG signal morphology. (a) Pulse onset. (b) Systolic peak. (c) Signal amplitude.
(d) peak-to-peak interval.
 METHODS
IT WAS EVALUATED: PPG
AMPLITUDE (PPGA),
HEART RATE (HR) AND
PULSE RATE VARIABILITY-
HIGH FREQUENCY (PRV-
HF)

MECHANICAL PAIN LOCALLY-DESIGNED,

ASSESSMENT IN MECHANICAL STIMULATOR
WAS USED TO APPLY THREE
FIFTEEN HEALTHY 2-SECONDS FORCE STIMULI
SUBJECTS (3, 6 AND 9 N)

EXCLUSION INFORMED
CRITERIA CONSENT
DATA ACQUISITION AND PROCESSING

% change = 100*(averagePOSTSTIM – averagePRESTIM) / averagePRESTIM.

 EXPERIMENTAL PROTOCOL

Fig. 3. The locally-designed, mechanical stimulator used in the present study. (a) Connection diagram. (b) The final appearance of
the device.
 RESULTS AND DISCUSSION

Fig. 4. The amplitude of the PPG signal (PPGA) as a function of three different intensities of mechanically induced pain. (a) The
parameter variation before and after the application of force stimuli at each pain level. (b) The 60-second parameter values
(median ± interquartile range) at each pain level.
 RESULTS AND DISCUSSION

Fig. 5. The heart rate (HR) as a function of three different intensities of mechanically induced pain. (a) The parameter variation
before and after the application of force stimuli at each pain level. (b) The 60-second parameter values (median ± interquartile
range) at each pain level.
 RESULTS AND DISCUSSION

Fig. 6. The high frequency band power of the pulse rate variability (PRV-HF) as a function of three different intensities of
mechanically induced pain. (a) The parameter variation before and after the application of force stimuli at each pain level. (b) The
60-second parameter values (median ± interquartile range) at each pain level.
RESULTS AND DISCUSSION
 RESULTS

Through the parameters of the PPG it was not possible

differentiate between three levels (low, medium and high)
of mechanical pain. only HR was capable of differentiating
between low and medium pain, as well between low and
high pain induced by mechanical stimulation
 CONCLUSSIONS

• Only HR was capable of differentiating between low and

medium pain, as well as between low and high pain
induced by mechanical stimulation.

• Further work should be extended to evaluate the effects

of tonic (duration > 60 s) mechanical stimulation on a
wider range of PPG-derived parameters and should be
conducted such that all stimulus intensities are
administered in a randomized order.
 REFERENCES
1. Loggia ML, Juneau M, Bushnell MC. Autonomic responses to heat pain: Heart rate, skin
conductance, and their relation to verbal ratings and stimulus intensity. Pain.
2011;152(3):592-598. doi:10.1016/j.pain.2010.11.032
2. Allen J. Photoplethysmography and its application in clinical physiological
measurement. Physiol Meas. 2007;28(3). doi:10.1088/0967-3334/28/3/R01
3. Argüello, E. J., Serna, R. D.: A novel and low-complexity peak detection algorithm for
heart rate estimation from low-amplitude photoplethysmographic (PPG) signals. Journal
of medical engineering & technology 42(8), 569-577 (2018).
4. Merskey H, Bogduk N. Classification of Chronic Pain.; 1994. doi:10.1002/ana.20394
5. Treister R, Kliger M, Zuckerman G, Aryeh IG, Eisenberg E. Differentiating between heat
pain intensities: The combined effect of multiple autonomic parameters. Pain.
2012;153(9):1807-1814. doi:10.1016/j.pain.2012.04.008
6. Magerl, W., Geldner, G., & Handwerker, H. O. (1990). Pain and vascular reflexes in man
elicited by prolonged noxious mechano-stimulation. Pain, 43(2), 219–225.
https://doi.org/10.1016/0304-3959(90)91075-T
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