RESEARCH ARTICLE Reliability of pain pressure threshold algometry in persons with conservatively managed wrist fractures Humaira Sæbø 1,2 | Ingvill Fjell Naterstad 1 | Martin Bjørn Stausholm 1,3 | Jan Magnus Bjordal 1 | Jon Joensen 1 1 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway 2 Bergen Accident Emergency Hospital (A&E), Bergen, Norway 3 Physical and Occupational Therapy Research Unit, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark Correspondence Humaira Sæbø, Physiotherapist, MSc, Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway. Email: humaira.sebo@uib.no Funding information University of Bergen; The Norwegian Fund for Post‐Graduate Training in Physiotherapy Abstract Objective: Wrist fracture is a common injury in Norway. Pressure algometry is widely used to quantify patients' pain threshold in various anatomical locations. The aim of this study was to explore the reliability of pain pressure threshold (PPT) algometry in persons with conservatively managed distal radius fractures. Methods: In this cross‐sectional study, three raters (A, B, and C) tested the PPT of participants (18–97 years of age) with a unilateral distal radius fracture after removal of the cast. The raters conducted two measurements of both wrists. Intrarater reli- ability was examined in 75, 50, and 25 participants by Raters A, B, and C, respectively. Interrater reliability was tested in 50 and 25 participants by Rater Pairs A–B and A–C, respectively. Relative reliability was calculated with intraclass correlation coefficient (ICC 1.1 ) and absolute reliability using within‐subject standard deviation (S w ). Results: There was a significant difference in the PPT between the participants' injured and noninjured wrists (p < .0001). The mean PPT was 29% lower in the injured than in the noninjured wrists, 175 kPa (SD ± 62) versus 248 kPa (SD ± 83). Intrarater reli- ability (A) of PPT algometry was better in injured wrists than in noninjured wrists (ICC 1.1 = 0.825 vs. 0.765 and S w = 27 vs. 43 kPa). Similarly, interrater reliability of PPT algometry was better in injured wrists than in noninjured wrists. In injured wrists, the interrater reliability of PPT algometry between Raters A and B was 0.617 (ICC 1.1 ) and S w was 51 kPa, and between Raters A and C, the interrater reliability was 0.706 (ICC 1.1 ) and S w was 48 kPa. Conclusion: PPT algometry is a useful measurement tool with acceptable reliability and thus suitable for monitoring and quantifying pain in persons with conservatively managed wrist fractures. To be more certain that a change has occurred, the same rater should perform the measurements. KEYWORDS observer variation, pain measurement, pain threshold, radius fractures, wrist injury 1 | INTRODUCTION Wrist fracture is the most prevalent fracture in Norway with approxi- mately 15,000 incidences a year (Frønsdal et al., 2013). Conservative treatment of a distal radius fracture is immobilization with cast for 4–6 weeks (Frønsdal et al., 2013). After removal of the cast, pain, swelling, and reduced mobility of the wrist are common (Lidstrom, 1959). To secure an optimal recovery, it is important to monitor the Received: 4 September 2018 Revised: 27 April 2019 Accepted: 17 May 2019 DOI: 10.1002/pri.1797 Physiother Res Int. 2019;e1797. https://doi.org/10.1002/pri.1797 © 2019 John Wiley & Sons, Ltd. wileyonlinelibrary.com/journal/pri 1 of 6