MANUAL THERAPY Cross friction algometry (CFA): Comparison of pressure pain thresholds between patients with chronic non-specific low back pain and healthy subjects Andre Farasyn, PhD PT DO*, Bert Lassat, MSc PT Vrije Universiteit Brussel (VUB), Faculty of Physical Education & Rehabilitation Sciences, Laarbeeklaan 103, BE 1090 Brussels, Belgium Received 28 June 2015; received in revised form 6 September 2015; accepted 30 September 2015 KEYWORDS Algometry; Cross-friction algometry; Trigger point; Low back pain Summary Palpation is widely used to assess muscular sensitivity in clinical settings but still remains a subjective evaluation. This cross-sectional study assessed a newly developed cross- friction algometry making palpation measurable. The objective was to investigate the reli- ability of pressure pain thresholds obtained using Cross-Friction Algometry (CFA-PPTs) measured at the level of Erector spinae and Gluteus maximus central muscle parts, and to compare the CFA-PPTs between patients with chronic nonspecific low back pain (nCLBP) and matching healthy subjects. Participants: Patients presenting nCLBP to GP’s and send into a Pain Center and healthy sub- jects recruited via university ad valvas & flyers distribution. Outcome measures: 30 patients with nCLBP were measured for cross-friction algometry. Other evaluations consisted of the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). Results: The inter- and intra-reliability were tested and found to be sufficient. The mean CFA- PPT values of the Erector spinae at levels T8, T10, L1 & L3 and the Gluteus maximus of the nCLBP group were significantly lower (p  0.001) when compared to the CFA-PPT values of the healthy group. The greatest difference (58%) was found at L1 Erector spinae level and at the superior part of the Gluteus maximus measuring point (59%). Within the group of pa- tients with nCLBP it was surprising to notice that there was no significant correlation between all the reference points measured using CFA-PPTs and the outcomes of the VAS and ODI scores. Conclusions: With the aid of CFA, the importance of local muscular disorder in the lumbar part of the Erector spinae and Gluteus maximus in patients with nCLBP is obviously demonstrated, but also reveals the very large inter-individual differences in muscular fibrosis sensitivity and/ * Corresponding author. Tel.: þ32 2 447 45 29. E-mail address: andre.farasyn@vub.ac.be (A. Farasyn). + MODEL Please cite this article in press as: Farasyn, A., Lassat, B., Cross friction algometry (CFA): Comparison of pressure pain thresholds between patients with chronic non-specific low back pain and healthy subjects, Journal of Bodywork & Movement Therapies (2015), http:// dx.doi.org/10.1016/j.jbmt.2015.09.005 http://dx.doi.org/10.1016/j.jbmt.2015.09.005 1360-8592/ª 2015 Elsevier Ltd. All rights reserved. Available online at www.sciencedirect.com ScienceDirect journal homepage: www.elsevier.com/jbmt Journal of Bodywork & Movement Therapies (2015) xx,1e11