The reliability of measuring pain distribution and location using body pain diagrams in patients with acute whiplash-associated disorders

J Manipulative Physiol Ther. 2013 Sep;36(7):395-402. doi: 10.1016/j.jmpt.2013.05.023. Epub 2013 Jul 25.

Abstract

Objective: The objective of this study was to measure the interexaminer reliability of scoring pain distribution using paper and electronic body pain diagrams in patients with acute whiplash-associated disorder and to assess the intermethod reliability of measuring pain distribution and location using paper and electronic diagrams.

Methods: We conducted an interexaminer reliability study on 80 participants recruited from a randomized controlled trial on the conservative management of acute grade I/II whiplash-associated disorder. Participants were assessed for inclusion/exclusion criteria by an experienced clinician. As part of the baseline assessment, participants independently completed paper and electronic pain diagrams. Diagrams were scored independently by 2 examiners using the body region method. Interexaminer and intermethod reliability was computed using intraclass correlation coefficients (ICCs) for pain distribution and κ coefficient for pain location. We used Bland-Altman plots to compute limits of agreement.

Results: The interexaminer reliability was ICC = 0.925 for paper and ICC = 0.997 for the electronic body pain diagram. The intermethod reliability for measuring pain distribution ranged from ICC = 0.63 to ICC = 0.93. For pain location, the intermethod reliability varied from κ = 0.23 (posterior neck) to κ = 0.90 (right side of the face).

Conclusions: We found good to excellent interexaminer reliability for scoring 2 versions of the body pain diagram. Pain distribution and pain location were reliably and consistently measured on body pain diagrams using paper and electronic methods; therefore, clinicians and researchers may choose either medium when using body pain diagrams.

Keywords: Neck Pain; Pain; Pain Measurement; Reproducibility of Results; Whiplash Injuries.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Body Surface Area
  • Cohort Studies
  • Confidence Intervals
  • Disability Evaluation
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Observer Variation
  • Pain / diagnosis*
  • Pain / etiology
  • Pain Measurement / methods*
  • Reproducibility of Results
  • Whiplash Injuries / complications
  • Whiplash Injuries / diagnosis*
  • Whiplash Injuries / therapy
  • Young Adult