The reliability of body pain diagrams in the quantitative measurement of pain distribution and location in patients with musculoskeletal pain: a systematic review

Danielle Southerst; Pierre Côté; Maja Stupar; Paula Stern; Silvano Mior

doi:10.1016/j.jmpt.2013.05.021

The reliability of body pain diagrams in the quantitative measurement of pain distribution and location in patients with musculoskeletal pain: a systematic review

J Manipulative Physiol Ther. 2013 Sep;36(7):450-9. doi: 10.1016/j.jmpt.2013.05.021. Epub 2013 Jul 8.

Authors

Danielle Southerst¹, Pierre Côté, Maja Stupar, Paula Stern, Silvano Mior

Affiliation

¹ Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Faculty of Health Sciences, University of Ontario Institute of Technology, Toronto, ON, Canada. dsoutherst@uoit.ca

PMID: 23845196
DOI: 10.1016/j.jmpt.2013.05.021

Abstract

Objective: The purpose of this study was to perform a systematic review of test-retest, intraexaminer, and interexaminer reliability of measuring pain location and distribution using the body pain diagram.

Methods: We conducted a systematic review of the literature using a search conducted in Medline, CINAHL, and Nursing and Allied Health from inception to March 1, 2012. Articles were screened and selected by pairs of reviewers using predetermined inclusion criteria. Internal validity was assessed independently by 2 reviewers using a modified version of the QUADAS instrument. Articles with adequate internal validity were included in the best evidence synthesis.

Results: We reviewed 10 studies. Of those, 6 were included in the best evidence synthesis. We found varying levels of evidence that pain location and pain distribution can be measured reliably using the body pain diagram in patients with acute and chronic low back pain with or without radiculopathy. The test-retest reliability for measuring pain distribution ranged from intraclass correlation coefficient of 0.58 to 0.94. Similarly, the test-retest reliability for measuring pain location ranged from kappa (κ) of 0.13 to 0.85. The intraexaminer and interexaminer reliability for measuring pain distribution were intraclass correlation coefficient of 0.99 and 0.99, respectively. The intraexaminer and interexaminer reliability for measuring pain location ranged from κ of 0.77 to 0.88 and 0.61 to 1.00, respectively.

Conclusions: We found important variations in the test-retest reliability of pain location and distribution across different test-retest scenarios and across body regions. The intraexaminer and interexaminer reliability for the measurement of pain distribution and pain location using the body pain diagram in patients with acute and chronic low back pain with or without radiculopathy are adequate.

Keywords: Pain; Pain Measurement; Reproducibility of Results.

Publication types

Review
Systematic Review

MeSH terms

Acute Disease
Adult
Body Surface Area
Chronic Disease
Evaluation Studies as Topic
Evidence-Based Medicine
Female
Humans
Low Back Pain / diagnosis*
Male
Middle Aged
Musculoskeletal Pain / diagnosis*
Observer Variation
Pain Measurement / methods*
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index