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Sample records for pain map reliability

  1. The Knee Pain Map: Reliability of a Method to Identify Knee Pain Location and Pattern

    PubMed Central

    THOMPSON, LAURA R.; BOUDREAU, ROBERT; HANNON, MICHAEL J.; NEWMAN, ANNE B.; CHU, CONSTANCE R.; JANSEN, MARY; NEVITT, MICHAEL C.; KWOH, C. KENT

    2009-01-01

    Objective To describe the location and pattern of knee pain in patients with chronic, frequent knee pain using the Knee Pain Map, and to evaluate the inter- and intrarater reliability of the map. Methods A cohort of 799 participants from the University of Pittsburgh Osteoarthritis Initiative Clinical Center who had knee pain in the last 12 months were studied. Trained interviewers assessed and recorded participant-reported knee pain patterns into 8 local areas, 4 regional areas, or as diffuse. Inter- and intrarater reliability were assessed using Fleiss’ kappa. Results Participants most often reported localized (69%) followed by regional (14%) or diffuse (10%) knee pain. In those with localized pain, the most commonly reported locations were the medial (56%) and lateral (43%) joint lines. In those with regional pain, the most commonly reported regions were the patella (44%) and medial region (38%). There was excellent interrater reliability for the identification of localized and regional pain patterns (κ = 0.7–0.9 and 0.7–0.8, respectively). The interrater reliability for specific locations was also excellent (κ = 0.7–1.0) when the number of participants with pain in a location was >4. For regional pain, the kappa for specific regions varied from 0.7–1.0. Conclusion The majority of participants could identify the location of their knee pain, and trained interviewers could reliably record those locations. The variation in locations suggests that there are multiple sources of pain in knee OA. Additional studies are needed to determine whether specific knee pain patterns correlate with discrete pathologic findings on radiographs or magnetic resonance images. PMID:19479703

  2. MAP kinase and pain

    PubMed Central

    Ji, Ru-Rong; Gereau, Robert W.; Malcangio, Marzia; Strichartz, Gary R.

    2008-01-01

    Mitogen-activated protein kinases (MAPKs) are important for intracellular signal transduction and play critical roles in regulating neural plasticity and inflammatory responses. The MAPK family consists of three major members: extracellular signal-regulated kinases (ERK), p38, and c-Jun N-terminal kinase (JNK), which represent three separate signaling pathways. Accumulating evidence shows that all three MAPK pathways contribute to pain sensitization after tissue and nerve injury via distinct molecular and cellular mechanisms. Activation (phosphorylation) of MAPKs under different persistent pain conditions results in the induction and maintenance of pain hypersensitivity via non-transcriptional and transcriptional regulation. In particular, ERK activation in spinal cord dorsal horn neurons by nociceptive activity, via multiple neurotransmitter receptors, and using different second messenger pathways plays a critical role in central sensitization by regulating the activity of glutamate receptors and potassium channels and inducing gene transcription. ERK activation in amygdala neurons is also required for inflammatory pain sensitization. After nerve injury, ERK, p38, and JNK are differentially activated in spinal glial cells (microglia vs astrocytes), leading to the synthesis of proinflammatory/pronociceptive mediators, thereby enhancing and prolonging pain. Inhibition of all three MAPK pathways has been shown to attenuate inflammatory and neuropathic pain in different animal models. Development of specific inhibitors for MAPK pathways to target neurons and glial cells may lead to new therapies for pain management. Although it is well documented that MAPK pathways can increase pain sensitivity via peripheral mechanisms, this review will focus on central mechanisms of MAPKs, especially ERK. PMID:19150373

  3. The cartography of pain: the evolving contribution of pain maps.

    PubMed

    Schott, Geoffrey D

    2010-09-01

    Pain maps are nowadays widely used in clinical practice. This article aims to critically review the fundamental principles that underlie the mapping of pain, to analyse the evolving iconography of pain maps and their sometimes straightforward and sometimes contentious nature when used in the clinic, and to draw attention to some more recent developments in mapping pain. It is concluded that these maps are intriguing and evolving cartographic tools which can be used for depicting not only the spatial features but also the interpretative or perceptual components and accompaniments of pain. Copyright 2009 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

  4. Pain mapping for common shoulder disorders.

    PubMed

    Bayam, Levent; Ahmad, Mudussar A; Naqui, Syed Z; Chouhan, Aroonkumar; Funk, Lennard

    2011-07-01

    We conducted a study to ascertain specific patterns of pain in patients with common shoulder disorders and to describe a comprehensive shoulder pain map. We prospectively studied 94 cases involving an upper limb pain map and correlated the maps with the final diagnoses made by 2 clinicians who were blinded to the pain map findings. Pattern, severity, and type of pain were specific to each common shoulder disorder. In subacromial impingement, pain was predominantly sharp, occurred around the anterior aspect of the shoulder, radiated down the arm, and was associated with dull, aching pain radiating to the hand. A similar pain pattern was found in rotator cuff tears. In acromioclavicular joint pathology, pain was sharp, stabbing, and well localized to the anterosuperior shoulder area. Glenohumeral joint arthritis was marked by the most severe pain, which occurred in a mixed pattern and affected the entire arm. Whereas the pain of instability was a mixture of sharp and dull pain, the pain of calcific tendonitis was severe and sharp. Both pains were limited to the upper arm and shoulder. Pain mapping revealed definitive patterns for shoulder pathologies. We advocate using pain maps as useful diagnostic guides and research tools.

  5. Reliability of tactile tools for pain assessment in blind athletes.

    PubMed

    Leite, Ana Claudia de Souza; Pagliuca, Lorita M Freitag; Almeida, Paulo Cesar P; Dallaire, Clemence C

    2008-06-01

    Health professionals have numerous visual and reporting scales at their disposal to assess pain. In recent years new tactile tools have been created (Pain Texture Scale and Tactile Pain Scale). This study validates these scales compared with the Numerical Rating Scale in 36 blind athletes who were assessed before and after competitions in the World Paralympics Games organized by the International Blind Sports Federation (IBSA) in Quebec, Canada. The reliability of these scales was analyzed through the intraclass correlation coefficient. Results showed good reliability for the Tactile Pain Scale and satisfactory reliability for the Pain Texture Scale.

  6. Reliable Digit Span is Unaffected by Laboratory-Induced Pain

    ERIC Educational Resources Information Center

    Etherton, Joseph L.; Bianchini, Kevin J.; Ciota, Megan A.; Greve, Kevin W.

    2005-01-01

    Reliable Digit Span (RDS) is an indicator used to assess the validity of cognitive test performance. Scores of 7 or lower suggest poor effort or negative response bias. The possibility that RDS scores are also affected by pain has not been addressed thus potentially threatening RDS specificity. The current study used cold pressor-induced pain to…

  7. Painful Memories: Reliability of Pain Intensity Recall at 3 Months in Senior Patients

    PubMed Central

    Lee, Jacques S.; Griffith, Lauren E.; Paquet, Jean; Chauny, Jean-Marc

    2017-01-01

    Background. Validity of pain recall is questioned in research. Objective. To evaluate the reliability of pain intensity recall for seniors in an emergency department (ED). Methods. This study was part of a prospective multicenter project for seniors (≥65 years old) treated in an ED for minor traumatic injury. Pain intensity (0–10 numerical rating scale) was evaluated at the initial ED visit, at one week (baseline), and 3 months. At three months, patients were asked to recall the pain intensity they had at baseline. Results. 482 patients were interviewed (mean age 76.6 years, SD ± 7.3) and 72.8% were female. Intraclass correlation coefficient between pain at baseline and its recall was 0.24 (95% CI: 0.14–0.33). Senior patients tended to overestimate their pain intensity by a mean of 1.2 (95% CI: 0.9–1.5) units. A stepwise multiple regression analysis showed that the variance of baseline pain recall at 3 months was explained by pain at ED visit (11%), pain at 3 months (7%), and pain at baseline (2%). Conclusion. The accuracy of pain intensity recall after three months is poor in seniors and seems to be influenced by the pain experienced at the time of injury. PMID:28260963

  8. Reliability of conditioned pain modulation: a systematic review

    PubMed Central

    Kennedy, Donna L.; Kemp, Harriet I.; Ridout, Deborah; Yarnitsky, David; Rice, Andrew S.C.

    2016-01-01

    Abstract A systematic literature review was undertaken to determine if conditioned pain modulation (CPM) is reliable. Longitudinal, English language observational studies of the repeatability of a CPM test paradigm in adult humans were included. Two independent reviewers assessed the risk of bias in 6 domains; study participation; study attrition; prognostic factor measurement; outcome measurement; confounding and analysis using the Quality in Prognosis Studies (QUIPS) critical assessment tool. Intraclass correlation coefficients (ICCs) less than 0.4 were considered to be poor; 0.4 and 0.59 to be fair; 0.6 and 0.75 good and greater than 0.75 excellent. Ten studies were included in the final review. Meta-analysis was not appropriate because of differences between studies. The intersession reliability of the CPM effect was investigated in 8 studies and reported as good (ICC = 0.6-0.75) in 3 studies and excellent (ICC > 0.75) in subgroups in 2 of those 3. The assessment of risk of bias demonstrated that reporting is not comprehensive for the description of sample demographics, recruitment strategy, and study attrition. The absence of blinding, a lack of control for confounding factors, and lack of standardisation in statistical analysis are common. Conditioned pain modulation is a reliable measure; however, the degree of reliability is heavily dependent on stimulation parameters and study methodology and this warrants consideration for investigators. The validation of CPM as a robust prognostic factor in experimental and clinical pain studies may be facilitated by improvements in the reporting of CPM reliability studies. PMID:27559835

  9. Mapping methods for computationally efficient and accurate structural reliability

    NASA Technical Reports Server (NTRS)

    Shiao, Michael C.; Chamis, Christos C.

    1992-01-01

    Mapping methods are developed to improve the accuracy and efficiency of probabilistic structural analyses with coarse finite element meshes. The mapping methods consist of the following: (1) deterministic structural analyses with fine (convergent) finite element meshes; (2) probabilistic structural analyses with coarse finite element meshes; (3) the relationship between the probabilistic structural responses from the coarse and fine finite element meshes; and (4) a probabilistic mapping. The results show that the scatter in the probabilistic structural responses and structural reliability can be efficiently predicted using a coarse finite element model and proper mapping methods with good accuracy. Therefore, large structures can be efficiently analyzed probabilistically using finite element methods.

  10. Mapping methods for computationally efficient and accurate structural reliability

    NASA Technical Reports Server (NTRS)

    Shiao, Michael C.; Chamis, Christos C.

    1992-01-01

    Mapping methods are developed to improve the accuracy and efficiency of probabilistic structural analyses with coarse finite element meshes. The mapping methods consist of: (1) deterministic structural analyses with fine (convergent) finite element meshes, (2) probabilistic structural analyses with coarse finite element meshes, (3) the relationship between the probabilistic structural responses from the coarse and fine finite element meshes, and (4) a probabilistic mapping. The results show that the scatter of the probabilistic structural responses and structural reliability can be accurately predicted using a coarse finite element model with proper mapping methods. Therefore, large structures can be analyzed probabilistically using finite element methods.

  11. A method for scoring the pain map of the McGill Pain Questionnaire for use in epidemiologic studies.

    PubMed

    Escalante, A; Lichtenstein, M J; White, K; Rios, N; Hazuda, H P

    1995-10-01

    Identifying and quantifying the location of pain may be important for understanding specific functional impairments in elderly populations. The purpose of the present analysis was two-fold: first, to describe the reliability of a scoring method for the McGill Pain Map (MPM), and second, to validate the method of scoring the MPM as a tool for assessing areas of body pain in an epidemiologic study. In interviews performed at the subjects' homes, 411 community dwelling Mexican-American and non-Hispanic white subjects aged 65-74 from the San Antonio Longitudinal Study of Aging (SALSA) were asked to describe the location of their pain on the map of the human body included in the McGill Pain Questionnaire. The location of pain was scored by overlaying the survey figures with a MPM template divided into 36 anatomical areas. Inter- and intra-rater agreement among three raters was measured by calculating a kappa statistic for each of the body areas, and an intraclass correlation coefficient for the total number of painful areas (NPA). Internal validity was measured by Spearman's rho between the NPA and the Present Pain Index (PPI) and Pain Rating Index (PRI) of the McGill Pain Questionnaire, and external validity by correlation between NPA and the Perceived Health (PH), Amount of Bodily Pain (APB), and Pain Interference with Work (PIW) items of the Medical Outcomes Study, and the Perceived Physical Health (PPH) question of the San Antonio Heart Study. Average inter-rater agreement for individual MPM areas was 0.92 +/- 0.01, and average agreement for NPA was 0.96 +/- 0.01. Intra-rater agreement for individual areas averaged 0.94 +/- 0.01, and for NPA = 0.99 +/- 0.001. Pain in one or more areas was present in 47.7% of the subjects. For the whole sample, correlations between NPA and the validation indices were: PPI (0.91), PRI (0.89), PH (0.25), ABP (0.64), PIW (0.49), and PPH (0.20). Among the 196 subjects with pain, correlations were: PPI (0.34), PRI (0.34), PH (0.19), ABP

  12. Inter-observer reliability of two pain scales for newborns.

    PubMed

    Bellieni, Carlo V; Cordelli, Duccio M; Caliani, Caterina; Palazzi, Camilla; Franci, Nadia; Perrone, Serafina; Bagnoli, Franco; Buonocore, Giuseppe

    2007-08-01

    To assess inter-observer reliability of two of the most widely used pain scales for newborns. More than 30 scales exist to assess neonatal pain, but they are rarely used because they are too complicated or unreliable. We scored pain level in two groups of babies during a heelprick. The first group of 20 premature babies (mean gestational age: 34.2+/-1.2 weeks) was studied using the PIPP scale, and the second group of 20 term babies (mean gestational age: 39.5+/-0.9 weeks) with the NIPS scale. We compared the pain scores assigned by the nurse who took the blood sample (nurse A) and those assigned by another who was present during heelprick (nurse B) with those assigned by a nurse who later watched the video clip of the procedure (nurse C). We chose the latter as "objective" score, because in this case the scorer could watch the recorded event several times, timing and scoring it thoroughly. NIPS: 8/20 scores were different between nurse A and nurse C, but only in one case was this difference greater than 2 (Cohen's K=0.60). In the case of nurse B, there were 12/20 differences with respect to the score assigned by nurse C but only one baby was assigned a score that differed by more than 2 (Cohen's K=0.30). PIPP: 16/20 scores were different between nurse A and nurse C; in 9 cases this difference was more than 2 (Cohen's K=0.10). In the case of nurse B, differences with respect to the score assigned by nurse C occurred in 17/20 cases and for six babies the difference in score was more than 2 (Cohen's K=0.16). Our results indicate a higher inter-observer reliability of NIPS than PIPP, though NIPS did not have a very high inter-observer agreement score. Caregivers who use them to assess pain in real time at the cribside should be aware of the limits we have highlighted in this study.

  13. Microlaparoscopic Conscious Pain Mapping in the Evaluation of Chronic Pelvic Pain: A Case Report

    PubMed Central

    2002-01-01

    Chronic pelvic pain is a debilitating, life-altering syndrome that negatively affects a woman's quality of life and personal relationships. Many women continue to suffer with pelvic pain despite having undergone multiple medical and surgical treatments. Unfortunately, some women are incorrectly labeled as having psychological illness when organic disease may be present. I report a case of a woman who underwent multiple pelvic and abdominal surgeries before the cause of her pain was identified through microlaparoscopic conscious pain mapping. PMID:12004805

  14. Reliability of measures of impairments associated with patellofemoral pain syndrome

    PubMed Central

    Piva, Sara R; Fitzgerald, Kelley; Irrgang, James J; Jones, Scott; Hando, Benjamin R; Browder, David A; Childs, John D

    2006-01-01

    Background The reliability and measurement error of several impairment measures used during the clinical examination of patients with patellofemoral pain syndrome (PFPS) has not been established. The purpose was to determine the inter-tester reliability and measurement error of measures of impairments associated with PFPS in patients with PFPS. Methods A single group repeated measures design was used. Two pairs of physical therapists participated in data collection. Examiners were blinded to each others' measurements. Results Thirty patients (age 29 +/- 8; 17 female) with PFPS participated in this study. Inter-tester reliability coefficients were substantial for measures of hamstrings, quadriceps, plantarflexors, and ITB/TFL complex length, hip abductors strength, and foot pronation (ICCs from .85 to .97); moderate for measures of Q-angle, tibial torsion, hip external rotation strength, lateral retinacular tightness, and quality of movement during a step down task (ICCs from .67 to .79); and poor for femoral anteversion (ICC of .45). Standard error of measurement (SEM) for measures of muscle length ranged from 1.6 degrees to 4.3 degrees. SEM for Q-angle, tibial torsion, and femoral anteversion were 2.4 degrees, 2.9 degrees, and 4.5 degrees respectively. SEM for foot pronation was 1 mm. SEM for measures of muscle strength was 1.8 Kg for abduction and 2.4 Kg for external rotation. Conclusion Several of the impairments associated with PFPS had sufficient reliability and low measurement error. Further investigation is needed to test if these impairment measurements are related to physical function and whether or not they are useful for decision-making. PMID:16579850

  15. Test-retest reliability of pain-related functional brain connectivity compared with pain self-report.

    PubMed

    Letzen, Janelle E; Boissoneault, Jeff; Sevel, Landrew S; Robinson, Michael E

    2016-03-01

    Test-retest reliability, or reproducibility of results over time, is poorly established for functional brain connectivity (fcMRI) during painful stimulation. As reliability informs the validity of research findings, it is imperative to examine, especially given recent emphasis on using functional neuroimaging as a tool for biomarker development. Although proposed pain neural signatures have been derived using complex, multivariate algorithms, even the reliability of less complex fcMRI findings has yet to be reported. This study examined the test-retest reliability for fcMRI of pain-related brain regions, and self-reported pain (through visual analogue scales [VASs]). Thirty-two healthy individuals completed 3 consecutive fMRI runs of a thermal pain task. Functional connectivity analyses were completed on pain-related brain regions. Intraclass correlations were conducted on fcMRI values and VAS scores across the fMRI runs. Intraclass correlations coefficients for fcMRI values varied widely (range = -.174-.766), with fcMRI between right nucleus accumbens and medial prefrontal cortex showing the highest reliability (range = .649-.766). Intraclass correlations coefficients for VAS scores ranged from .906 to .947. Overall, self-reported pain was more reliable than fcMRI data. These results highlight that fMRI findings might be less reliable than inherently assumed and have implications for future studies proposing pain markers.

  16. Test-retest reliability of pain-related functional brain connectivity compared to pain self-report

    PubMed Central

    Letzen, Janelle E.; Boissoneault, Jeff; Sevel, Landrew S.; Robinson, Michael E.

    2015-01-01

    Test-retest reliability, or reproducibility of results over time, is poorly established for functional brain connectivity (fcMRI) during painful stimulation. As reliability informs the validity of research findings, it is imperative to examine, especially given recent emphasis on using functional neuroimaging as a tool for biomarker development. Although proposed pain neural signatures have been derived using complex, multivariate algorithms, even the reliability of less complex fcMRI findings has yet to be reported. The present study examined the test-retest reliability for fcMRI of pain-related brain regions, as well as self-reported pain [via visual analogue scales (VASs)]. Thirty-two healthy individuals completed three consecutive fMRI runs of a thermal pain task. Functional connectivity analyses were completed on pain-related brain regions. Intraclass correlations (ICC) were conducted on fcMRI values and VAS scores across the fMRI runs. ICC coefficients for fcMRI values varied widely (range = −.174–.766), with fcMRI between right nucleus accumbens and medial prefrontal cortex showing the highest reliability (range = .649–.766). ICC coefficients for VAS scores ranged from .906–.947. Overall, self-reported pain was more reliable than fcMRI data. These results highlight that fMRI findings might be less reliable than inherently assumed, and have implications for future studies proposing pain markers. PMID:26371795

  17. Pain Management: Road Map to Revolution.

    PubMed

    George, Steven Z

    2017-02-01

    Steven Z. George, PT, PhD, is a profound scholar whose contributions to the science of musculoskeletal pain rehabilitation have been both impactful and innovative to the area of clinical practice, as well as the profession at large. Highly regarded as an expert in pain-related psychosocial factors and their impact on rehabilitative outcomes, George is a clinical researcher decorated with accolades, ranging from substantial grant funding to high-impact publications. After 14 years at the University of Florida, George is currently Director of Musculoskeletal Research, Duke Clinical Research Institute, and Vice Chair of Clinical Research, Orthopaedic Surgery, at Duke University. He completed postdoctoral training in pain science and rehabilitation outcomes at the University of Florida and holds a PhD in rehabilitation science and MS in orthopedic physical therapy from the University of Pittsburgh and a BS in physical therapy from the West Virginia University School of Medicine. In his research, George has a primary theme focused on the use of biopsychosocial models to prevent and treat chronic musculoskeletal pain. Specific research areas include the effects of manual therapy on pain sensitivity, genetic and psychological risk factors associated with persistent pain and disability, and behavioral interventions for low back pain. Having authored over 185 peer-reviewed publications in physical therapy, orthopedic, rehabilitation, and pain research journals, George exemplifies a noteworthy level of compassion to improving the profession's, as well as society's, understanding of how to effectively provide pain relief. He is an editorial board member for Physical Therapy and Journal of Pain. He is also an International Editorial Review Board member for the Journal of Orthopaedic & Sports Physical Therapy. George's dedication has been highlighted through various awards, including the John C. Liebeskind Early Career Scholar Award from the American Pain Society, the Ulf

  18. Test-retest reliability of patient reports of low back pain.

    PubMed

    Roach, K E; Brown, M D; Dunigan, K M; Kusek, C L; Walas, M

    1997-11-01

    Low back pain is, in large part, a subjective illness. Clinicians must use patient descriptions of the severity and location of low back pain and how it responds to various activities and positions to make diagnostic and treatment decisions. Therefore, it is important to understand how reliably patients describe these aspects of low back pain. The purpose of this study was to determine the test-retest reliability of a visual analogue scale measure of pain intensity, a pain drawing measure of pain location, and the pain response to activity and position questionnaire. Fifty-three subjects (28 men and 25 women) with a mean age of 54.2 years were recruited from an outpatient orthopaedic clinic. They completed the visual analogue scale, pain drawing, and pain response to activity and position questionnaire before and again immediately after seeing their physician. Thirty-three subjects also completed the visual analogue scale and pain drawing measure that evening and the next morning. Test-retest reliability of the visual analogue scale and pain drawing measure was examined using an intraclass correlation coefficient. Reliability of each item on the pain response to activity and position questionnaire was examined by calculating an unweighted Cohen's kappa. Overall, the three pain measures demonstrated fair to good test-retest reliability: 1) visual analogue scale = .66-.93, 2) pain drawing = .58-.94, and 3) pain response to activity and position questionnaire = .46-.89. The results of this study suggest that, although there is some variability in how consistently patients report various aspects of low back pain, the reliability of these pain measures is sufficient to permit their use in making clinical decisions and measuring treatment outcomes.

  19. The reliability of clinical judgments and criteria associated with mechanisms-based classifications of pain in patients with low back pain disorders: a preliminary reliability study

    PubMed Central

    Smart, Keith M; Curley, Antoinette; Blake, Catherine; Staines, Anthony; Doody, Catherine

    2010-01-01

    Mechanisms-based classifications of pain have been advocated for their potential to aid understanding of clinical presentations of pain and improve clinical outcomes. However, the reliability of mechanisms-based classifications of pain and the clinical criteria upon which such classifications are based are not known. The purpose of this investigation was to assess the inter- and intra-examiner reliability of clinical judgments associated with: (i) mechanisms-based classifications of pain; and (ii) the identification and interpretation of individual symptoms and signs from a Delphi-derived expert consensus list of clinical criteria associated with mechanisms-based classifications of pain in patients with low back (±leg) pain disorders. The inter- and intra-examiner reliability of an examination protocol performed by two physiotherapists on two separate cohorts of 40 patients was assessed. Data were analysed using kappa and percentage of agreement values. Inter- and intra-examiner agreement associated with clinicians’ mechanisms-based classifications of low back (±leg) pain was ‘substantial’ (kappa  = 0.77; 95% confidence interval (CI): 0.57–0.96; % agreement  = 87.5) and ‘almost perfect’ (kappa  = 0.96; 95% CI: 0.92–1.00; % agreement = 92.5), respectively. Sixty-eight and 95% of items on the clinical criteria checklist demonstrated clinically acceptable (kappa ⩾ 0.61 or % agreement ⩾ 80%) inter- and intra-examiner reliability, respectively. The results of this study provide preliminary evidence supporting the reliability of clinical judgments associated with mechanisms-based classifications of pain in patients with low back (±leg) pain disorders. The reliability of mechanisms-based classifications of pain should be investigated using larger samples of patients and multiple independent examiners. PMID:21655393

  20. Mapping methods for computationally efficient and accurate structural reliability

    NASA Technical Reports Server (NTRS)

    Shiao, Michael C.; Chamis, Christos C.

    1991-01-01

    The influence of mesh coarseness in the structural reliability is evaluated. The objectives are to describe the alternatives and to demonstrate their effectiveness. The results show that special mapping methods can be developed by using: (1) deterministic structural responses from a fine (convergent) finite element mesh; (2) probabilistic distributions of structural responses from a coarse finite element mesh; (3) the relationship between the probabilistic structural responses from the coarse and fine finite element meshes; and (4) probabilistic mapping. The structural responses from different finite element meshes are highly correlated.

  1. Intrarater Reliability of Pain Intensity, Tissue Blood Flow, Thermal Pain Threshold, Pressure Pain Threshold and Lumbo-Pelvic Stability Tests in Subjects with Low Back Pain

    PubMed Central

    Paungmali, Aatit; Sitilertpisan, Patraporn; Taneyhill, Khanittha; Pirunsan, Ubon; Uthaikhup, Sureeporn

    2012-01-01

    Purpose This preliminary study aimed to determine the intrarater reliability of the quantitative tests for the study of non-specific low back pain. Methods Test-retest reliability of the measurements of ratio data was determined by an intraclass correlation coefficient (ICC), standard error of measurements (SEMs), coefficient of variation (CV), and one-way repeated measures ANOVA using the values collected from 13 young individuals (25.8 ± 6.2 years) with chronic non-specific low back pain on two occasions separated by 2 days. Percent agreement of the ordinal data was also determined by Cohen's Kappa statistics (kappa). The measures consisted of tissue blood flow (BF), average pain visual analog scales (VAS), pressure pain threshold (PPT), cold pain threshold (CPT), heat pain threshold (HPT) and lumbo-pelvic stability test (LPST). An acceptable reliability was determined as the ICC values of greater than 0.85, SEMs less than 5%, CV less than 15%, the kappa scores of greater than 80% and no evidence of systematic error (ANOVA, P>0.05). Results ICC of all measures in the lumbo-sacral area were greater than 0.87. The kappa was also greater than 83%. Most measures demonstrated a minimal error of measurements and less potential of systemic error in nature. Only the SEMs and the CV of the CPT exceeded the acceptable level. Conclusions It is concluded that most of the quantitative measurements are reliable for the study of non-specific low back pain, however the CPT should be applied with care as it has a great variation among individuals and potential of measurement error. PMID:22461960

  2. Technology mapping for hot-carrier reliability enhancement

    NASA Astrophysics Data System (ADS)

    Chen, Zhan; Koren, Israel

    1997-09-01

    As semiconductor devices enter the deep sub-micron era, reliability has become a major issue and challenge in VLSI design. Among all the failure mechanisms, hot-carrier effect is one of those which have the most significant impact on the long-term reliability of high-density VLSI circuits. In this paper, we address the problem of minimizing hot-carrier effect during the technology mapping stage of VLSI logic synthesis. We first present a logic-level hot-carrier model, and then, based on this model, we propose a technology mapping algorithm for hot-carrier effect minimization. The proposed algorithm has been implemented in the framework of the Berkeley logic optimization package SIS. Our results show that an average of 29. 1% decrease in hot-carrier effect can be achieved by carefully choosing logic gates from cell libraries to implement given logic functions for a set of benchmarks. It has also been observed that the best design for hot-carrier effect minimization does not necessarily coincide with the best design for low power, which has long been considered as a rough measure for VLSI reliability.

  3. On the reliability of manually produced bedrock lineament maps

    NASA Astrophysics Data System (ADS)

    Scheiber, Thomas; Viola, Giulio; Fredin, Ola; Jarna, Alexandra; Gasser, Deta; Łapinska-Viola, Renata

    2016-04-01

    Manual extraction of topographic features from digital elevation models (DEMs) is a commonly used technique to produce lineament maps of fractured basement areas. There are, however, several sources of bias which can influence the results. In this study we investigated the influence of the factors (a) scale, (b) illumination azimuth and (c) operator on remote sensing results by using a LiDAR (Light Detection and Ranging) DEM of a fractured bedrock terrain located in SW Norway. Six operators with different backgrounds in Earth sciences and remote sensing techniques mapped the same LiDAR DEM at three different scales and illuminated from three different directions. This resulted in a total of 54 lineament maps which were compared on the basis of number, length and orientation of the drawn lineaments. The maps show considerable output variability depending on the three investigated factors. In detail: (1) at larger scales, the number of lineaments drawn increases, the line lengths generally decrease, and the orientation variability increases; (2) Linear features oriented perpendicular to the source of illumination are preferentially enhanced; (3) The reproducibility among the different operators is generally poor. Each operator has a personal mapping style and his/her own perception of what is a lineament. Consequently, we question the reliability of manually produced bedrock lineament maps drawn by one person only and suggest the following approach: In every lineament mapping study it is important to define clear mapping goals and design the project accordingly. Care should be taken to find the appropriate mapping scale and to establish the ideal illumination azimuths so that important trends are not underrepresented. In a remote sensing project with several persons included, an agreement should be reached on a given common view on the data, which can be achieved by the mapping of a small test area. The operators should be aware of the human perception bias. Finally

  4. Brain and human pain: topographic EEG amplitude and coherence mapping.

    PubMed

    Chen, A C; Rappelsberger, P

    1994-01-01

    Nineteen young healthy volunteers (8 males and 11 females) participated in an experimental ice-cube cold pressor test to study topographic changes of EEG parameters in response to painful stimulation. EEG was recorded with 19 electrodes and quantified by amplitude and coherence analyses. Mean amplitudes and values for local (between adjacent electrodes) and interhemispheric (between electrodes on homologous sites of both hemispheres) coherences were computed for six frequency bands. For the evaluation of changes between EEG at rest (baseline) and EEG during painful stimulation (right or left hand), non-parametric paired Wilcoxon tests were performed. The obtained descriptive error probabilities were presented in probability maps. In the behavioural pain tolerance and subjective pain ratings, no difference in gender or stimulation condition was observed. Under painful stimulation the results showed: (A) most pronounced decrease of Alpha amplitude in the central areas and some increase of high Beta amplitude; (B) increase of local coherence for Alpha and Beta 2 mainly in central regions and centro-frontal leads; and (C) increase of interhemispheric coherence for Alpha and Beta 2 in the central areas. The results of this study indicate clearly that peripheral painful stimulation is reflected by EEG changes. Decrease of EEG amplitude and simultaneous increase of EEG coherence in the central regions can be cortical correlates of human pain.

  5. Orofacial Pain during Mastication in People with Dementia: Reliability Testing of the Orofacial Pain Scale for Non-Verbal Individuals

    PubMed Central

    de Vries, Merlijn W.; Visscher, Corine; Delwel, Suzanne; van der Steen, Jenny T.; Pieper, Marjoleine J. C.; Scherder, Erik J. A.; Achterberg, Wilco P.; Lobbezoo, Frank

    2016-01-01

    Objectives. The aim of this study was to establish the reliability of the “chewing” subscale of the OPS-NVI, a novel tool designed to estimate presence and severity of orofacial pain in nonverbal patients. Methods. The OPS-NVI consists of 16 items for observed behavior, classified into four categories and a subjective estimate of pain. Two observers used the OPS-NVI for 237 video clips of people with dementia in Dutch nursing homes during their meal to observe their behavior and to estimate the intensity of orofacial pain. Six weeks later, the same observers rated the video clips a second time. Results. Bottom and ceiling effects for some items were found. This resulted in exclusion of these items from the statistical analyses. The categories which included the remaining items (n = 6) showed reliability varying between fair-to-good and excellent (interobserver reliability, ICC: 0.40–0.47; intraobserver reliability, ICC: 0.40–0.92). Conclusions. The “chewing” subscale of the OPS-NVI showed a fair-to-good to excellent interobserver and intraobserver reliability in this dementia population. This study contributes to the validation process of the OPS-NVI as a whole and stresses the need for further assessment of the reliability of the OPS-NVI with subjects that might already show signs of orofacial pain. PMID:26977118

  6. Reliability of assessing end-feel and pain and resistance sequence in subjects with painful shoulders and knees.

    PubMed

    Hayes, K W; Petersen, C M

    2001-08-01

    Descriptive. Examine the intrarater and interrater reliability of end-feel and pain/resistance sequence for patients with painful shoulders and knees. Clinicians make diagnostic and intervention decisions based on end-feel and pain/resistance sequence, but few studies have examined agreement within and between physical therapists when assessing subjects with pathology. Subjects with unilateral knee pain (18 men and 22 women with a mean age of 31.8 +/- 9.5 years) or shoulder pain (21 men and 25 women with a mean age of 34.3 +/- 12.9 years) were examined twice. Two physical therapists used standardized positions to evaluate 2 knee motions and 5 shoulder motions. Evaluators did not interview subjects and were blinded to previous test results. Evaluators applied overpressure and noted the end-feel while subjects identified the moment their pain was reproduced. Following testing, subjects rated their pain intensity. Analyses included: percentage of agreement; kappa, weighted kappa, and maximum kappa coefficients; and confidence intervals. Analyses were repeated for subjects whose pain intensity during testing did not change between examinations. Intrarater kappa coefficients varied from 0.65 to 1.00 for end-feel, and intrarater weighted kappa coefficients varied from 0.59 to 0.87 for pain/resistance sequence. Most coefficients remained stable or improved for the unchanged subjects. Interrater kappa coefficients for end-feel and weighted kappa coefficients for pain/resistance sequence varied from -0.01 to 0.70. End-feel kappa coefficients remained low for the unchanged subjects, but pain/resistance sequence weighted kappa coefficients improved. Unbalanced distribution affected many coefficients, producing low coefficients even when the percentage of agreement was high. The appropriate use of end-feel and pain/resistance sequence data requires reliable data gathering, especially when patients are managed by more than one physical therapist. Intrarater reliability of end

  7. The application of high-reliability theory to promote pain management.

    PubMed

    Samuels, Joanne G

    2010-11-01

    Evidence-based pain management, a high-volume hospital service, impacts resource utilization and quality indicators. Despite extensive efforts to improve care, outcomes remain poor, and barriers seem insurmountable. Change management strategies that embrace organizational and individual accountabilities are warranted. Conceptualizing evidence-based pain management within the context of high-reliability theory may help redesign systems and processes to better meet needs of patients. The author discusses using a high-reliability framework as a change management strategy.

  8. Sensitivity and Specificity of Reliable Digit Span in Malingered Pain-Related Disability

    ERIC Educational Resources Information Center

    Etherton, Joseph L.; Bianchini, Kevin J.; Greve, Kevin W.; Heinly, Matthew T.

    2005-01-01

    The reliable digit span (RDS) performance of chronic pain patients with unambiguous spinal injuries and no evidence of exaggeration or response bias (n = 53) was compared to that of chronic pain patients meeting criteria for definite malingered neurocognitive dysfunction (n = 35), and a group of nonmalingering moderate-severe traumatic brain…

  9. Sensitivity and Specificity of Reliable Digit Span in Malingered Pain-Related Disability

    ERIC Educational Resources Information Center

    Etherton, Joseph L.; Bianchini, Kevin J.; Greve, Kevin W.; Heinly, Matthew T.

    2005-01-01

    The reliable digit span (RDS) performance of chronic pain patients with unambiguous spinal injuries and no evidence of exaggeration or response bias (n = 53) was compared to that of chronic pain patients meeting criteria for definite malingered neurocognitive dysfunction (n = 35), and a group of nonmalingering moderate-severe traumatic brain…

  10. Reliability and Validity of the Korean Cancer Pain Assessment Tool (KCPAT)

    PubMed Central

    Kim, Jeong A; Lee, Juneyoung; Park, Jeanno; Lee, Myung Ah; Yeom, Chang Hwan; Jang, Se Kwon; Yoon, Duck Mi; Kim, Jun Suk

    2005-01-01

    The Korean Cancer Pain Assessment Tool (KCPAT), which was developed in 2003, consists of questions concerning the location of pain, the nature of pain, the present pain intensity, the symptoms associated with the pain, and psychosocial/spiritual pain assessments. This study was carried out to evaluate the reliability and validity of the KCPAT. A stratified, proportional-quota, clustered, systematic sampling procedure was used. The study population (903 cancer patients) was 1% of the target population (90,252 cancer patients). A total of 314 (34.8%) questionnaires were collected. The results showed that the average pain score (5 point on Likert scale) according to the cancer type and the at-present average pain score (VAS, 0-10) were correlated (r=0.56, p<0.0001), and showed moderate agreement (kappa=0.364). The mean satisfaction score was 3.8 (1-5). The average time to complete the questionnaire was 8.9 min. In conclusion, the KCPAT is a reliable and valid instrument for assessing cancer pain in Koreans. PMID:16224166

  11. Reliability and Validity of the Pain Anxiety Symptom Scale in Persian Speaking Chronic Low Back Pain Patients.

    PubMed

    Shanbehzadeh, Sanaz; Salavati, Mahyar; Tavahomi, Mahnaz; Khatibi, Ali; Moghadam, Saeed Talebian; Khademi-Kalantari, Khosro

    2017-03-06

    Psychometric testing of the Persian version of Pain Anxiety Symptom Scale 20 OBJECTIVE.: To assess the reliability and construct validity of the PASS-20 in nonspecific chronic Low back pain (LBP) patients. The PASS-20 is a self-report questionnaire that assess pain related anxiety. The Psychometric properties of this instrument has not been assessed in Persian speaking chronic LBP patients. One hundred and sixty participants with chronic LBP completed the Persian version of PASS-20, Tampa Scale of Kinesiophobia (TSK), Fear-Avoidance Beliefs Questionnaire (FABQ), Pain Catastrophizing Scale (PCS), trait form of the State-Trait Anxiety (STAI-T), Oswestry Low Back Pain Disability Index (ODI), Beck Depression Inventory (BDI-II) and Visual Analogue Scale (VAS). In order to evaluate test-retest reliability, sixty patients filled out the PASS-20, 6 to 8 days after the first visit. Test-retest reliability (ICC, SEM and MDC), internal consistency, dimensionality and construct validity were examined. The ICCs of the PASS-20 subscales and total score ranged from 0.71 to 0.8. The SEMs for PASS-20 total score was 7.29 and for the subscales ranged from 2.43 to 2.98. The MDC for the total score was 20.14 and for the subscales ranged from 6.71 to 8.23. The Cronbach's alpha values for the subscales and total score ranged from 0.70 to 0.91. Significant positive correlations were found between the PASS-20 total score and PCS, TSK, FABQ, ODI, BDI, STAI-T and pain intensity. The Persian version of the PASS-20 showed acceptable psychometric properties for the assessment of pain related anxiety in Persian speaking patients with chronic LBP. 3.

  12. Reliability and validity of cervical position measurements in individuals with and without chronic neck pain

    PubMed Central

    Neil, Joseph; Tallon, Allison; Adamo, Diane E.

    2015-01-01

    Objectives The cervical range of motion device (CROM) has been shown to provide reliable forward head position (FHP) measurement when the upper cervical angle (UCA) is controlled. However, measurement without UCA standardization is reflective of habitual patterns. Criterion validity has not been reported. The purposes of this study were to establish: (1) criterion validity of CROM FHP and UCA compared to Optotrak data, (2) relative reliability and minimal detectable change (MDC95) in patients with and without cervical pain, and (3) to compare UCA and FHP in patients with and without pain in habitual postures. Methods (1) Within-subjects single session concurrent criterion validity design. Simultaneous CROM and OP measurement was conducted in habitual sitting posture in 16 healthy young adults. (2) Reliability and MDC95 of UCA and FHP were calculated from three trials. (3) Values for adults over 35 years with cervical pain and age-matched healthy controls were compared. Results (1) Forward head position distances were moderately correlated and UCA angles were highly correlated. The mean (standard deviation) differences can be expected to vary between 1·48 cm (1·74) for FHP and −1·7 (2·46)° for UCA. (2) Reliability for CROM FHP measurements were good to excellent (no pain) and moderate (pain). Cervical range of motion FHP MDC95 was moderately low (no pain), and moderate (pain). Reliability for CROM UCA measurements was excellent and MDC95 low for both groups. There was no difference in FHP distances between the pain and no pain groups, UCA was significantly more extended in the pain group (P<0·05). Discussion Cervical range of motion FHP measurements were only moderately correlated with Optotrak data, and limits of agreement (LOA) and MDC95 were relatively large. There was also no difference in CROM FHP distance between older symptomatic and asymptomatic individuals. Cervical range of motion FHP measurement is therefore not recommended as a clinical outcome

  13. Reliability and validity of cervical position measurements in individuals with and without chronic neck pain.

    PubMed

    Dunleavy, Kim; Neil, Joseph; Tallon, Allison; Adamo, Diane E

    2015-09-01

    The cervical range of motion device (CROM) has been shown to provide reliable forward head position (FHP) measurement when the upper cervical angle (UCA) is controlled. However, measurement without UCA standardization is reflective of habitual patterns. Criterion validity has not been reported. The purposes of this study were to establish: (1) criterion validity of CROM FHP and UCA compared to Optotrak data, (2) relative reliability and minimal detectable change (MDC95) in patients with and without cervical pain, and (3) to compare UCA and FHP in patients with and without pain in habitual postures. (1) Within-subjects single session concurrent criterion validity design. Simultaneous CROM and OP measurement was conducted in habitual sitting posture in 16 healthy young adults. (2) Reliability and MDC95 of UCA and FHP were calculated from three trials. (3) Values for adults over 35 years with cervical pain and age-matched healthy controls were compared. (1) Forward head position distances were moderately correlated and UCA angles were highly correlated. The mean (standard deviation) differences can be expected to vary between 1·48 cm (1·74) for FHP and -1·7 (2·46)° for UCA. (2) Reliability for CROM FHP measurements were good to excellent (no pain) and moderate (pain). Cervical range of motion FHP MDC95 was moderately low (no pain), and moderate (pain). Reliability for CROM UCA measurements was excellent and MDC95 low for both groups. There was no difference in FHP distances between the pain and no pain groups, UCA was significantly more extended in the pain group (P<0·05). Cervical range of motion FHP measurements were only moderately correlated with Optotrak data, and limits of agreement (LOA) and MDC95 were relatively large. There was also no difference in CROM FHP distance between older symptomatic and asymptomatic individuals. Cervical range of motion FHP measurement is therefore not recommended as a clinical outcome measure. Cervical range of motion UCA

  14. Interrater reliability of the history and physical examination in patients with mechanical neck pain.

    PubMed

    Cleland, Joshua A; Childs, John D; Fritz, Julie M; Whitman, Julie M

    2006-10-01

    To examine the interrater reliability of the history and physical examination in patients with mechanical neck pain. Single-group repeated measures for interrater reliability. Outpatient physical therapy clinic. Twenty-two patients with mechanical neck pain underwent a standardized history and physical examination by a physical therapist. Following a 5-minute break, a second therapist who was blind to the findings of examiner 1 performed the second standardized history and physical examination. The Cohen kappa and weighted kappa were used to calculate the interrater reliability of ordinal level data from the history and physical examination. Intraclass correlation coefficients model 2,1 (ICC(2,1)) and the 95% confidence intervals were calculated to determine the interrater reliability for continuous variables. The kappa coefficients ranged from -.06 to .90 for the variables obtained from the history. Reliability values for categorical data collected during the physical examination ranged from no to substantial agreement depending on the particular test and measure. ICC(2,1) for cervical range of motion (ROM) measurements ranged between .66 and .78. We have reported the interrater reliability of the history and physical examination in a group of patients with a primary report of neck pain. The reliability variables varied considerably for manual assessment techniques and were significantly higher for the examination of muscle length and cervical ROM. Ultimately, it will be up to each clinician to determine if a particular test or measure poses adequate reliability to assist in the clinical decision making process.

  15. Measuring the Pain Area: An Intra- and Inter-Rater Reliability Study Using Image Analysis Software.

    PubMed

    Dos Reis, Felipe Jose Jandre; de Barros E Silva, Veronica; de Lucena, Raphaela Nunes; Mendes Cardoso, Bruno Alexandre; Nogueira, Leandro Calazans

    2016-01-01

    Pain drawings have frequently been used for clinical information and research. The aim of this study was to investigate intra- and inter-rater reliability of area measurements performed on pain drawings. Our secondary objective was to verify the reliability when using computers with different screen sizes, both with and without mouse hardware. Pain drawings were completed by patients with chronic neck pain or neck-shoulder-arm pain. Four independent examiners participated in the study. Examiners A and B used the same computer with a 16-inch screen and wired mouse hardware. Examiner C used a notebook with a 16-inch screen and no mouse hardware, and Examiner D used a computer with an 11.6-inch screen and a wireless mouse. Image measurements were obtained using GIMP and NIH ImageJ computer programs. The length of all the images was measured using GIMP software to a set scale in ImageJ. Thus, each marked area was encircled and the total surface area (cm(2) ) was calculated for each pain drawing measurement. A total of 117 areas were identified and 52 pain drawings were analyzed. The intrarater reliability between all examiners was high (ICC = 0.989). The inter-rater reliability was also high. No significant differences were observed when using different screen sizes or when using or not using the mouse hardware. This suggests that the precision of these measurements is acceptable for the use of this method as a measurement tool in clinical practice and research. © 2014 World Institute of Pain.

  16. Reliability of phantom pain relief in neurorehabilitation using a multimodal virtual reality system.

    PubMed

    Sano, Yuko; Ichinose, Akimichi; Wake, Naoki; Osumi, Michihiro; Sumitani, Masahiko; Kumagaya, Shin-Ichiro; Kuniyoshi, Yasuo

    2015-01-01

    The objective of this study is to demonstrate the reliability of relief from phantom limb pain in neurore-habilitation using a multimodal virtual reality system. We have developed a virtual reality rehabilitation system with multimodal sensory feedback and applied it to six patients with brachial plexus avulsion or arm amputation. In an experiment, patients executed a reaching task using a virtual phantom limb displayed in a three-dimensional computer graphic environment manipulated by their real intact limb. The intensity of the phantom limb pain was evaluated through a short-form McGill pain questionnaire. The experiments were conducted twice on different days at more than four-week intervals for each patient. The reliability of our task's ability to relieve pain was demonstrated by the test-retest method, which checks the degree of the relative similarity between the pain reduction rates in two experiments using Fisher's intraclass correlation coefficient (ICC). The ICC was 0.737, indicating sufficient reproducibility of our task. The average of the reduction rates across participants was 50.2%, and it was significantly different from 0 (p <; 0:001). Overall, our findings indicate that neurorehabilitation using our multimodal virtual reality system reduces the phantom limb pain with sufficient reliability.

  17. Patient rating of wrist pain and disability: a reliable and valid measurement tool.

    PubMed

    MacDermid, J C; Turgeon, T; Richards, R S; Beadle, M; Roth, J H

    1998-01-01

    The goal of this study was to develop a reliable and valid tool for quantifying patient-rated wrist pain and disability. Survey, tool development, reliability, and validity study. Upper extremity unit. One hundred members of the International Wrist Investigators were surveyed by mail to assist in development of the scale. Patients with distal radius (n = 64) or scaphoid (n = 35) fractures were enrolled in a reliability study, and 101 patients with distal radius fractures were enrolled in a validity study. Information from the expert survey, biomechanical literature, and patient interviews was used as a basis for item generation and definition of structural limitations for a scale that would be practical in the clinic. Patients with distal radius or scaphoid fractures completed the Patient-Rated Wrist Evaluation (PRWE) on two occasions to determine test-retest reliability. Patients with distal radius fractures (n = 101) completed the PRWE and the SF-36 and were tested with traditional impairment measures at baseline and at two, three, and six months after fracture to determine construct and criterion validity. Reliability coefficients (ICCs) and validity correlations (Pearson product moment correlations). Patient opinions on pain and on ability to do activities of daily living and work were thought to be the most important dimensions to include in subjective outcome tools. Brevity and simplicity were seen as essential in the clinic environment. A fifteen-item questionnaire (the PRWE) was designed to measure wrist pain and disability. Test-retest reliability was excellent (ICCs > 0.90). Validity assessment demonstrated that the instrument detected significant differences over time (p < 0.01) and was appropriately correlated with alternate forms of assessing parameters of pain and disability. The PRWE provides a brief, reliable, and valid measure of patient-rated pain and disability.

  18. An evidence map of yoga for low back pain.

    PubMed

    Goode, Adam P; Coeytaux, Remy R; McDuffie, Jennifer; Duan-Porter, Wei; Sharma, Poonam; Mennella, Hillary; Nagi, Avishek; Williams, John W

    2016-04-01

    Yoga is being increasingly studied as a treatment strategy for a variety of different clinical conditions, including low back pain (LBP). We set out to conduct an evidence map of yoga for the treatment, prevention and recurrence of acute or chronic low back pain (cLBP). We searched Medline, Cochrane Database of Systematic Reviews, EMBASE, Allied and Complementary Medicine Database and ClinicalTrials.gov for randomized controlled trials (RCT), systematic reviews or planned studies on the treatment or prevention of acute back pain or cLBP. Two independent reviewers screened papers for inclusion, extracted data and assessed the quality of included studies. Three eligible systematic reviews were identified that included 10 RCTs (n=956) that evaluated yoga for non-specific cLBP. We did not identify additional RCTs beyond those included in the systematic reviews. Our search of ClinicalTrials.gov identified one small (n=10) unpublished trial and one large (n=320) planned clinical trial. The most recent good quality systematic review indicated significant effects for short- and long-term pain reduction (n=6 trials; standardized mean difference [SMD] -0.48; 95% CI, -0.65 to -0.31; I(2)=0% and n=5; SMD -0.33; 95% CI, -0.59 to -0.07; I(2)=48%, respectively). Long-term effects for back specific disability were also identified (n=5; SMD -0.35; 95% CI, -0.55 to -0.15; I(2)=20%). No studies were identified evaluating yoga for prevention or treatment of acute LBP. Evidence suggests benefit of yoga in midlife adults with non-specific cLBP for short- and long-term pain and back-specific disability, but the effects of yoga for health-related quality of life, well- being and acute LBP are uncertain. Without additional studies, further systematic reviews are unlikely to be informative. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Reliability of the Superimposed-Burst Technique in Patients With Patellofemoral Pain: A Technical Report.

    PubMed

    Norte, Grant E; Frye, Jamie L; Hart, Joseph M

    2015-11-01

    The superimposed-burst (SIB) technique is commonly used to quantify central activation failure after knee-joint injury, but its reliability has not been established in pathologic cohorts. To assess within-session and between-sessions reliability of the SIB technique in patients with patellofemoral pain. Descriptive laboratory study. University laboratory. A total of 10 patients with self-reported patellofemoral pain (1 man, 9 women; age = 24.1 ± 3.8 years, height = 167.8 ± 15.2 cm, mass = 71.6 ± 17.5 kg) and 10 healthy control participants (3 men, 7 women; age = 27.4 ± 5.0 years, height = 173.5 ± 9.9 cm, mass = 78.2 ± 16.5 kg) volunteered. Participants were assessed at 6 intervals spanning 21 days. Intraclass correlation coefficients (ICCs [3,3]) were used to assess reliability. Quadriceps central activation ratio, knee-extension maximal voluntary isometric contraction force, and SIB force. The quadriceps central activation ratio was highly reliable within session (ICC [3,3] = 0.97) and between sessions through day 21 (ICC [3,3] = 0.90-0.95). Acceptable reliability of knee extension (ICC [3,3] = 0.75-0.91) and SIB force (ICC [3,3] = 0.77-0.89) was observed through day 21. The SIB technique was reliable for clinical research up to 21 days in patients with patellofemoral pain.

  20. Validity and reliability of a pain location tool for pediatric abdominal surgery.

    PubMed

    Hamill, James K; Cole, Alana M; Liley, Andrew; Hill, Andrew G

    2015-06-01

    For children with surgical problems, pain location conveys important clinical information. We developed a Location and Level of Intensity of Postoperative Pain (Lolipops) tool consisting of a body outline with a seven-sector abdominal grid, the International Association for the Study of Pain Revised Faces Pain Scale, and a recording chart. The aim of the study was to assess the validity and reliability of Lolipops. Children aged 5-14 years who had undergone laparoscopic appendectomy took both nurse- and investigator-administered Lolipops, and an investigator administered Varni Thompson Pediatric Pain Questionnaires, within 24 hours of surgery. The average age of the 42 participants was 10.7 years; 64% were boys; 24 (57.1%) had acute appendicitis, 13 (31%) had perforated appendicitis, and 5 (11.9%) were uninflamed. Pain scores were higher at the laparoscopic port incision sites than in upper abdominal sites distant from incisions or expected inflammation, mean (SD) 3.3 (2.3) and 1.1 (1.8), respectively (p < .0001). In children with acute appendicitis, pain scores were higher in the right iliac fossa than in upper abdominal sites, mean (SD) 3.3 (2.5) and 0.4 (0.7), respectively (p = .001). In children with perforated appendicitis, Lolipops demonstrated a more widespread pain pattern. Correlations between nurse and investigator were fair to moderate with an overall intraclass correlation coefficient of 0.597. This study presents a new tool to measure the location of pain in pediatric surgical patients and shows it to be valid and reliable.

  1. Agreement between physiotherapists rating scapular posture in multiple planes in patients with neck pain: Reliability study.

    PubMed

    O'Leary, Shaun; Christensen, Steffan W; Verouhis, Alexis; Pape, Morten; Nilsen, Oivind; McPhail, Steven M

    2015-12-01

    Evaluation of scapular posture is an integral component of the clinical assessment of painful neck disorders. The aim of this study was to evaluate agreement between therapist judgements of scapula posture in multiple biomechanical planes in individuals with neck pain. Inter-therapist reliability study. Research laboratory. Fifteen participants with chronic neck pain. Four physiotherapists recorded ratings of scapular orientation (relative to the thorax) in five different scapula postural planes (plane of scapula, sagittal plane, transverse plane, horizontal plane, and vertical plane) under four test conditions (at rest, and during three isometric shoulder conditions) in all participants. Inter-therapist reliability was expressed using both generalized and paired kappa coefficient. Following adjustment for expected agreement and the high prevalence of neutral ratings (81%), on average both the generalised kappa (0.37) as well as Cohen's Kappa for the two therapist pairs (0.45 and 0.42) demonstrated only slight to moderate inter-therapist reliability. The findings suggest that ratings of scapular posture in individuals with neck pain by visual inspection has only slight to moderate reliability and should only be used in conjunction with other clinical tests when judging scapula function in these patients. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  2. Training induces scapular dyskinesis in pain-free competitive swimmers: a reliability and observational study.

    PubMed

    Madsen, Pernille H; Bak, Klaus; Jensen, Susanne; Welter, Ulrik

    2011-03-01

    Scapular dyskinesis is a major etiological factor in overhead athletes' shoulder problems. Our hypotheses were to evaluate if (1) visual observation of scapular dyskinesis during scaption has substantial interobserver reliability, and (2) scapular dyskinesis may be induced by swim training in pain-free swimmers. A reliability and observational study. Bachelor project at a college institution and at a private sports orthopedic hospital. Seventy-eight competitive swimmers with no history of shoulder pain were included in the study. Fourteen swimmers were evaluated regarding reliability. Inclusion criteria were competitive swimmers with high training volume who previously had no shoulder pain. Observations of scapular dyskinesis (yes/no) during simple scaption. The interobserver reliability of scaption and wall push-up was evaluated in 14 swimmers using kappa analysis. Prevalence of scapular dyskinesis at 4 time intervals during a swim training session. The scaption test resulted in a weighted kappa value of 0.75. Scapular dyskinesis was seen in 29 shoulders (37%) after the first time interval, in another 24 (cumulated prevalence 68%) after one-half of the training session, and in an additional 4 swimmers (cumulated prevalence 73%) after three-quarters of the training session. During the last quarter of the training session, another 7 swimmers had dyskinesis, resulting in a cumulated prevalence of 82%. The prevalence of abnormal scapular kinesis during a normal training session is high in previously pain-free swimmers. The prevalence increases with more training and occurs early during the training session.

  3. The Reliability of Maitland's Irritability Judgments in Patients with Low Back Pain

    PubMed Central

    Barakatt, Edward T; Romano, Patrick S; Riddle, Daniel L; Beckett, Laurel A

    2009-01-01

    Maitland's construct of musculoskeletal pain irritability is widely used by physical therapists but has not been defined to the extent that its measurement properties can be tested. The purpose of this study was to examine the inter-rater reliability of physical therapists' irritability judgments during application to patients with low back pain (LBP). Eighty patients with LBP received two consecutive examinations at their initial clinic visit by two physical therapists. Patients reported pain location and intensity prior to each evaluation. Therapists judged subjects' LBP as irritable or non-irritable. Inter-rater agreement of physical therapist irritability judgments was moderate (kappa = 0.44, prevalence-adjusted kappa = 0.50). This level of reliability of therapists' LBP irritability judgments may be improved upon by development of an operational definition of pain irritability. Further research is needed to identify measures appropriate for inclusion in an operational definition of pain irritability and to assess the value of making pain irritability judgments in evidence-based physical therapy practice. PMID:20046619

  4. The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping.

    PubMed

    van Randeraad-van der Zee, Carlijn H; Beurskens, Anna J H M; Swinkels, Raymond A H M; Pool, Jan J M; Batterham, Roy W; Osborne, Richard H; de Vet, Henrica C W

    2016-05-01

    To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.

  5. Reliability and construct validity of self-report questionnaires for patients with pelvic girdle pain.

    PubMed

    Grotle, Margreth; Garratt, Andrew M; Krogstad Jenssen, Hanne; Stuge, Britt

    2012-01-01

    There is little evidence for the measurement properties of instruments commonly used for women with pelvic girdle pain. The aim of this study was to examine the internal consistency, test-retest reliability, and construct validity of instruments used for women with pelvic girdle pain. This was a cross-sectional methodology study, including test-retest reliability assessment. Women with pelvic girdle pain in pregnancy and after delivery participated in a postal survey that included the Pelvic Girdle Questionnaire (PGQ), Oswestry Disability Index (ODI), Disability Rating Index (DRI), Fear-Avoidance Beliefs Questionnaire (FABQ), Pain Catastrophizing Scale (PCS), and 8-item version of the Medical Study 36-Item Short-Form Health Survey questionnaire (SF-36). Test-retest reliability was assessed with a random subsample 1 week later. Internal consistency was assessed with the Cronbach alpha, and test-retest reliability was assessed with the intraclass correlation coefficient (ICC) and minimal detectable change (MDC). Construct validity based on hypotheses was assessed by correlation analysis. Discriminant validity was assessed with the area under the receiver operating characteristic curve. All participants responded to the main (N=87) and test-retest (n=42) surveys. Cronbach alpha values ranged from .88 to .94, and ICCs ranged from .78 to .94. The MDC at the individual level constituted about 7% to 14% of total scores for the 8-item version of the SF-36, ODI, and PGQ activity subscale; about 18% to 22% for the DRI, PGQ symptom subscale, and PCS; and about 25% for the FABQ. Hypotheses were mostly confirmed by correlations between the instruments. The PGQ was the only instrument that significantly discriminated participants who were pregnant from participants who were not pregnant as well as pain locations. A comparison of responsiveness to change of the various instruments used in this study was not undertaken, but will be carried out in a future study. Self

  6. Feasibility and reliability of pain pressure threshold measurements in patellar tendinopathy.

    PubMed

    van Wilgen, Paul; van der Noord, Robert; Zwerver, Johannes

    2011-11-01

    Patellar tendinopathy is a common and often difficult to treat overuse injury which is characterized by activity-related anterior knee and focal palpation tenderness of the patellar tendon. The clinical diagnosis is mainly based on clinical examination, in which the yardstick is a non-standardized manual palpation. To standardize this palpation procedure the use of an algometer seems applicable. The purpose of this study was to investigate the feasibility and reliability of the algometer in patellar tendinopathy. A cross sectional study was carried out.The algometer was applied to the patellar tendon in 20 asymptomatic volleyball players to measure the 'normal' pressure pain threshold. The inter-rater reliability was analyzed in 54 athletes with symptomatic patellar tendinopathy, the intra-rater reliability was analyzed in 48 athletes with symptomatic patellar tendinopathy. During the procedure difficulties were described, the SEM, intra class correlations and limits of agreement were determined using the Bland and Altman method. The feasibility of the algometer is adequate. The PPT of asymptomatic athletes differs significantly (p<.001) from athletes with a diagnosis of patellar tendinopathy. The inter-rater (ICC 0.93) and intra-rater (ICC 0.60) reliability of the pain pressure threshold are adequate to moderate. Although further research is warranted PPT algometry seems to be a feasible, reliable and useful tool in the diagnosis and treatment evaluation of athletes with patellar tendinopathy.

  7. Reliability and differentiation capability of dynamic and static kinematic measurements of rearfoot eversion in patellofemoral pain.

    PubMed

    Silva, Danilo de Oliveira; Briani, Ronaldo Valdir; Pazzinatto, Marcella Ferraz; Ferrari, Deisi; Aragão, Fernando Amâncio; Albuquerque, Carlos Eduardo de; Alves, Neri; Azevedo, Fábio Mícolis de

    2015-02-01

    Excessive rearfoot eversion is thought to be a risk factor for patellofemoral pain development, due to the kinesiological relationship with ascendant adaptations. Individuals with patellofemoral pain are often diagnosed through static clinical tests, in scientific studies and clinical practice. However, the adaptations seem to appear in dynamic conditions. Performing static vs. dynamic evaluations of widely used measures would add to the knowledge in this area. Thus, the aim of this study was to determine the reliability and differentiation capability of three rearfoot eversion measures: rearfoot range of motion, static clinical test and static measurement using a three-dimensional system. A total of 29 individuals with patellofemoral pain and 25 control individuals (18-30 years) participated in this study. Each subject underwent three-dimensional motion analysis during stair climbing and static clinical tests. Intraclass correlation coefficient and standard error measurements were performed to verify the reliability of the variables and receiver operating characteristic curves to show the diagnostic accuracy of each variable. In addition, analyses of variance were performed to identify differences between groups. Rearfoot range of motion demonstrated higher diagnostic accuracy (an area under the curve score of 0.72) than static measures and was able to differentiate the groups. Only the static clinical test presented poor and moderate reliability. Other variables presented high to very high values. Rearfoot range of motion was the variable that presented the best results in terms of reliability and differentiation capability. Static variables do not seem to be related to patellofemoral pain and have low accuracy values. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Interrater reliability of the mind map assessment rubric in a cohort of medical students

    PubMed Central

    D'Antoni, Anthony V; Zipp, Genevieve Pinto; Olson, Valerie G

    2009-01-01

    Background Learning strategies are thinking tools that students can use to actively acquire information. Examples of learning strategies include mnemonics, charts, and maps. One strategy that may help students master the tsunami of information presented in medical school is the mind map learning strategy. Currently, there is no valid and reliable rubric to grade mind maps and this may contribute to their underutilization in medicine. Because concept maps and mind maps engage learners similarly at a metacognitive level, a valid and reliable concept map assessment scoring system was adapted to form the mind map assessment rubric (MMAR). The MMAR can assess mind map depth based upon concept-links, cross-links, hierarchies, examples, pictures, and colors. The purpose of this study was to examine interrater reliability of the MMAR. Methods This exploratory study was conducted at a US medical school as part of a larger investigation on learning strategies. Sixty-six (N = 66) first-year medical students were given a 394-word text passage followed by a 30-minute presentation on mind mapping. After the presentation, subjects were again given the text passage and instructed to create mind maps based upon the passage. The mind maps were collected and independently scored using the MMAR by 3 examiners. Interrater reliability was measured using the intraclass correlation coefficient (ICC) statistic. Statistics were calculated using SPSS version 12.0 (Chicago, IL). Results Analysis of the mind maps revealed the following: concept-links ICC = .05 (95% CI, -.42 to .38), cross-links ICC = .58 (95% CI, .37 to .73), hierarchies ICC = .23 (95% CI, -.15 to .50), examples ICC = .53 (95% CI, .29 to .69), pictures ICC = .86 (95% CI, .79 to .91), colors ICC = .73 (95% CI, .59 to .82), and total score ICC = .86 (95% CI, .79 to .91). Conclusion The high ICC value for total mind map score indicates strong MMAR interrater reliability. Pictures and colors demonstrated moderate to strong

  9. Developing a Reliable Core Stability Assessment Battery for Patients with Nonspecific Low Back Pain.

    PubMed

    Ozcan Kahraman, Buse; Salik Sengul, Yesim; Kahraman, Turhan; Kalemci, Orhan

    2016-07-15

    Test-retest design. The objective was to examine the intrarater (test-retest) reliability of the core stability related tests and to develop a reliable core stability assessment battery. Studies suggest that core stability exercises may improve function and decrease pain in patients with nonspecific low back pain (LBP). Reliable clinical tests are required to implement adequate rehabilitation and to evaluate results of these interventions. The study had a test-retest design. Thirty-three different tests that might relate to core stability were identified with their mostly used protocols. Five different components of core stability including endurance, flexibility, strength, functional performance, and motor control were assessed in 38 patients with nonspecific LBP. The same testing procedure was performed again after 48 to 72 hours. Intraclass correlation coefficients (ICCs), standard error of measurement, and minimal detectable change were calculated to assess the intrarater reliability. The intrarater reliability of the tests ranged from little to very high (ICC = 0.08-0.98). Partial curl-up (ICC = 0.90), lateral bridge (ICC = 0.95-0.96), trunk flexor endurance (ICC = 0.97), sit and reach (ICC = 0.98), single-legged hop (ICC = 0.98-0.97), lateral step-down (ICC = 0.93-0.92), eyes open right and left leg unilateral stance (ICC = 0.97 and 0.91) tests had the highest intrarater reliability for each core stability component. The results indicated that the partial curl-up test (strength), side bridge and trunk flexor tests (endurance), sit-and-reach test (flexibility), single-legged hop, and lateral step-down (functional), unilateral stance test with eyes open (motor control) had very high intrarater reliability. A core stability assessment battery involving these tests can be used in patients with nonspecific LBP to assess all components of core stability. 3.

  10. Are physiotherapists reliable proxies for the recognition of pain in individuals with cerebral palsy? A cross sectional study.

    PubMed

    Riquelme, Inmaculada; Cifre, Ignacio; Montoya, Pedro

    2015-04-01

    Pain is an important problem for individuals with cerebral palsy (CP). In addition to pain associated to the pathology, individuals with CP are often exposed to physiotherapy procedures which may cause or relieve pain. The major aim of this study was to compare pain ratings self-reported by individuals with cerebral palsy and ratings about pain in others provided by their physiotherapists. Cross-sectional study. Children and young adults with cerebral palsy (n = 50) and their physiotherapists (n = 18) completed semi-structured interviews about clinical pain, as well as about procedural pain and pain relief elicited by standardized health procedures. Moreover, pain ratings were obtained during the application of hamstring stretching and passive joint mobilization. Moderate-to-high agreement was observed between individuals with cerebral palsy and their physiotherapists on presence and intensity of pain, pain interference with physical activities and current and retrospective pain ratings elicited by physiotherapy procedures. By contrast, agreement regarding pain relief elicited by physiotherapy techniques was low. Our data suggest that although physiotherapists may be reliable proxies for the recognition of pain in individuals with cerebral palsy, further research should be done to improve the communication between health professionals and individuals with cerebral palsy around pain. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Intertester reliability of judgments of the presence of trigger points in patients with low back pain.

    PubMed

    Nice, D A; Riddle, D L; Lamb, R L; Mayhew, T P; Rucker, K

    1992-10-01

    The purpose of this study was to determine the intertester reliability of assessments of the presence of trigger points in the region of the lumbar spine of patients with low back pain (LBP). A total of six trigger points described by Travell and Simons were studied. The trigger point examination procedures described by Travell and Simons were used by 12 physical therapists. Randomly paired therapists examined 50 patients for 197 trigger points. The Kappa coefficient, percent agreement, the observed proportion of positive agreement (Ppos), and the observed proportion of negative agreement (Pneg) were used to describe reliability. Kappa values ranged from .29 to .38. Percent agreement ranged from 76% to 79%. Ppos ranged from .43 to .52. The low Kappa and Ppos values suggest different therapists are unable to reliably determine when a trigger point is present in a patient with LBP. This study suggests the usefulness of examining for the presence of trigger points in patients with LBP should be questioned.

  12. Reliability and validity of the Japanese-language version of the physical performance test (PPT) battery in chronic pain patients.

    PubMed

    Sato, Daisuke; Kaneko, Fumiko; Okamura, Hitoshi

    2006-03-30

    To prepare a Japanese-language version of the Physical Performance Test (PPT) Battery and assess its reliability and validity. Activity limitations by pain were evaluated by means of the Japanese-language version of the PPT Battery in 82 patients with chronic pain in the limbs and trunk. Two self-report questionnaires, one related to sensory evaluation of pain, and the other related to affective evaluation of pain, and the Functional Independence Measure (FIM), which evaluates activities of daily living, were simultaneously administered to the subjects. The results for reliability showed that the ICC values for inter-rater reliability and intra-rater reliability were 0.91 or more for every item. The results for validity showed significant associations between the scores for all of the items on the Japanese-language version of the PPT Battery and the total scores on the FIM (p < 0.01). Significant associations were found between 5 of the 8 items on the Japanese-language version of the PPT Battery and affective state due to the pain. The Japanese-language version of the PPT Battery was shown to possess adequate reliability and validity as a scale for evaluating the activity limitations of patients with chronic limb or trunk pain. The results also suggested that it might be possible to improve the activity limitations of patients with chronic pain by improving their affective state in response to the pain.

  13. Nurses assessing pain with the Nociception Coma Scale: interrater reliability and validity.

    PubMed

    Vink, Peter; Eskes, Anne Maria; Lindeboom, Robert; van den Munckhof, Pepijn; Vermeulen, Hester

    2014-12-01

    The Nociception Coma Scale (NCS) is a pain observation tool, developed for patients with disorders of consciousness (DOC) due to acquired brain injury (ABI). The aim of this study was to assess the interrater reliability of the NCS and NCS-R among nurses for the assessment of pain in ABI patients with DOC. A secondary aim was further validation of both scales by assessing its discriminating abilities for the presence or absence of pain. Hospitalized patients with ABI (n = 10) were recorded on film during three conditions: baseline, after tactile stimulation, and after noxious stimulation. All stimulations were part of daily treatment for these patients. The 30 recordings were assessed with the NCS and NCS-R by 27 nurses from three university hospitals in the Netherlands. Each nurse viewed 9 to 12 recordings, totaling 270 assessments. Interrater reliability of the NCS/NCS-R items and total scores were estimated by intraclass correlations (ICC), which showed excellent and equal average measures reliability for the NCS and NCR-R total scores (ICC 0.95), and item scores (range 0.87-0.95). Secondary analysis was performed to assess differences in ICCs among nurses' education and experience and to assess the scales discriminating properties for the presence of pain. The NCS and NCS-R are valid and reproducible scales that can be used by nurses with an associate (of science) in nursing degree or baccalaureate (of science) in nursing degree. It seems that more experience with ABI patients is not a predictor for good agreement in the assessment of the NCS(-R).

  14. Long-term reliable change of pain scores in individual myogenous TMD patients.

    PubMed

    van Grootel, Robert J; van der Bilt, Andries; van der Glas, Hilbert W

    2007-08-01

    A within-patient change in pain score after treatment is statistically 'reliable' when it exceeds the smallest detectable difference (SDD). The aims of the present study were to: (i) determine SDDs for VAS-scores of pain intensity, for sufficiently long test-retest intervals to include most biological fluctuations, (ii) examine whether SDD is invariant to baseline score, and (iii) discuss the value of reliable change (RC) for detecting clinically important difference (CID) or as a possible indicator of successful treatment. SDDs were determined using duplicate data from 118 patients with myogenous Temporomandibular disorders: (1) VAS-scores of pain intensity from the masticatory system in a pre-treatment diary, and (2) VAS-scores of pain intensity from the hand (cold-pressor test). RC was determined in VAS-scores from a pre- and post-treatment questionnaire. The long-term SDD was 49mm. A regression analysis on duplicate VAS-scores showed that SDD was largely invariant to the baseline level. Because RC (change>SDD) exceeded CID, it might serve as an indicator of successful treatment. However, only 17% of the patients showed RC after treatment, mainly because the baseline was smaller than SDD in 67% of the patients thus making detection of any treatment effect impossible. For patients with possible detection (33%), the frequency of RC was 51%. If the detection threshold would be avoided by provoking pain in patients with a low baseline, a long-term RC in VAS-scores might occur in about half of all myogenous TMD patients and might then serve as an indicator of cases of treatment success.

  15. Development, scoring, and reliability of the Microscale Audit of Pedestrian Streetscapes (MAPS).

    PubMed

    Millstein, Rachel A; Cain, Kelli L; Sallis, James F; Conway, Terry L; Geremia, Carrie; Frank, Lawrence D; Chapman, Jim; Van Dyck, Delfien; Dipzinski, Lindsay R; Kerr, Jacqueline; Glanz, Karen; Saelens, Brian E

    2013-04-27

    Streetscape (microscale) features of the built environment can influence people's perceptions of their neighborhoods' suitability for physical activity. Many microscale audit tools have been developed, but few have published systematic scoring methods. We present the development, scoring, and reliability of the Microscale Audit of Pedestrian Streetscapes (MAPS) tool and its theoretically-based subscales. MAPS was based on prior instruments and was developed to assess details of streetscapes considered relevant for physical activity. MAPS sections (route, segments, crossings, and cul-de-sacs) were scored by two independent raters for reliability analyses. There were 290 route pairs, 516 segment pairs, 319 crossing pairs, and 53 cul-de-sac pairs in the reliability sample. Individual inter-rater item reliability analyses were computed using Kappa, intra-class correlation coefficient (ICC), and percent agreement. A conceptual framework for subscale creation was developed using theory, expert consensus, and policy relevance. Items were grouped into subscales, and subscales were analyzed for inter-rater reliability at tiered levels of aggregation. There were 160 items included in the subscales (out of 201 items total). Of those included in the subscales, 80 items (50.0%) had good/excellent reliability, 41 items (25.6%) had moderate reliability, and 18 items (11.3%) had low reliability, with limited variability in the remaining 21 items (13.1%). Seventeen of the 20 route section subscales, valence (positive/negative) scores, and overall scores (85.0%) demonstrated good/excellent reliability and 3 demonstrated moderate reliability. Of the 16 segment subscales, valence scores, and overall scores, 12 (75.0%) demonstrated good/excellent reliability, three demonstrated moderate reliability, and one demonstrated poor reliability. Of the 8 crossing subscales, valence scores, and overall scores, 6 (75.0%) demonstrated good/excellent reliability, and 2 demonstrated moderate

  16. Development, scoring, and reliability of the Microscale Audit of Pedestrian Streetscapes (MAPS)

    PubMed Central

    2013-01-01

    Background Streetscape (microscale) features of the built environment can influence people’s perceptions of their neighborhoods’ suitability for physical activity. Many microscale audit tools have been developed, but few have published systematic scoring methods. We present the development, scoring, and reliability of the Microscale Audit of Pedestrian Streetscapes (MAPS) tool and its theoretically-based subscales. Methods MAPS was based on prior instruments and was developed to assess details of streetscapes considered relevant for physical activity. MAPS sections (route, segments, crossings, and cul-de-sacs) were scored by two independent raters for reliability analyses. There were 290 route pairs, 516 segment pairs, 319 crossing pairs, and 53 cul-de-sac pairs in the reliability sample. Individual inter-rater item reliability analyses were computed using Kappa, intra-class correlation coefficient (ICC), and percent agreement. A conceptual framework for subscale creation was developed using theory, expert consensus, and policy relevance. Items were grouped into subscales, and subscales were analyzed for inter-rater reliability at tiered levels of aggregation. Results There were 160 items included in the subscales (out of 201 items total). Of those included in the subscales, 80 items (50.0%) had good/excellent reliability, 41 items (25.6%) had moderate reliability, and 18 items (11.3%) had low reliability, with limited variability in the remaining 21 items (13.1%). Seventeen of the 20 route section subscales, valence (positive/negative) scores, and overall scores (85.0%) demonstrated good/excellent reliability and 3 demonstrated moderate reliability. Of the 16 segment subscales, valence scores, and overall scores, 12 (75.0%) demonstrated good/excellent reliability, three demonstrated moderate reliability, and one demonstrated poor reliability. Of the 8 crossing subscales, valence scores, and overall scores, 6 (75.0%) demonstrated good/excellent reliability, and

  17. Reliability of physical functioning tests in patients with low back pain: a systematic review.

    PubMed

    Denteneer, Lenie; Van Daele, Ulrike; Truijen, Steven; De Hertogh, Willem; Meirte, Jill; Stassijns, Gaetane

    2017-09-04

    The aim of this study was to provide a comprehensive overview of physical functioning tests in patients with low back pain (LBP) and to investigate their reliability. A systematic computerized search was finalized in four different databases on the 24th of June 2017: Pubmed, Web of Science, Embase and Medline. PRISMA guidelines were followed during all stages of this review. Clinical studies that investigate the reliability of physical functioning tests in patients with LBP were eligible. The methodological quality of the included studies was assessed with the use of the COSMIN checklist. To come to final conclusions for reliability of the identified clinical tests, the current review assessed three factors namely outcome assessment, methodological quality and consistency of description. A total of 20 studies were found eligible and 38 clinical tests were identified. Good overall test retest reliability was concluded for the extensor endurance (ICC = .93-.97), flexor endurance (ICC = .90-.97), 5 minute walking (ICC = .89-.99), 50 foot walking (ICC = .76-.96), shuttle walk (ICC = .92-.99), sit to stand (ICC = .91-.99) and the loaded forward reach test (ICC = .74-.98). For interrater reliability, only one test namely the Biering-Sörensen (ICC = .88-.99) test could be concluded to have an overall good interrater reliability. None of the identified clinical tests could be concluded to have a good intrarater reliability. Further investigation should focus on a better overall study methodology and the use of identical protocols for the description of clinical tests. The assessment of reliability is only a first step in the recommendation process for the use of clinical tests. In future research, the identified clinical tests in the current review should be further investigated for validity. Only when these clinimetric properties of a clinical test have been thoroughly investigated, a final conclusion regarding the clinical and scientific use of the identified tests can

  18. Validity and reliability of the critical care pain observation tool: a replication study.

    PubMed

    Keane, Kathleen Marie

    2013-12-01

    Critically ill patients are often not able to self-report the presence of pain. Currently there is no generally accepted assessment tool for this population. The Critical-Care Pain Observation Tool (CPOT) was developed for pain assessment of critically ill patients. The purpose of this study was to replicate the findings of the Gelinas et al. (2006) CPOT reference study and examine the interrater reliability (IRR), discriminant validity (DV), and criterion validity (CV) of the CPOT. This quantitative study used a repeated measures design with a convenience sample of 21 postoperative open heart surgery patients cared for in a tertiary-care teaching hospital. Testing for IRR in this sample showed a range of results resulting in fair to almost perfect IRR; the findings of this study suggest that the instrument's IRR is acceptable but variable. Testing for DV demonstrated a significant difference in mean scores between noxious (painful) and nonnoxious (nonpainful) procedures. Testing for CV showed a weak nonsignificant Spearman correlation of 0.26 (P < .312) between CPOT scores and patient self-report during repositioning after extubation. This replication study adds to four studies that have examined psychometric attributes of the instrument and contributes to the process of translating the use of this instrument to the clinical setting.

  19. The reliability of assessing sternocleidomastoid muscle length and strength in adults with and without mild neck pain.

    PubMed

    Cibulka, Michael T; Herren, Jessica; Kilian, Anne; Smith, Steven; Mahmutovic, Fatima; Dolles, Courtney

    2017-04-01

    The sternocleidomastoid (SCM) is an important cervical spine muscle. Weakness of the SCM muscle has been implicated with cervical problems. No studies have examined the reliability of assessing the SCM muscle length or strength. Also no studies exist that have looked to see if imbalances in SCM muscle length or strength exists between the left and right sides in those with and without neck pain. To determine the reliability of assessing the SCM muscle for length and strength and to see if SCM length could predict SCM strength in those with and without neck pain. Cross-sectional study. Fifty-one subjects with and without mild neck pain. Intratester reliability was assessed for SCM muscle length and SCM muscle strength. Differences in SCM length and strength were examined in those with and without neck pain. Intratester reliability was shown to be excellent (ICC (2,2) > 0.90) for the left and right SCM when assessing muscle length and muscle strength for those with and without neck pain. No differences were noted when comparing left to right SCM between those with and without neck pain regarding muscle length or muscle strength. Neither regression models were able to predict SCM muscle strength from SCM muscle length. SCM muscle length and SCM strength can be reliably assessed using a bubble goniometer and HHD. No differences were found when comparing left to right SCM muscle length or strength in those with or without mild neck pain.

  20. High Test-retest-reliability of pain-related evoked potentials (PREP) in healthy subjects.

    PubMed

    Özgül, Özüm Simal; Maier, Christoph; Enax-Krumova, Elena K; Vollert, Jan; Fischer, Marc; Tegenthoff, Martin; Höffken, Oliver

    2017-03-22

    Pain-related-evoked potentials (PREP) is an established electrophysiological method to evaluate the signal transmission of electrically stimulated A-delta fibres. Although prerequisite for its clinical use, test-retest-reliability and side-to-side differences of bilateral stimulation in healthy subjects have not been examined yet. We performed PREP twice within 3 to 14days in 33 healthy subjects bilaterally by stimulating the dorsal hand. Detection (DT) and pain thresholds (PT) after electrical stimulation, the corresponding pain ratings, latencies of P0, N1, P1 and N2 components and the corresponding amplitudes were assessed. Impact of electrically induced pain intensity, age, sex, and arm length on PREP was analysed. MANOVA, t-Test, interclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD), Bland-Altmann-Analysis as well as ANCOVA were used for statistical analysis. Measurement from both sides on both days resulted in mean N1-latencies from 142.39 ±18.12ms to 144.03 ±16.62ms and in mean N1P1-amplitudes from 39.04 ±12.26μV to 40.53 ±12.9μV. Analysis of a side-to-side effect showed for the N1-latency a F-value of 0.038 and for the N1P1-amplitude of 0.004 (p >0.8). We found intraclass correlation coefficients (ICC) from 0.88 to 0.93 and a standard error of measurement (SEM) < 10% of mean values for all measurements concerning the N1-Latency and N1P1-amplitude. Intraclass correlation coefficients, standard error of measurement and Bland-Altman-Analyses revealed excellent test-retest-reliability for N1-latency and N1P1-amplitude without systematic error and there was no side-to-side effect on PREP. N1-latency (r=0.35, p <0.05) and N1P1-amplitude (r=-0.45, p <0.05) correlated with age and additionally N1-latency correlated with arm length (r=0.45, p<0.001). In contrast, pain intensity during the stimulation had no effect on both N1-latency and N1P1-amplitude. In summary, PREP showed high test-retest-reliability

  1. Road map for pain management in pancreatic cancer: A review

    PubMed Central

    Lahoud, Marie José; Kourie, Hampig Raphael; Antoun, Joelle; El Osta, Lana; Ghosn, Marwan

    2016-01-01

    Beside its poor prognosis and its late diagnosis, pancreatic cancer remains one of the most painful malignancies. Optimal management of pain in this cancer represents a real challenge for the oncologist whose objective is to ensure a better quality of life to his patients. We aimed in this paper to review all the treatment modalities incriminated in the management of pain in pancreatic cancer going from painkillers, chemotherapy, radiation therapy and interventional techniques to agents under investigation and alternative medicine. Although specific guidelines and recommendations for pain management in pancreatic cancer are still absent, we present all the possible pain treatments, with a progression from medical multimodal treatment to radiotherapy and chemotherapy then interventional techniques in case of resistance. In addition, alternative methods such as acupuncture and hypnosis can be added at any stage and seems to contribute to pain relief. PMID:27574552

  2. Pain charts (body maps or manikins) in assessment of the location of pediatric pain

    PubMed Central

    von Baeyer, Carl L; Lin, Vivian; Seidman, Laura C; Tsao, Jennie CI; Zeltzer, Lonnie K

    2011-01-01

    SUMMARY This article surveys the use of pain charts or pain drawings in eliciting information about the location of pain symptoms from children and adolescents. While pain charts are widely used and have been incorporated in multidimensional pediatric pain questionnaires and diaries, they present a number of issues requiring further study. These include, in particular, the number and size of different locations or areas of pain that need to be differentiated; the age at which children are able to complete pain charts unassisted; and whether the intensity and other qualities of pain can be accurately recorded on pain charts by children and adolescents. Based on data currently available, it is suggested that the unassisted use of pain charts be restricted to children aged 8 years or over, while for clinical purposes many younger children can complete pain charts with adult support. Where the investigator’s interest is restricted to a few areas of the body, checklists of body parts may have greater utility than pain charts. A new pain chart adapted for use in studies of pediatric recurrent and chronic pain is presented. PMID:21572558

  3. Inter-rater reliability of three standardized functional tests in patients with low back pain

    PubMed Central

    Tidstrand, Johan; Horneij, Eva

    2009-01-01

    Background Of all patients with low back pain, 85% are diagnosed as "non-specific lumbar pain". Lumbar instability has been described as one specific diagnosis which several authors have described as delayed muscular responses, impaired postural control as well as impaired muscular coordination among these patients. This has mostly been measured and evaluated in a laboratory setting. There are few standardized and evaluated functional tests, examining functional muscular coordination which are also applicable in the non-laboratory setting. In ordinary clinical work, tests of functional muscular coordination should be easy to apply. The aim of this present study was to therefore standardize and examine the inter-rater reliability of three functional tests of muscular functional coordination of the lumbar spine in patients with low back pain. Methods Nineteen consecutive individuals, ten men and nine women were included. (Mean age 42 years, SD ± 12 yrs). Two independent examiners assessed three tests: "single limb stance", "sitting on a Bobath ball with one leg lifted" and "unilateral pelvic lift" on the same occasion. The standardization procedure took altered positions of the spine or pelvis and compensatory movements of the free extremities into account. The inter-rater reliability was analyzed by Cohen's kappa coefficient (κ) and by percentage agreement. Results The inter-rater reliability for the right and the left leg respectively was: for the single limb stance very good (κ: 0.88–1.0), for sitting on a Bobath ball good (κ: 0.79) and very good (κ: 0.88) and for the unilateral pelvic lift: good (κ: 0.61) and moderate (κ: 0.47). Conclusion The present study showed good to very good inter-rater reliability for two standardized tests, that is, the single-limb stance and sitting on a Bobath-ball with one leg lifted. Inter-rater reliability for the unilateral pelvic lift test was moderate to good. Validation of the tests in their ability to evaluate lumbar

  4. Reliability and Validity of the Anterior Knee Pain Scale: Applications for Use as an Epidemiologic Screener

    PubMed Central

    2016-01-01

    A screening instrument’s ability to provide clinicians with consistent and reproducible information is crucial to intervention. Despite widespread acceptance and clinical use of the Kujala Anterior Knee Pain Scale (AKPS) in orthopedics and sports medicine, few studies have reported on its reliability and no such studies have concentrated on child or adolescent samples exclusively, segments of the population for which this instrument is often used. The purpose of the current study was to describe and report on the reliability and validity of the AKPS for use with high school female athletes participating in interscholastic athletics. The study was a secondary analysis of prospective epidemiologic data using established scale validation methods. The records of 414 female athletes 11.0 to 18.1 years of age (Mean 13.9 yrs, SD = 1.7 yrs) were used for analysis. Four different approaches to scoring and scale reduction of the AKPS were evaluated, including the original, ordinal 13-item form, a modified, ordinal 6-item form, a modified, dichotomous 13-item form, and a modified, dichotomous 6-item form. Three different types of reliability (internal consistency, equivalence across forms, standard error of measurement) and one type of validity (criterion-related) were estimated for the AKPS in the current sample. The four scoring formats of the AKPS scale were found to have high internal consistency (αcoef = 0.83 to 0.91), equivalence across the short and long forms (r = 0.98), acceptable standard errors of measurement (0.82 to 3.00), and moderate to high criterion related validity—as determined by physican’s diagnosis: 0.92 (13-item form), 0.90 (6-item form). The Kujala AKPS is a valid and reliable measure of anterior knee pain and appropriate for use as an epidemiologic screening tool with adolescent female athletes. PMID:27441381

  5. Muscle Trigger Points and Pressure Pain Sensitivity Maps of the Feet in Women with Fibromyalgia Syndrome.

    PubMed

    Tornero-Caballero, Maria C; Salom-Moreno, Jaime; Cigarán-Méndez, Margarita; Morales-Cabezas, Matilde; Madeleine, Pascal; Fernández-de-Las-Peñas, César

    2016-10-01

    OBJECTIVE : To investigate the presence of trigger points (TrPs) in feet musculature and topographical pressure sensitivity maps of the feet as well as the relationship between TrPs, pressure pain maps, and clinical variables in women with fibromyalgia (FMS). METHODS : Fifty-one FMS women and 24 comparable healthy women participated. TrPs within the flexor hallucis brevis, adductor hallucis, dorsal interossei, extensor digitorum brevis, and quadratus plantae, as well as external and internal gastrocnemius, were explored. Pressure pain thresholds (PPTs) were assessed in a blind manner over seven locations on each foot. Topographical pressure sensitivity maps of the plantar region were generated using the averaged PPT of each location. RESULTS : The prevalence rate of foot pain was 63% (n = 32). The number of active TrPs for each FMS woman with foot pain was 5 ± 1.5 without any latent TrPs. Women with FMS without foot pain and healthy controls had only latent TrPs (2.2 ± 0.8 and 1.5 ± 1.3, respectively). Active TrPs in the flexor hallucis brevis and adductor hallucis muscles were the most prevalent. Topographical pressure pain sensitivity maps revealed that FMS women with foot pain had lower PPT than FMS women without pain and healthy controls, and higher PPT on the calcaneus bone (P < 0.001). CONCLUSIONS : The presence of foot pain in women with FMS is high. The referred pain elicited by active TrPs in the foot muscles reproduced the symptoms in these patients. FMS women suffering foot pain showed higher pressure hypersensitivity in the plantar region than those FMS women without pain.

  6. Inter-rater reliability of select physical examination procedures in patients with neck pain.

    PubMed

    Hanney, William J; George, Steven Z; Kolber, Morey J; Young, Ian; Salamh, Paul A; Cleland, Joshua A

    2014-07-01

    This study evaluated the inter-rater reliability of select examination procedures in patients with neck pain (NP) conducted over a 24- to 48-h period. Twenty-two patients with mechanical NP participated in a standardized examination. One examiner performed standardized examination procedures and a second blinded examiner repeated the procedures 24-48 h later with no treatment administered between examinations. Inter-rater reliability was calculated with the Cohen Kappa and weighted Kappa for ordinal data while continuous level data were calculated using an intraclass correlation coefficient model 2,1 (ICC2,1). Coefficients for categorical variables ranged from poor to moderate agreement (-0.22 to 0.70 Kappa) and coefficients for continuous data ranged from slight to moderate (ICC2,1 0.28-0.74). The standard error of measurement for cervical range of motion ranged from 5.3° to 9.9° while the minimal detectable change ranged from 12.5° to 23.1°. This study is the first to report inter-rater reliability values for select components of the cervical examination in those patients with NP performed 24-48 h after the initial examination. There was considerably less reliability when compared to previous studies, thus clinicians should consider how the passage of time may influence variability in examination findings over a 24- to 48-h period.

  7. Cross-cultural adaptation, reliability and validity of the Turkish version of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire.

    PubMed

    Gunaydin, Gurkan; Hazar Kanik, Zeynep; Karabicak, Gul Oznur; Sozlu, Ugur; Pala, Omer Osman; Alkan, Zeynep Beyza; Basar, Selda; Citaker, Seyit

    2016-05-01

    Low back pain is among the most common musculoskeletal system disorders. Outcome measures are needed for the measurement of function, to establish a treatment program, and for monitoring the improvement in low back pain. There exist several questionnaires enquiring about function in low back pain. One of these is Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, whose reliability and validity were previously established. Other than the original version of the questionnaire, only its Persian version exists. The present study aims to investigate the cross-cultural adaptation, reliability and validity of the Turkish version of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire. The study included 103 patients with low back pain. For reliability assessment of the questionnaire, test-retest and internal consistency analyses were performed. The results of test-retest analysis were assessed by Intraclass Correlation Coefficient method. For internal consistency, Cronbach Alpha value was used. Validity analyses of the questionnaire were performed by construct validity. For construct validity, convergent validity was tested. Convergent validity of the questionnaire was calculated via its correlation with suitable subscales of the Short Form-36 and the total score of the Oswestry Disability Index by using Pearson's correlation coefficient. Intraclass Correlation Coefficient values for test-retest reliability were found to be in the range of 0.765-0.924, which indicate a sufficient level of test-retest reliability. Cronbach's Alpha value was found to be 0.804 indicating a high internal consistency. Pearson's correlation coefficient between Japanese Orthopaedic Association Back Pain Evaluation Questionnaire to Short Form-36 and Oswestry Disability Index values were ranged between 0.424 and -0.810, indicating a good correlation. Considering all these data, it was concluded that the Turkish version of the Japanese Orthopaedic Association

  8. Validity and Reliability of Turkish Translation of Neuropathic Pain Impact on Quality-of-Life (NePIQoL) Questionnaire.

    PubMed

    Acar, Betul; Turkel, Yakup; Kocak, Orhan M; Erdemoglu, A Kemal

    2016-09-01

    The aim of this study was to adapt the "Neuropathic Pain Impact on Quality-of-Life Questionnaire" (NePIQoL) into Turkish and to test its validity and reliability in neuropathic pain patients. We enrolled 200 chronic pain patients who admitted to the Neurology Department of Kirikkale University, Faculty of Medicine, in our study. Patients were diagnosed with neuropathic or nociceptive pain based on medical history, physical examination, electromyography and nerve conduction studies, laboratory examinations, and imaging techniques. Discriminant analysis was used to diagnose the neuropathic pain regarding sensitivity and specificity. The original version of the NePIQoL was translated into Turkish by standard procedures. Total NePIQoL scores were statistically different between neuropathic and nociceptive pain patients in both the first and second NePIQoL applications (P < 0.001). Cronbach's alpha coefficient of total 12 items of the first and second applications was 0.95. These results suggest a high validity level for the Turkish version of the NePIQoL. The Turkish version of NePIQoL appears to be reliable and valid for neuropathic pain impact on quality of life in patients with neuropathic pain. © 2015 World Institute of Pain.

  9. Topographical mapping and mechanical pain sensitivity of myofascial trigger points in the infraspinatus muscle.

    PubMed

    Ge, Hong-You; Fernández-de-Las-Peñas, César; Madeleine, Pascal; Arendt-Nielsen, Lars

    2008-10-01

    To screen for the presence of latent and active myofascial trigger points (MTrPs) in patients with unilateral shoulder and arm pain and perform topographical mapping of mechanical pain sensitivity bilaterally in the infraspinatus muscles. Nineteen patients with unilateral musculoskeletal shoulder pain participated in the study. The area overlying the infraspinatus on each side was divided into 10 adjacent sub-areas of 1cm(2), corresponding to the area of a pressure algometer probe. Pressure pain threshold (PPT) was measured in each sub-area bilaterally in the infraspinatus muscles. Following PPT measurement, an acupuncture needle was inserted into each sub-area five times in different directions in order to induce local twitch response and/or referred pain. A significantly lower PPT level in the infraspinatus muscle was detected on the painful side compared with the non-painful side (P=0.001). PPT at midfiber region of the infraspinatus muscles was lower than that at other muscle parts (P<0.05). Multiple, but not single, active MTrPs were found in the infraspinatus muscle on the painful side and there were also multiple latent MTrPs bilaterally in the infraspinatus muscles. PPT at active MTrPs was much lower than the latent MTrPs and again lower than the non-MTrPs. There exists bilateral mechanical hyperalgesia in patients with unilateral shoulder pain. Further, the association of multiple active MTrPs with unilateral shoulder pain and the heterogeneity of mechanical pain sensitivity distribution suggest a crucial role of peripheral sensitization in chronic myofascial pain conditions. Additionally, the locations of MTrPs identified with dry needling correspond well to PPT topographical mapping, suggesting that dry needling and PPT topographical mapping are sensitive techniques in the identification of MTrPs.

  10. Reliability and responsiveness of measures of pain in people with osteoarthritis of the knee: a psychometric evaluation

    PubMed Central

    Turner, Katie V.; Moreton, Bryan M.; Walsh, David A.; Lincoln, Nadina B.

    2017-01-01

    Abstract Purpose: To examine the fit between data from the Short Form McGill Pain Questionnaire (SF-MPQ-2) and the Rasch model, and to explore the reliability and internal responsiveness of measures of pain in people with knee osteoarthritis. Methods: Participants with knee osteoarthritis completed the SF-MPQ-2, Intermittent and Constant Osteoarthritis Pain questionnaire (ICOAP) and painDETECT. Participants were sent the same questionnaires 3 and 6 months later. Results: Fit to the Rasch model was not achieved for the SF-MPQ-2 Total scale. The Continuous subscale yielded adequate fit statistics after splitting item 10 on uniform DIF for gender, and removing item 9. The Intermittent subscale fit the Rasch model after rescoring items. The Neuropathic subscale had relatively good fit to the model. Test–retest reliability was satisfactory for most scales using both original and Rasch scoring ranging from fair to substantial. Effect sizes ranged from 0.13 to 1.79 indicating good internal responsiveness for most scales. Conclusions: These findings support the use of ICOAP subscales as reliable and responsive measure of pain in people with knee osteoarthritis. The MPQ-SF-2 subscales found to be acceptable alternatives. Implications for RehabilitationThe McGill Pain Questionnaire short version 2 is not a unidimensional scale in people with knee osteoarthritis, whereas three of the subscales are unidimensional.The McGill Pain Questionnaire short version 2 Affective subscale does not have good measurement properties for people with knee osteoarthritis.The McGill Pain Questionnaire short version 2 and the Intermittent and Constant Osteoarthritis Pain scales can be used to assess change over time.The painDETECT performs better as a screening measure than as an outcome measure. PMID:27027698

  11. Test-retest reliability of quantitative sensory testing for mechanical somatosensory and pain modulation assessment of masticatory structures.

    PubMed

    Costa, Y M; Morita-Neto, O; de Araújo-Júnior, E N S; Sampaio, F A; Conti, P C R; Bonjardim, L R

    2017-03-01

    Assessing the reliability of medical measurements is a crucial step towards the elaboration of an applicable clinical instrument. There are few studies that evaluate the reliability of somatosensory assessment and pain modulation of masticatory structures. This study estimated the test-retest reliability, that is over time, of the mechanical somatosensory assessment of anterior temporalis, masseter and temporomandibular joint (TMJ) and the conditioned pain modulation (CPM) using the anterior temporalis as the test site. Twenty healthy women were evaluated in two sessions (1 week apart) by the same examiner. Mechanical detection threshold (MDT), mechanical pain threshold (MPT), wind-up ratio (WUR) and pressure pain threshold (PPT) were assessed on the skin overlying the anterior temporalis, masseter and TMJ of the dominant side. CPM was tested by comparing PPT before and during the hand immersion in a hot water bath. anova and intra-class correlation coefficients (ICCs) were applied to the data (α = 5%). The overall ICCs showed acceptable values for the test-retest reliability of mechanical somatosensory assessment of masticatory structures. The ICC values of 75% of all quantitative sensory measurements were considered fair to excellent (fair = 8·4%, good = 33·3% and excellent = 33·3%). However, the CPM paradigm presented poor reliability (ICC = 0·25). The mechanical somatosensory assessment of the masticatory structures, but not the proposed CPM protocol, can be considered sufficiently reliable over time to evaluate the trigeminal sensory function.

  12. The Critical care Pain Observation Tool is reliable in non-agitated but not in agitated intubated patients.

    PubMed

    Chookalayia, Hoda; Heidarzadeh, Mehdi; Hassanpour-Darghah, Mohammad; Aghamohammadi-Kalkhoran, Masoomeh; Karimollahi, Mansoreh

    2017-09-15

    The Critical-Care Pain. Tool is one of the instruments developed to assess pain in patients who are unable to communicate verbally. The study aimed to survey the psychometric properties of Critical-Care Pain. Tool in four groups of non-verbal patients according to their Richmond Agitation Sedation Score (RASS). 65 critically ill patients (medical, surgical, trauma) were assessed using the critical care pain observation tool on six occasions (before, during and after nociceptive and non-nociceptive procedures). Patients were divided into four groups according to their RASS score: 1. All patients (RASS -3 to +2), 2. Sedated patients (RASS -3 to -1), 3. Restless patients (RASS +1), 4. Agitated patients (RASS +2). Discriminant and criterion validity, confirmatory factor analysis and internal reliability showed good validity and reliability in the critical care pain observation tool in all groups except agitated patients. The results showed that, in general, the CPOT has good version of the critical care pain observation tool has good psychometric properties to evaluate pain in non-verbal patients admitted to intensive care units who have a RASS score ranging from -3 to +1, but it is not a good tool to evaluate pain in patients who are agitated according to RASS. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Reliability and discriminatory testing of a client-based metrology instrument, feline musculoskeletal pain index (FMPI) for the evaluation of degenerative joint disease-associated pain in cats.

    PubMed

    Benito, J; Depuy, V; Hardie, E; Zamprogno, H; Thomson, A; Simpson, W; Roe, S; Hansen, B; Lascelles, B D X

    2013-06-01

    The objective of this study was to test the readability, reliability, repeatability and discriminatory ability of an owner-completed instrument to assess feline degenerative joint disease (DJD)-associated pain (feline musculoskeletal pain index, FMPI). Readability was explored using four different formulas (Flesch, Fry, SMOG and FOG) and the final FMPI instrument was produced. To assess the instrument, client-owned cats that were defined as normal (normal group) or as having DJD-associated pain and mobility impairment (pain-DJD group) were recruited. A total of 32 client-owned cats were enrolled in the study (normal, n=13; pain-DJD, n=19). Owners completed the FMPI on two occasions, 14days apart. Internal consistency (reliability) and repeatability (test-retest) were explored using Cronbach's α and weighted κ statistic, respectively. Data from the two groups were compared using analysis of covariance (controlling for age) to evaluate discriminatory ability. The FMPI was constructed with 21 questions covering activity, pain intensity and overall quality of life. It had a 6th grade readability score. Reliability of the FMPI was excellent (Cronbach's α>0.8 for all groupings of questions in normal and pain-DJD cats) and repeatability was good (weighted κ statistic >0.74) for normal and pain-DJD cats. All components of the FMPI were able to distinguish between normal cats and cats with DJD (P<0.001 for all components). This initial evaluation of the FMPI suggests that this instrument is worthy of continued investigation. Published by Elsevier Ltd.

  14. The Modified Low Back Pain Disability Questionnaire: Reliability, Validity and Responsiveness of a Dutch Language Version.

    PubMed

    Denteneer, Lenie; Stassijns, Gaetane; Truijen, Steven; De Herthogh, Willem; Meirte, Jill; Deckers, Kristiaan; Van Daele, Ulrike

    2017-06-27

    Cross sectional study OBJECTIVE.: The goal of this study is to translate the English version of the Modified Low Back Pain Disability Questionnaire (MDQ) into a Dutch version and investigate its clinimetric properties for patients with nonspecific chronic low back pain (CLBP). Fritz et al (2001) developed a modified version of the Oswestry Disability Questionnaire (ODI) to assess functional status and named it the MDQ. In this version, a question regarding employment and homemaking ability was substituted for the question related to sex life. Good clinimetric properties for the MDQ were identified but up until now it is not clear if the clinimetric properties of the MDQ would change if it was translated into a Dutch version. translation of the MDQ into Dutch was done in four steps. Test-retest reliability was investigated using the intraclass correlation coefficient (ICC) model. Validity was calculated using Pearson correlations and a 2-way analysis of variance (ANOVA) for repeated measures. Finally, responsiveness was calculated with the area under the curve (AUC), minimal detectable change (MDC) and the standardized response mean (SRM). A total of 80 completed questionnaires were collected in three different hospitals and a total of 43 patients finished a 9 weeks intervention period, completing the retest. Test-retest reliability was excellent with an ICC of 0.89 (95% CI, 0.74-0.95). To confirm the convergent validity, the MDQ answered all predefined hypothesises (r = -0.65-0.69 / p = 0.01-0.00) and good results for construct validity were found (p = 0.02). The MDQ had an AUC of 0.64 (95% CI, 0.47-0.81), an MDC of 8.80 points and a SRM of 0.65. The Dutch version of the MDQ shows good clinimetric properties and is shown to be usable in the assessment of the functional status of Dutch speaking patients with nonspecific CLBP. 3.

  15. Reliability of joint mobility and pain assessment of the thoracic spine and rib cage in asymptomatic individuals.

    PubMed

    Heiderscheit, Bryan; Boissonnault, William

    2008-01-01

    Despite the importance of correctly diagnosing a spinal dysfunction, limited research exists related to physical therapists' ability to reliably identify a joint exhibiting signs of dysfunction. The purpose of this investigation was to determine the inter- and intra-examiner reliability of a thoracic spine and rib cage joint mobility and pain assessment between two experienced manipulative physical therapists. Nine healthy subjects (3 male, 6 female; ages 23-35) without history of mid- or low back pain participated. Posterior-to-anterior pressures were applied to the thoracic spine and rib articulations with anterior-to-posterior pressures applied to the costosternal joints of each subject by two examiners to evaluate joint mobility and pain provocation. Both examiners assessed all subjects twice and were blinded to subject identity. Kappa statistics were calculated using a strict and expanded definition of agreement to determine the between- and within-examiner reliability for each outcome. Intra-examiner reliability of joint mobility assessment ranged from slight to fair based on the strict agreement but improved to good when findings were compared across +/- 1 spinal/rib level. Pain provocation reliability increased to very good under the expanded agreement; however, this finding should be viewed with caution due to limited pain prevalence in the subject sample. Selected clinical prediction rules, applied to the care of individuals with back pain, characterize the patient's regional mobility simply as hypomobile, normal, or hypermobile; consequently, we feel the results of an expanded definition of agreement may be more appropriate for clinic practice. Further research is needed to determine the reliability in individuals with thoracic spine and rib cage symptoms.

  16. Topographical pressure and thermal pain sensitivity mapping in patients with unilateral lateral epicondylalgia.

    PubMed

    Ruiz-Ruiz, Beatriz; Fernández-de-Las-Peñas, César; Ortega-Santiago, Ricardo; Arendt-Nielsen, Lars; Madeleine, Pascal

    2011-10-01

    Our aim was to quantify spatial differences in pressure and thermal pain sensitivity maps between patients with unilateral lateral epicondylalgia (LE) and age- and sex-matched controls. Pressure (PPT), cold (CPT), and heat (HPT) pain thresholds were assessed over 12 points forming a 3 × 4 matrix (4 points in the superior part, 4 points in the middle, and 4 points in the lower part around the lateral epicondyle) bilaterally in 16 subjects with strictly unilateral LE and 16 age- and sex-matched controls in a blinded design. Topographical pain sensitivity maps to pressure and thermal stimulation over the elbow in patients with LE and healthy controls were calculated. A multilevel 3-way ANCOVA test was applied to detect differences in topographical maps between groups. Subjects with LE showed bilateral lower PPT, higher CPT (pain at higher temperature) and lower HPT (pain at lower temperature) at all the measurement points as compared to controls (all, P < .01). PPT were lower at points over the extensor carpi radialis brevis (ECRB) muscle as compared to points over the extensor digitorum communis muscle (P < .01) and over the extensor carpi ulnaris muscle (P < .001). CPT and HPT were not significantly different between points (P > .05). Topographical pressure and thermal pain sensitivity maps revealed bilateral hyperalgesia in patients with strictly unilateral LE. LE patients exhibited heterogeneously distributed pressure pain hyperalgesia while cold or heat maps were homogenous. The most sensitive localizations for PPT assessment corresponded to the muscle belly of the ECRB. Our results confirm the role of ECRB muscle in LE and argue for evidence of peripheral and central sensitization mechanisms in patients with strictly unilateral symptoms. Topographical pressure and thermal sensitivity maps revealed bilateral hyperalgesia in patients with strictly unilateral lateral epicondylalgia (LE). LE patients exhibited heterogeneously distributed pressure pain hyperalgesia

  17. Reliability and group differences in quantitative cervicothoracic measures among individuals with and without chronic neck pain.

    PubMed

    Shahidi, Bahar; Johnson, Cynthia L; Curran-Everett, Douglas; Maluf, Katrina S

    2012-10-31

    Clinicians frequently rely on subjective categorization of impairments in mobility, strength, and endurance for clinical decision-making; however, these assessments are often unreliable and lack sensitivity to change. The objective of this study was to determine the inter-rater reliability, minimum detectable change (MDC), and group differences in quantitative cervicothoracic measures for individuals with and without chronic neck pain (NP). Nineteen individuals with NP and 20 healthy controls participated in this case control study. Two physical therapists performed a 30-minute examination on separate days. A handheld dynamometer, gravity inclinometer, ruler, and stopwatch were used to quantify cervical range of motion (ROM), cervical muscle strength and endurance, and scapulothoracic muscle length and strength, respectively. Intraclass correlation coefficients for inter-rater reliability were significantly greater than zero for most impairment measures, with point estimates ranging from 0.45 to 0.93. The NP group exhibited reduced cervical ROM (P ≤ 0.012) and muscle strength (P ≤ 0.038) in most movement directions, reduced cervical extensor endurance (P = 0.029), and reduced rhomboid and middle trapezius muscle strength (P ≤ 0.049). Results demonstrate the feasibility of obtaining objective cervicothoracic impairment measures with acceptable inter-rater agreement across time. The clinical utility of these measures is supported by evidence of impaired mobility, strength, and endurance among patients with NP, with corresponding MDC values that can help establish benchmarks for clinically significant change.

  18. Quantitative validation of sensory mapping in persistent postherniorrhaphy inguinal pain patients undergoing triple neurectomy.

    PubMed

    Bjurström, M F; Álvarez, R; Nicol, A L; Olmstead, R; Amid, P K; Chen, D C

    2017-04-01

    Neurectomy of the inguinal nerves may be considered for selected refractory cases of chronic postherniorrhaphy inguinal pain (CPIP). There is to date a paucity of easily applicable clinical tools to identify neuropathic pain and examine the neurosensory effects of remedial surgery. The present quantitative sensory testing (QST) pilot study evaluates a sensory mapping technique. Longitudinal (preoperative, immediate postoperative, and late postoperative) dermatomal sensory mapping and a comprehensive QST protocol were conducted in CPIP patients with unilateral, predominantly neuropathic inguinodynia presenting for triple neurectomy (n = 13). QST was conducted in four areas on the affected, painful side and in one contralateral comparison site. QST variables were compared according to sensory mapping outcomes: (o)/normal sensation, (+)/pain, and (-)/numbness. Diagnostic ability of the sensory mapping outcomes to detect QST-assessed allodynia or hypoesthesia was estimated through calculation of specificity and sensitivity values. Preoperatively, patients exhibited mechanical hypoesthesia and allodynia and pressure allodynia and hyperalgesia in painful areas mapped (+) (p < .05); sensory mapping outcome (+) demonstrated high ability to detect mechanical allodynia [sensitivity 0.74 (95% CI 0.61-0.86), specificity 0.94 (0.84-1.00)] and pressure allodynia [sensitivity 0.96 (0.89-1.00), specificity 1.00 (1.00-1.00)], but not thermal allodynia. Postoperatively, mapped areas of numbness (-) were associated with mechanical and thermal hypoesthesia (p < .05); (-) showed high sensitivity and specificity to detect mechanical and cold hypoesthesia. Sensory mapping provides an accurate clinical neuropathic assessment with strong correlation to QST findings of preoperative mechanical and pressure allodynia, and postoperative mechanical and thermal hypoesthesia in CPIP patients undergoing neurectomy.

  19. Reliability of procedures used in the physical examination of non-specific low back pain: a systematic review.

    PubMed

    May, Stephen; Littlewood, Chris; Bishop, Annette

    2006-01-01

    The purpose of this systematic review was to determine the quality of the research and to assess the reliability of different types of physical examination procedures used in the assessment of patients with non-specific low back pain. A search of electronic databases (MEDLINE, PEDro, AMED, EMBASE, Cochrane, and CINAHL) up to August 2005 identified 48 relevant studies which were analysed for quality and reliability. Pre-established criteria were used to judge the quality of the studies and satisfactory reliability, and conclusions emphasised high quality studies (> or = 60% methods score). The mean quality score of the studies was 52% (range 0 to 88%), indicating weak to moderate methodology. Based on the upper threshold used (kappa/ICC > 0.85) most procedures demonstrated either conflicting evidence or moderate to strong evidence of low reliability. When the lower threshold was used (kappa/ICC > 0.70) evidence about pain response to repeated movements changed from contradictory to moderate evidence for high reliability. Most procedures commonly used by clinicians in the examination of patients with back pain demonstrate low reliability.

  20. Interrater reliability of the cervicothoracic and shoulder physical examination in patients with a primary complaint of shoulder pain.

    PubMed

    Burns, Scott A; Cleland, Joshua A; Carpenter, Kristin; Mintken, Paul E

    2016-03-01

    Examine the interrater reliability of cervicothoracic and shoulder physical examination in patients with a primary complaint of shoulder pain. Single-group repeated-measures design for interrater reliability. Orthopaedic physical therapy clinics. Twenty-one patients with a primary complaint of shoulder pain underwent a standardized examination by a physical therapist (PT). A PT conducted the first examination and one of two additional PTs conducted the 2nd examination. The Cohen κ and weighted κ were used to calculate the interrater reliability of ordinal level data. Intraclass correlation coefficients model 2,1 (ICC2,1) and the 95% confidence intervals were calculated to determine the interrater reliability. The kappa coefficients ranged from -.24 to .83 for the mobility assessment of the glenohumeral, acromioclavicular and sternoclavicular joints. The kappa coefficients ranged from -.20 to .58 for joint mobility assessment of the cervical and thoracic spine. The kappa coefficients ranged from .23 to 1.0 for special tests of the shoulder and cervical spine. The present study reported the reliability of a comprehensive upper quarter physical examination for a group of patients with a primary report of shoulder pain. The reliability varied considerably for the cervical and shoulder examination and was significantly higher for the examination of muscle length and cervical range of motion. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. The Norwegian version of the American Pain Society Patient Outcome Questionnaire: reliability and validity of three subscales.

    PubMed

    Dihle, Alfhild; Helseth, Sølvi; Christophersen, Knut-Andreas

    2008-08-01

    To examine some psychometric properties of the Norwegian version of the American Pain Society's Patient Outcome Questionnaire(APS-POQ-N). This study is part of an investigation of Norwegian orthopaedic surgical patients, where the overall aim is to evaluate the quality of postoperative pain management. Therefore, an adequate questionnaire on the quality of postoperative pain management was needed. The sample included 114 orthopaedic postoperative patients. The instrument consists of three main subscales, namely the modified Brief Pain Inventory(modified BPI subscale), the subscale on satisfaction with pain management(Satisfaction subscale) and the subscale on beliefs about pain management (Beliefs subscale), together with six single items about pain management. The reliability of these three main subscales was estimated using Cronbach's alpha coefficients and the construct validity was evaluated using principal-axis factor analysis with oblimin rotation. Face and content validity of the APS-POQ-N were satisfactory, while the modified BPI and the Beliefs subscales showed acceptable internal consistency but the Satisfaction subscale did not. Factor analyses yielded a three-factor solution for the modified BPI, a one-factor solution for the Satisfaction subscale and a two-factor solution for the Beliefs subscale. The APS-POQ-N appears, in general, to be an acceptable method of evaluating postoperative pain management in orthopaedic postoperative patients.However, the alpha value of the Satisfaction subscale was low, and thus the subscale is not recommended for this purpose.

  2. Assessment of landslide distribution map reliability in Niigata prefecture - Japan using frequency ratio approach

    NASA Astrophysics Data System (ADS)

    Rahardianto, Trias; Saputra, Aditya; Gomez, Christopher

    2017-07-01

    Research on landslide susceptibility has evolved rapidly over the few last decades thanks to the availability of large databases. Landslide research used to be focused on discreet events but the usage of large inventory dataset has become a central pillar of landslide susceptibility, hazard, and risk assessment. Indeed, extracting meaningful information from the large database is now at the forth of geoscientific research, following the big-data research trend. Indeed, the more comprehensive information of the past landslide available in a particular area is, the better the produced map will be, in order to support the effective decision making, planning, and engineering practice. The landslide inventory data which is freely accessible online gives an opportunity for many researchers and decision makers to prevent casualties and economic loss caused by future landslides. This data is advantageous especially for areas with poor landslide historical data. Since the construction criteria of landslide inventory map and its quality evaluation remain poorly defined, the assessment of open source landslide inventory map reliability is required. The present contribution aims to assess the reliability of open-source landslide inventory data based on the particular topographical setting of the observed area in Niigata prefecture, Japan. Geographic Information System (GIS) platform and statistical approach are applied to analyze the data. Frequency ratio method is utilized to model and assess the landslide map. The outcomes of the generated model showed unsatisfactory results with AUC value of 0.603 indicate the low prediction accuracy and unreliability of the model.

  3. How to Map Theory: Reliable Methods Are Fruitless Without Rigorous Theory.

    PubMed

    Gray, Kurt

    2017-08-01

    Good science requires both reliable methods and rigorous theory. Theory allows us to build a unified structure of knowledge, to connect the dots of individual studies and reveal the bigger picture. Some have criticized the proliferation of pet "Theories," but generic "theory" is essential to healthy science, because questions of theory are ultimately those of validity. Although reliable methods and rigorous theory are synergistic, Action Identification suggests psychological tension between them: The more we focus on methodological details, the less we notice the broader connections. Therefore, psychology needs to supplement training in methods (how to design studies and analyze data) with training in theory (how to connect studies and synthesize ideas). This article provides a technique for visually outlining theory: theory mapping. Theory mapping contains five elements, which are illustrated with moral judgment and with cars. Also included are 15 additional theory maps provided by experts in emotion, culture, priming, power, stress, ideology, morality, marketing, decision-making, and more (see all at theorymaps.org ). Theory mapping provides both precision and synthesis, which helps to resolve arguments, prevent redundancies, assess the theoretical contribution of papers, and evaluate the likelihood of surprising effects.

  4. Testing the Reliability of Manual Mapping of Glacial Landforms: Initial Results

    NASA Astrophysics Data System (ADS)

    Hillier, John K.; Smith, Mike J.

    2015-04-01

    Mapped topographic features are important for understanding processes that sculpt the Earth's surface. Manual, interpretive, techniques for mapping are commonly used yet, it is difficult to assess their effectiveness. Here 'real' DEMs are modified by inserting 'synthetic' drumlins in to them [Hillier and Smith, 2012] for mappers to identify. Interactive maps are presented that display 12,121 outlines drawn by 25 interpreters searching for a total of 21,625 drumlins. Overall detection rates (i.e. ncoincident/ntotal) are low at 34-40%, interestingly comparable to automated methods [Eisank et al., 2014], but reliability (i.e. ncoincident/nmapped) is higher at 72-86%. A pilot study also indicates that drumlin height is the key dimension driving detectability, with rates decreasing from 100% to

  5. Is the Conditioned Pain Modulation Paradigm Reliable? A Test-Retest Assessment Using the Nociceptive Withdrawal Reflex

    PubMed Central

    Biurrun Manresa, José A.; Fritsche, Raphael; Vuilleumier, Pascal H.; Oehler, Carmen; Mørch, Carsten D.; Arendt-Nielsen, Lars; Andersen, Ole K.; Curatolo, Michele

    2014-01-01

    The aim of this study was to determine the reliability of the conditioned pain modulation (CPM) paradigm assessed by an objective electrophysiological method, the nociceptive withdrawal reflex (NWR), and psychophysical measures, using hypothetical sample sizes for future studies as analytical goals. Thirty-four healthy volunteers participated in two identical experimental sessions, separated by 1 to 3 weeks. In each session, the cold pressor test (CPT) was used to induce CPM, and the NWR thresholds, electrical pain detection thresholds and pain intensity ratings after suprathreshold electrical stimulation were assessed before and during CPT. CPM was consistently detected by all methods, and the electrophysiological measures did not introduce additional variation to the assessment. In particular, 99% of the trials resulted in higher NWR thresholds during CPT, with an average increase of 3.4 mA (p<0.001). Similarly, 96% of the trials resulted in higher electrical pain detection thresholds during CPT, with an average increase of 2.2 mA (p<0.001). Pain intensity ratings after suprathreshold electrical stimulation were reduced during CPT in 84% of the trials, displaying an average decrease of 1.5 points in a numeric rating scale (p<0.001). Under these experimental conditions, CPM reliability was acceptable for all assessment methods in terms of sample sizes for potential experiments. The presented results are encouraging with regards to the use of the CPM as an assessment tool in experimental and clinical pain. Trial Registration: Clinical Trials.gov NCT01636440 PMID:24950186

  6. Interexaminer reliability of the electromagnetic radiation receiver for determining lumbar spinal joint dysfunction in subjects with low back pain

    SciTech Connect

    Gemmell, H.A.; Jacobson, B.H.; Edwards, S.W.; Heng, B.J.

    1990-03-01

    Twenty subjects (6 male, 14 female) with low back pain were examined by two experienced and licensed chiropractic doctors (E1 and E2). Both examiners examined the patients using a Toftness Electromagnetic Radiation Receiver (EMRR) and by manual palpation (MP) of the spinous processes. Interexaminer reliability was calculated at three sites (L3, L4, L5) for the following combinations: (a) E1,MP--E2,MP; (b) E1,EMRR--E2,EMRR; (c) E1,MP--E2,EMRR; and (d) E2,MP--E1,EMRR, and intraexaminer reliability was calculated for the following variables: (e) E1,MP--E1,EMRR; and (f) E2,MP--E2,EMRR. Results of a Kappa coefficient analysis for interexaminer reliability of the stated combinations and at the specific sites were: (a) -0.071, 0.400, 0.200; (b) -0.013, 0.100, -0.120; (c) 0.286, 0.300, 0.200; (d) -0.081, 0.000, 0.048. These results predominantly indicate a poor to fair interexaminer reliability. The results of a Kappa coefficient analysis for intraexaminer reliability of the stated combinations were: (e) 0.111, 0.400, 0.737; (f) 0.000, 0.100, 0.368. These results indicate a poor to fair reliability. It was concluded that in subjects with low back pain the EMRR may not be a reliable indicator of spinal joint dysfunction.

  7. Cross-cultural translation, validity, and reliability of the French version of the Neurophysiology of Pain Questionnaire.

    PubMed

    Demoulin, Christophe; Brasseur, Pauline; Roussel, Nathalie; Brereton, Clara; Humblet, Fabienne; Flynn, Daniel; Van Beveren, Julien; Osinsky, Thomas; Donneau, Anne-Françoise; Crielaard, Jean-Michel; Vanderthommen, Marc; Bruyère, Olivier

    2017-11-01

    Pain physiology education is an important component in the management of patients with chronic musculoskeletal pain. The Neurophysiology of Pain Questionnaire (NPQ) was developed in English to assess pain physiology knowledge in patients. This study aimed to translate the NPQ into French (NPQ-Fr) and to investigate the main psychometric properties of the NPQ-Fr. The translation was performed using the best practice translation guidelines. One hundred and one French-speaking patients with chronic non-specific spinal pain completed the NPQ-Fr to assess its acceptability and presence of floor/ceiling effects and test its dimensionality. The construct validity was tested by comparing the patients' NPQ-Fr scores to those of 17 physiotherapists and investigating its correlation with subscales of the Short Form-36 questionnaire. The reliability (i.e., internal consistency and test-retest reliability) was also investigated. To test the test-retest reliability, 70 patients were asked to complete the NPQ-Fr twice with one week in between. Regarding the NPQ-Fr psychometric properties: 1) acceptability was good; 2) internal consistency reached a Cronbach α-coefficient of 0.44; 3) no floor and ceiling effects were observed in patients; 4) a principal factor analysis generated three major factors; 5) construct validity was good; and 6) reliability was acceptable (intraclass correlation coefficient = 0.644; standard error of measurement = 1.5). The NPQ-Fr has satisfactory basic psychometric properties in patients with chronic spinal pain.

  8. Evaluating reliability of hidden Markov models that describe the lifting patterns of chronic lower back pain patients and controls.

    PubMed

    Slaboda, Jill C; Boston, J Robert; Rudy, Thomas E

    2006-01-01

    Two hidden Markov models (HMMs) were designed to identify sub-groups of chronic lower back pain (CLBP) subjects based on time series of lifting parameters obtained during a repetitive lifting task. Two simulation studies were conducted to determine the reliability of this approach, using data from the repetitive lifting study. The first simulation verifies that control and CLBP HMMs based on these data can reliably identify sequences that were generated from that model. The second simulation determines whether the HMMs can reliably identify sequences that are intentionally misclassified (CLBP lifting sequences included in the control group and visa versa). The kappa statistic is used to quantify reliability. The simulation results show that the HMMs provide a reliable technique to analyze time series of lifting patterns and can be used to identify misclassified subjects as a subgroup.

  9. 3-D pain drawings and seating pressure maps: relationships and challenges.

    PubMed

    Spyridonis, Fotios; Ghinea, Gheorghita

    2011-05-01

    Mobility impaired people constitute a significant portion of the adult population, which often experience back pain at some point during their lifetime. Such pain is usually characterized by severe implications reflected on both their personal lives, as well as on a country's health and economic systems. The traditional 2-D representations of the human body often used can be limited in their ability to efficiently visualize such pain for diagnosis purposes. Yet, patients have been shown to prefer such drawings. However, considering that pain is a feeling or emotion that is subjective in nature, the pain drawings could be consequently regarded as a subjective means of communicating such pain. As a result, the study described in this paper proposes an alternative, which encompasses a 3-D pain visualization solution, developed in a previous work of ours. This alternative is complemented with the upcoming technique of pressure mapping for more objectivity in the pain data collection. The results of this study have shown that the proposed approach is a promising solution for the purpose intended, and it could generally prove to be a significant complementary method in the area of medical practice for the mobility impaired community.

  10. Pressure Pain Sensitivity Maps of the Neck-Shoulder Region in Breast Cancer Survivors.

    PubMed

    Caro-Morán, Elena; Fernández-Lao, Carolina; Díaz-Rodríguez, Lourdes; Cantarero-Villanueva, Irene; Madeleine, Pascal; Arroyo-Morales, Manuel

    2016-10-01

    The aim of the present study was to report pressure pain sensitivity topographical maps of the frontal and dorsal parts of the shoulder region, and locate the pressure pain sensitive areas in breast cancer survivors compared with matched healthy control subjects. Twenty-two breast cancer survivors (BCS) and 22 matched control subjects participated. A numeric pain rating scale of the neck-shoulder area and pressure pain thresholds (PPTs) was assessed bilaterally over 28 points in the frontal and dorsal neck-shoulder area. Topographical pain sensitivity maps of the upper trapezius, pectoral, and anterior deltoid areas were computed. A three-way analysis of variance was carried out to evaluate the differences in PPTs. The BCS reported spontaneous neck pain (mean ± SD 3.6 ± 2.8), pain in the affected shoulder (4.3 ± 2.7), and pain in the non-affected shoulder (0.9 ± 1.8). Additionally, the BCS exhibited bilaterally lower PPTs in all the measurement points as compared with the control subjects (P < 0.05). The PPTs were lower at the superior part of the trapezius muscle (P < 0.001), the musculotendinous insertion, the anterior part of the deltoid muscle (P < 0.001), and the tendon of the pectoral muscle (P < 0.001) as compared with the control subjects. The results suggest the sensitization processes in the BCS and give preliminary evidence to most sensitive areas in the superior part of the upper trapezius and musculotendinous insertion of the pectoral muscle. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Assessing the risk of central post-stroke pain of thalamic origin by lesion mapping.

    PubMed

    Sprenger, Till; Seifert, Christian L; Valet, Michael; Andreou, Anna P; Foerschler, Annette; Zimmer, Claus; Collins, D Louis; Goadsby, Peter J; Tölle, Thomas R; Chakravarty, M Mallar

    2012-08-01

    Central post-stroke pain of thalamic origin is an extremely distressing and often refractory disorder. There are no well-established predictors for pain development after thalamic stroke, and the role of different thalamic nuclei is unclear. Here, we used structural magnetic resonance imaging to identify the thalamic nuclei, specifically implicated in the generation of central post-stroke pain of thalamic origin. Lesions of 10 patients with central post-stroke pain of thalamic origin and 10 control patients with thalamic strokes without pain were identified as volumes of interest on magnetic resonance imaging data. Non-linear deformations were estimated to match each image with a high-resolution template and were applied to each volume of interest. By using a digital atlas of the thalamus, we elucidated the involvement of different nuclei with respect to each lesion. Patient and control volumes of interest were summed separately to identify unique areas of involvement. Voxelwise odds ratio maps were calculated to localize the anatomical site where lesions put patients at risk of developing central post-stroke pain of thalamic origin. In the patients with pain, mainly lateral and posterior thalamic nuclei were affected, whereas a more anterior-medial lesion pattern was evident in the controls. The lesions of 9 of 10 pain patients overlapped at the border of the ventral posterior nucleus and the pulvinar, coinciding with the ventrocaudalis portae nucleus. The lesions of this area showed an odds ratio of 81 in favour of developing thalamic pain. The high odds ratio at the ventral posterior nucleus-pulvinar border zone indicates that this area is crucial in the pathogenesis of thalamic pain and demonstrates the feasibility of identifying patients at risk of developing central post-stroke pain of thalamic origin early after thalamic insults. This provides a basis for pre-emptive treatment studies.

  12. Electric toothbrush application is a reliable and valid test for differentiating temporomandibular disorders pain patients from controls

    PubMed Central

    Nixdorf, Donald R; Hemmaty, Azar; Look, John O; Schiffman, Eric L; John, Mike T

    2009-01-01

    Background Current methods for identifying patients with pain hypersensitivity are sufficiently complex to limit their widespread application in clinical settings. We assessed the reliability and validity of a simple multi-modal vibrotactile stimulus, applied using an electric toothbrush, to evaluate its potential as a screening tool for central sensitization. Methods Fourteen female temporomandibular disorders (TMD) subjects with myofascial pain (RDC/TMD Ia or Ib) and arthralgia (RDC/TMD IIIa) were compared to 13 pain-free controls of matched age and gender. Vibrotactile stimulus was performed with an electric toothbrush, applied with 1 pound pressure for 30 seconds in four locations: over the lateral pole of the temporomandibular joint, masseter, temporalis, and mid-ventral surface of forearm. Pain intensity (0–10) was recorded following the stimulus at 0, 15, 30, and 60 seconds. Test-retest reliability was assessed with measurements from 8 participants, taken 2–12 hours apart. Case versus control differentiation involved comparison of area under the curve (AUC). A receiver operating characteristic (ROC) curve was used to determine cutoff AUC scores for maximum sensitivity and specificity for this multi-modal vibrotactile stimulus. Results Test-retest reliability resulted in an ICC of 0.87 for all 4 pooled sites. ROC-determined AUC cutoff scores resulted in a sensitivity of 57% and specificity of 92% for all 4 pooled sites. Conclusion The electric toothbrush stimulus had excellent test-retest reliability. Validity of the scores was demonstrated with modest sensitivity and good specificity for differentiating TMD pain patients from controls, which are acceptable properties for a screening test. PMID:19643013

  13. Development, validity, and reliability of The Assessment of Pain and Occupational Performance (POP): a new instrument using two dimensions in the investigation of disability in back pain.

    PubMed

    Perneros, Gerd; Tropp, Hans

    2009-06-01

    Questionnaires for measuring the functional status of patients with low back pain (LBP) focus on disability and present responses for each question in a predetermined, fixed relationship between "can do/difficulties and pain." Their design does not permit a separation of the two. To present the development of The Assessment of Pain and Occupational Performance (POP) and to evaluate validity and reliability. A prospective, consecutive study of patients investigated by use of the POP. A total of 220 patients participated in the study. In a cross-sectional study including 53 patients with chronic musculoskeletal pain, empirical tests of content and construct validity established the definitive version of the POP. The POP focuses on performance of activities. It is a disease-specific, discriminative assessment instrument designed for patients with back pain (BP) and LBP. Based on a semi-structured interview the POP investigates each of 36 activities in two dimensions, with separate, defined scales from "normally healthy" to "extremes" for level of activity (x-scale) and pain intensity (y-scale). The final scores are expressed in percent, 0% to 100%. Patients with chronic LBP (CLBP) (n=142) were allocated to the specific (S) group, that is, patients with specific LBP problems (n=97) or to the nonspecific (NS) group, that is, those with NS BP (n=45). The ability of the POP to differentiate between the two known groups was evaluated. Construct-convergent validity between the POP and the Oswestry Disability Index (ODI) was carried out for the S group. Inter-rater reliability was established between six pairs of raters who examined 25 patients recruited from primary health care, the P-LBP group. In construct known group validity, the median, the interquartile range, and the Mann-Whitney U test showed that the S group had a significantly higher level of activity (p<.001) combined with worse pain (p=.001) compared with the NS group. There were significant differences between

  14. Reliability and validity of lumbar and abdominal trunk muscle endurance tests in office workers with nonspecific subacute low back pain.

    PubMed

    del Pozo-Cruz, Borja; Mocholi, Miguel H; del Pozo-Cruz, Jesus; Parraca, Jose A; Adsuar, Jose C; Gusi, Narcis

    2014-01-01

    Despite the widespread use of trunk endurance tests, the reliability and validity of these tests in office workers with subacute nonspecific low back pain are unknown. This cross-sectional study involved 190 subjects: 30 men and 42 women without low back pain and 47 men and 71 women with low back pain. All subjects underwent timed prone and supine isometric lumbar and abdominal trunk endurance tests that were performed until subjective fatigue occurred. All subjects also completed the Roland Morris and Oswestry self-reported disability questionnaires. A test-retest study (7 days) was conducted with 31 participants with low back pain from the study. For the abdominal trunk endurance test, males and females with low back pain had mean (SD) values of 62.06 (36.87) and 46.06 (29.28) seconds, respectively, both significantly lower than the asymptomatic workers. For the lumbar test, males and females with low back pain had mean (SD) values of 79.57 (30.66) and 75.49 (28.97) seconds, respectively, again, both significantly lower than the asymptomatic workers. The intraclass correlation coefficients of both tests exceeded 0.90 and the Kappa indices were excellent for both men and women. Receiver-operating curve analyses revealed areas under the curve very close to or exceeding 0.70 for both men and women for both tests. The lumbar and abdominal trunk muscle endurance tests appeared to be reliable and valid measures in office workers with subacute low back pain.

  15. Genomic dark matter: the reliability of short read mapping illustrated by the genome mappability score

    PubMed Central

    Lee, Hayan; Schatz, Michael C.

    2012-01-01

    Motivation: Genome resequencing and short read mapping are two of the primary tools of genomics and are used for many important applications. The current state-of-the-art in mapping uses the quality values and mapping quality scores to evaluate the reliability of the mapping. These attributes, however, are assigned to individual reads and do not directly measure the problematic repeats across the genome. Here, we present the Genome Mappability Score (GMS) as a novel measure of the complexity of resequencing a genome. The GMS is a weighted probability that any read could be unambiguously mapped to a given position and thus measures the overall composition of the genome itself. Results: We have developed the Genome Mappability Analyzer to compute the GMS of every position in a genome. It leverages the parallelism of cloud computing to analyze large genomes, and enabled us to identify the 5–14% of the human, mouse, fly and yeast genomes that are difficult to analyze with short reads. We examined the accuracy of the widely used BWA/SAMtools polymorphism discovery pipeline in the context of the GMS, and found discovery errors are dominated by false negatives, especially in regions with poor GMS. These errors are fundamental to the mapping process and cannot be overcome by increasing coverage. As such, the GMS should be considered in every resequencing project to pinpoint the ‘dark matter’ of the genome, including of known clinically relevant variations in these regions. Availability: The source code and profiles of several model organisms are available at http://gma-bio.sourceforge.net Contact: hlee@cshl.edu Supplementary Information: Supplementary data are available at Bioinformatics online. PMID:22668792

  16. Inter-method reliability of paper surveys and computer assisted telephone interviews in a randomized controlled trial of yoga for low back pain.

    PubMed

    Cerrada, Christian J; Weinberg, Janice; Sherman, Karen J; Saper, Robert B

    2014-04-09

    Little is known about the reliability of different methods of survey administration in low back pain trials. This analysis was designed to determine the reliability of responses to self-administered paper surveys compared to computer assisted telephone interviews (CATI) for the primary outcomes of pain intensity and back-related function, and secondary outcomes of patient satisfaction, SF-36, and global improvement among participants enrolled in a study of yoga for chronic low back pain. Pain intensity, back-related function, and both physical and mental health components of the SF-36 showed excellent reliability at all three time points; ICC scores ranged from 0.82 to 0.98. Pain medication use showed good reliability; kappa statistics ranged from 0.68 to 0.78. Patient satisfaction had moderate to excellent reliability; ICC scores ranged from 0.40 to 0.86. Global improvement showed poor reliability at 6 weeks (ICC = 0.24) and 12 weeks (ICC = 0.10). CATI shows excellent reliability for primary outcomes and at least some secondary outcomes when compared to self-administered paper surveys in a low back pain yoga trial. Having two reliable options for data collection may be helpful to increase response rates for core outcomes in back pain trials. ClinicalTrials.gov: NCT01761617. Date of trial registration: December 4, 2012.

  17. Inter-method reliability of paper surveys and computer assisted telephone interviews in a randomized controlled trial of yoga for low back pain

    PubMed Central

    2014-01-01

    Background Little is known about the reliability of different methods of survey administration in low back pain trials. This analysis was designed to determine the reliability of responses to self-administered paper surveys compared to computer assisted telephone interviews (CATI) for the primary outcomes of pain intensity and back-related function, and secondary outcomes of patient satisfaction, SF-36, and global improvement among participants enrolled in a study of yoga for chronic low back pain. Results Pain intensity, back-related function, and both physical and mental health components of the SF-36 showed excellent reliability at all three time points; ICC scores ranged from 0.82 to 0.98. Pain medication use showed good reliability; kappa statistics ranged from 0.68 to 0.78. Patient satisfaction had moderate to excellent reliability; ICC scores ranged from 0.40 to 0.86. Global improvement showed poor reliability at 6 weeks (ICC = 0.24) and 12 weeks (ICC = 0.10). Conclusion CATI shows excellent reliability for primary outcomes and at least some secondary outcomes when compared to self-administered paper surveys in a low back pain yoga trial. Having two reliable options for data collection may be helpful to increase response rates for core outcomes in back pain trials. Trial registration ClinicalTrials.gov: NCT01761617. Date of trial registration: December 4, 2012. PMID:24716775

  18. Reliability evaluation of auxiliary feedwater system by mapping GO-FLOW models into Bayesian networks.

    PubMed

    Liu, Zengkai; Liu, Yonghong; Wu, Xinlei; Yang, Dongwei; Cai, Baoping; Zheng, Chao

    2016-09-01

    Bayesian network (BN) is a widely used formalism for representing uncertainty in probabilistic systems and it has become a popular tool in reliability engineering. The GO-FLOW method is a success-oriented system analysis technique and capable of evaluating system reliability and risk. To overcome the limitations of GO-FLOW method and add new method for BN model development, this paper presents a novel approach on constructing a BN from GO-FLOW model. GO-FLOW model involves with several discrete time points and some signals change at different time points. But it is a static system at one time point, which can be described with BN. Therefore, the developed BN with the proposed method in this paper is equivalent to GO-FLOW model at one time point. The equivalent BNs of the fourteen basic operators in the GO-FLOW methodology are developed. Then, the existing GO-FLOW models can be mapped into equivalent BNs on basis of the developed BNs of operators. A case of auxiliary feedwater system of a pressurized water reactor is used to illustrate the method. The results demonstrate that the GO-FLOW chart can be successfully mapped into equivalent BNs. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

  19. The burn specific pain anxiety scale: introduction of a reliable and valid measure.

    PubMed

    Taal, L A; Faber, A W

    1997-03-01

    The burn specific pain anxiety scale (BSPAS) is a nine-item self-report scale for the assessment of pain-related and anticipatory anxiety in burned patients. This paper describes a study designed to explore the psychometric properties of the scale. The study used 35 burned patients hospitalized in Rotterdam and Groningen, The Netherlands, to confirm the internal consistency of the instrument and provide an assessment of its validity. The alpha coefficient was high: 0.94. The BSPAS correlated statistically significantly with the STAI-S, procedural pain, non-procedural pain, and nurses' visual analog observation ratings of tension.

  20. Reliability and Concurrent Validity of the Palliative Outcome Scale, the Rotterdam Symptom Checklist, and the Brief Pain Inventory

    PubMed Central

    Perez-Hoyos, Santiago; Agra-Varela, Yolanda

    2013-01-01

    Abstract Background Some domains of the questionnaires used to measure symptoms and quality of life (QOL) in patients with advanced cancer seem to measure similar dimensions or constructs, so it would be useful for clinicians to demonstrate the interchangeability of equivalent domains of the questionnaires in measuring the same constructs. Objective This study investigated the reliability and concurrent validity of the Palliative Outcome Scale (POS), the Rotterdam Symptom Checklist (RSCL), and the Brief Pain Inventory (BPI), used to measure symptom control in patients with advanced cancer. Design This was an evaluative study. Setting/Subjects Subjects were patients with advanced cancer attended by Spanish primary care physicians. Measurements Secondary analysis was performed of 117 outpatients who completed the POS, BPI, and RSCL at two different times, with an interval of 7 to 10 days. Bland and Altman analyses and plot, repeatability coefficient, as well as Spearman correlations were carried out. Results There were 117 included patients. Mean age was 69.4 (11.5) years, gender was 60% male, 37.6% completed only elementary school, diagnoses were mainly digestive and lung cancer, with a low functional rate and presence of oncologic pain. First and second questionnaire rounds showed significant correlations and agreement. Agreement was shown between pain intensity of BPI and pain and physical scales of RSCL, and between physical symptoms of RSCL and of POS, with significant correlations in equivalent dimensions. Conclusion BPI, POS, and RSCL have shown adequate reliability and moderate concurrent validity among them. PMID:23808642

  1. Cross-Cultural Adaptation, Validity, and Reliability of the Persian Version of the Orebro Musculoskeletal Pain Screening Questionnaire.

    PubMed

    Shafeei, Asrin; Mokhtarinia, Hamid Reza; Maleki-Ghahfarokhi, Azam; Piri, Leila

    2017-08-01

    Observational study. To cross-culturally translate the Orebro Musculoskeletal Pain Screening Questionnaire (OMPQ) into Persian and then evaluate its psychometric properties (reliability, validity, ceiling, and flooring effects). To the authors' knowledge, prior to this study there has been no validated instrument to screen the risk of chronicity in Persian-speaking patients with low back pain (LBP) in Iran. The OMPQ was specifically developed as a self-administered screening tool for assessing the risk of LBP chronicity. The forward-backward translation method was used for the translation and cross-cultural adaptation of the original questionnaire. In total, 202 patients with subacute LBP completed the OMPQ and the pain disability questionnaire (PDQ), which was used to assess convergent validity. 62 patients completed the OMPQ a week later as a retest. Slight changes were made to the OMPQ during the translation/cultural adaptation process; face validity of the Persian version was obtained. The Persian OMPQ showed excellent test-retest reliability (intraclass correlation coefficient=0.89). Its internal consistency was 0.71, and its convergent validity was confirmed by good correlation coefficient between the OMPQ and PDQ total scores (r=0.72, p<0.05). No ceiling or floor effects were observed. The Persian version of the OMPQ is acceptable for the target society in terms of face validity, construct validity, reliability, and consistency. It is therefore considered a useful instrument for screening Iranian patients with LBP.

  2. Reliability of ultrasound measurement of automatic activity of the abdominal muscle in participants with and without chronic low back pain

    PubMed Central

    2013-01-01

    Background Ultrasound (US) imaging has been considered as a non-invasive technique to measure thickness and estimate relative abdominal muscle activity. Although some studies have assessed the reliability of US imaging, no study has assessed the reliability of US measurement of automatic activity of abdominal muscles in positions with different levels of stability in participants with chronic low back pain (cLBP). The purpose of this study was to investigate within-day and between-days reliability of US thickness measurements of automatic activity of the abdominal muscles in asymptomatic participants and within-day reliability in those with cLBP. Methods A total of 20 participants (10 with cLBP, 10 healthy) participated in the study. The reliability of US thickness measurements at supine lying and sitting positions (sitting on a chair, sitting on a gym ball with both feet on the ground or lifting one foot off the floor) were assessed. We evaluated within-day reliability in all participants and between-days reliability in asymptomatic participants. Results We found high ICC scores (0.85-0.95) and also small SEM and MDC scores in both groups. The reliability of the measurements was comparable between participants with and without LBP in each position but the SEMs and MDCs was slightly higher in patient group compared with healthy group. It indicates high intra-tester reliability for the US measurement of the thickness of abdominal muscles in all positions. Conclusion US imaging can be used as a reliable method for assessment of automatic activity of abdominal muscles in positions with low levels of stability in participants with and without LBP. PMID:24479859

  3. The reliability of depression diagnosis in chronic low back pain. A pilot study.

    PubMed

    Gallagher, R M; Moore, P; Chernoff, I

    1995-11-01

    The variability in estimated rates of major depressive disorder (MDD) in chronic pain samples may be accounted for by sample and methodological differences. Most studies rely on a single measure of depression and lack independent or repeated measures. This study investigated the prevalence of psychiatric disorders in a convenience sample of 18 patients disabled by low back pain (LBP) referred to, evaluated, and treated in a comprehensive pain rehabilitation program specifically designed to restore work readiness and return to work. Subjects had one or more spinal conditions, had work-related back pain for more than 6 months (x = 23.8), were Caucasian, predominantly young (x = 37.5) and male (55%), and were disabled on workers' compensation and approved for rehabilitation. The performance of three diagnostic procedures, the Pain Medicine Evaluation, an independent Structured Clinical Interview for DSM-III-R (SCID), and Longitudinal Clinical Diagnosis were compared with the "gold standard" of the Final Diagnosis which incorporated information from the other three. Also, the performance of a questionnaire, The Pain & Mood Structural Interview (PMSI), designed to assess the causal relationship of pain and mood and specifically the confounding effects of physical factors, was examined. Thirteen of 18 patients (72%) were diagnosed with MDD at Final Diagnosis. MDD diagnosis was made on 4 of 18 patients (22%) on the initial Pain Medicine Evaluation and on 9 of 18 patients (50%) on the SCID, with only 1 ruled out by the confounding questionnaire, for a SCID current prevalence of 44%. Both the SCID and Pain Medicine Evaluation accurately diagnosed the MDD cases they identified; 9 of 13 MDD cases (69%) were precipitated by a physical factor other than their pain. Three episodes of MDD were ruled out by confounding. These findings are discussed in relation to their implications for assessing pain patients for psychiatric comorbidity.

  4. Head-eye movement control tests in patients with chronic neck pain; inter-observer reliability and discriminative validity.

    PubMed

    Della Casa, Eveline; Affolter Helbling, Jutta; Meichtry, André; Luomajoki, Hannu; Kool, Jan

    2014-01-14

    Head-eye movement control deficit is an identified problem in patients with chronic neck pain, particularly in cases of whiplash associated disorders (WAD). To date, there is no evidence concerning the reliability and validity of visually assessed active head-eye movement control tests. Therefore, the objectives of the present cross-sectional study were, a) to develop a test battery; and b) to investigate inter-observer reliability and discriminative validity in patients with chronic neck pain compared to healthy controls. The study was conducted at two physiotherapy clinics in Switzerland. Ethics Committee approval was obtained. Ten active head-eye coordination tests, on 23 patients with chronic neck pain and associated symptoms and 19 healthy controls, were videotaped. The tests included eye movements in the neutral head position and 45° relative neck rotation, gaze stability and sequential head-eye movements. All tests were performed in the sitting and standing positions. Two blinded physiotherapists independently rated the randomized videos. Performance was rated as "negative", "moderately positive" or "clearly positive". Weighted kappa (wK) and 95% confidence intervals (CI) were calculated to investigate inter-observer reliability. Good reliability was defined as wK >0.5 with a lower boundary of 95% CI >0.2. Odds ratios (to define cut-off points) and the distribution of the classificator, numbers of positive tests, were calculated. Three out of ten tests showed "excellent" (wK 0.82 to 0.86), five out of ten tests showed "substantial" (wK 0.69 to 0.79) and two out of ten tests showed "moderate" (wK 0.54 to 0.59) reliability. Results were comparable in the sitting and standing positions. On average, three out of five tests were rated positive in patients and one out of five tests was rated positive in healthy controls. An odds ratio of 13.3 to 18.6 was obtained using ≥2/5 tests as a cut-off point. Visual assessment by physiotherapists of head-eye movement

  5. The shoulder medial rotation test: an intertester and intratester reliability study in overhead athletes with chronic shoulder pain.

    PubMed

    Lluch, Enrique; Benítez, Josep; Dueñas, Lirios; Casaña, José; Alakhdar, Yasser; Nijs, Jo; Struyf, Filip

    2014-01-01

    The purpose of this study was to examine intertester and intratester reliability of the shoulder medial rotation test (MRT) and reliability differences depending on examiner expertise. Seventeen athletes with chronic shoulder pain participated in the study. Four independent observers with different experience levels simultaneously rated MRT performance as "correct" or "incorrect," after a standardized assessment protocol, the same day (for intertester reliability) and in a 7-day interval (for intratester reliability). The intrarater reliability was admissible for 2 experts and one novice, with κ values ranging between 0.32 to 0.76 and poor for one novice (κ <0). Interrater agreement for all 4 assessors demonstrated slight agreement (κ = 0.06; 95% confidence interval: 0.06-0.47), increasing to fair agreement (κ = 0.33; 95% confidence interval: 0.21-0.69) when comparing the MRT findings between the 2 experienced assessors. Practice with the MRT in novices only marginally improved their level of agreement. Reliability of the MRT for detecting movement control of the shoulder girdle was fair at best for experienced examiners and poor overall. Dexterity and repetitive performance of the test is necessary for correct interpretation of the MRT. Copyright © 2014 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  6. Laterality judgments in people with low back pain--A cross-sectional observational and test-retest reliability study.

    PubMed

    Linder, Martin; Michaelson, Peter; Röijezon, Ulrik

    2016-02-01

    Disruption of cortical representation, or body schema, has been indicated as a factor in the persistence and recurrence of low back pain (LBP). This has been observed through impaired laterality judgment ability and it has been suggested that this ability is affected in a spatial rather than anatomical manner. We compared laterality judgment performance of foot and trunk movements between people with LBP with or without leg pain and healthy controls, and investigated associations between test performance and pain. We also assessed the test-retest reliability of the Recognise Online™ software when used in a clinical and a home setting. Cross-sectional observational and test-retest study. Thirty individuals with LBP and 30 healthy controls performed judgment tests of foot and trunk laterality once supervised in a clinic and twice at home. No statistically significant group differences were found. LBP intensity was negatively related to trunk laterality accuracy (p = 0.019). Intraclass correlation values ranged from 0.51 to 0.91. Reaction time improved significantly between test occasions while accuracy did not. Laterality judgments were not impaired in subjects with LBP compared to controls. Further research may clarify the relationship between pain mechanisms in LBP and laterality judgment ability. Reliability values were mostly acceptable, with wide and low confidence intervals, suggesting test-retest reliability for Recognise Online™ could be questioned in this trial. A significant learning effect was observed which should be considered in clinical and research application of the test. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Reliability of a seated three-dimensional passive intervertebral motion test for mobility, end-feel, and pain provocation in patients with cervicalgia.

    PubMed

    Manning, Dana M; Dedrick, Gregory S; Sizer, Phillip S; Brismée, Jean-Michel

    2012-08-01

    Neck pain can be evaluated with passive intervertebral motion (PIVM). No study has evaluated the reliability of three-dimensional (3D) segmental PIVM testing of the cervical spine in symptomatic subjects in a functional, seated position. The purpose of this study was to evaluate inter-rater reliability of such 3D PIVM technique for pain provocation, hypomobility, and end-feel detection. Subjects (n = 63), age 44±15·6 years, neck pain 3·4±1·6 cm with visual analog scale, were evaluated by two of three raters with varied manual therapy education and experience. To perform the test, the rater passively invoked side-bending motion at each cervical joint from C2-C3 to C6-C7, allowing segmental synkinetic rotation and extension to occur. Each joint was assessed for hypomobility, hard end-feel, and pain provocation. Kappa statistics were used to determine the inter-rater reliability for each variable for joints C2-C3 through C6-C7 for both the most painful and least painful sides. Percent agreements for pain provocation, hypomobility, and end-feel ranged 65-83%, 62-84%, and 68-87%, respectively. Kappa values for pain provocation, hypomobility, and end-feel on the most painful side were fair to moderate (0·29-0·53, 0·21-0·48, and 0·25-0·50, respectively), and on the least painful side were fair to substantial (0·43-0·65, 0·33-0·58, and 0·28-0·60, respectively). This is the first investigation to assess reliability of 3D cervical segmental testing in sitting and to assess reliability of end-feel. The seated 3D PIVM test has sufficient clinical reliability for use in patients with cervicalgia for the assessment of hypomobility, end-feel, and pain provocation.

  8. Construct validity and reliability of a real-time multidimensional smartphone app to assess pain in children and adolescents with cancer.

    PubMed

    Stinson, Jennifer N; Jibb, Lindsay A; Nguyen, Cynthia; Nathan, Paul C; Maloney, Anne Marie; Dupuis, L Lee; Gerstle, J Ted; Hopyan, Sevan; Alman, Benjamin A; Strahlendorf, Caron; Portwine, Carol; Johnston, Donna L

    2015-12-01

    We evaluated the construct validity (including responsiveness), reliability, and feasibility of the Pain Squad multidimensional smartphone-based pain assessment application (app) in children and adolescents with cancer, using 2 descriptive studies with repeated measures. Participants (8-18 years) undergoing cancer treatment were drawn from 4 pediatric cancer centers. In study 1, 92 participants self-reported their level of pain twice daily for 2 weeks using the Pain Squad app to assess app construct validity and reliability. In study 2, 14 participants recorded their level of pain twice a day for 1 week before and 2 weeks after cancer-related surgery to determine app responsiveness. Participants in both studies completed multiple measures to determine the construct validity and feasibility of the Pain Squad app. Correlations between average weekly pain ratings on the Pain Squad app and recalled least, average, and worst weekly pain were moderate to high (0.43-0.68). Correlations with health-related quality of life and pain coping (measured with PedsQL Inventory 4.0, PedsQL Cancer Module, and Pain Coping Questionnaire) were -0.46 to 0.29. The app showed excellent internal consistency (α = 0.96). Pain ratings changed because of surgery with large effect sizes between baseline and the first week postsurgery (>0.85) and small effect sizes between baseline and the second week postsurgery (0.13-0.32). These findings provide evidence of the construct validity, reliability, and feasibility of the Pain Squad app in children and adolescents with cancer. Use of real-time data capture approaches should be considered in future studies of childhood cancer pain. A video accompanying this abstract is available online as Supplemental Digital Content at http://links.lww.com/PAIN/A169.

  9. Reliability and validity of three pain provocation tests used for the diagnosis of chronic proximal hamstring tendinopathy.

    PubMed

    Cacchio, Angelo; Borra, Fabrizio; Severini, Gabriele; Foglia, Andrea; Musarra, Frank; Taddio, Nicola; De Paulis, Fosco

    2012-09-01

    The clinical assessment of chronic proximal hamstring tendinopathy (PHT) in athletes is a challenge to sports medicine. To be able to compare the results of research and treatments, the methods used to diagnose and evaluate PHT must be clearly defined and reproducible. To assess the reliability and validity of three pain provocation tests used for the diagnosis of PHT. Ninety-two athletes with (N=46) and without (N=46) PHT were examined by one physician and two physiotherapists, who were trained in the examination techniques before the study. The examiners were blinded to the symptoms and identity of the athletes. The three pain provocation tests examined were the Puranen-Orava, bent-knee stretch and modified bent-knee stretch tests. Intraclass correlation coefficients (ICCs) based on the repeated measures analysis of variance were used to analyse the intraexaminer and interexaminer reliability, while sensitivity, specificity, predictive values and likelihood ratios were used to determine the validity of the three tests. The ICC values in all three tests revealed a high correlation (range 0.82 to 0.88) for the interexaminer reliability and a high-to-very high correlation (range 0.87 to 0.93) for the intraexaminer reliability. All three tests displayed a moderate-to-high validity, with the highest degree of validity being yielded by the modified bent-knee stretch test. All three pain provocation tests proved to be of potential value in assessing chronic PHT in athletes. However, we recommend that they be used in conjunction with other objective measures, such as MRI.

  10. Upper Limb Neurodynamic Test 1 on Healthy Individuals: Intra- and Intersession Reliability of the Angle between Pain Onset and Submaximal Pain

    PubMed Central

    Gatti, Roberto

    2016-01-01

    Assessment of nerve trunk mechanosensitivity using the upper limb neurodynamic test 1 (ULNT1) often includes measurement of the angle of occurrence in the range of pain onset (PO) and submaximal pain (SP). A measurement that better fits the idea of mechanosensitivity could be the angle between PO and SP (AbOS). This study investigated the intra- and intersession reliability of AbOS, PO, and SP during the ULNT1. Forty-four healthy volunteers underwent three ULNT1 to the point of PO and SP, twice in the first session and once in the second. AbOS, PO, and SP angles of occurrence reliability were examined using the Intraclass Correlation Coefficient (ICC 3,1) and Bland-Altman plots. The intra- and intersession ICC values for AbOS were 0.71 (95% CI: 0.47; 0.85) and 0.79 (95% CI: 0.60; 0.89), respectively. The intra- and intersession mean difference and 95% limits of agreement (±1.96 SD) in the Bland-Altman plots were 2.3° (−18.3°; 23.1°) and 2.8° (−14.7°; 20.4°), respectively. The intra- and intersession reliability of the AbOS during the ULNT1 in healthy individuals is high and higher than the reliability of PO and SP angles of occurrence. The AbOS could be a preferable variable in the assessment of neural mechanosensitivity. PMID:27746681

  11. Depression of home cage wheel running: a reliable and clinically relevant method to assess migraine pain in rats.

    PubMed

    Kandasamy, Ram; Lee, Andrea T; Morgan, Michael M

    2017-12-01

    The development of new anti-migraine treatments is limited by the difficulty inassessing migraine pain in laboratory animals. Depression of activity is one of the few diagnostic criteria formigraine that can be mimicked in rats. The goal of the present study was to test the hypothesis thatdepression of home cage wheel running is a reliable and clinically relevant method to assess migraine painin rats. Adult female rats were implanted with a cannula to inject allyl isothiocyanate (AITC) onto the dura to induce migraine pain, as has been shown before. Rats recovered from implantation surgery for 8 days in cages containing a running wheel. Home cage wheel running was recorded 23 h a day. AITC and the migraine medication sumatriptan were administered in the hour prior to onset of the dark phase. Administration of AITC caused a concentration-dependent decrease in wheel running that lasted 3 h. The duration and magnitude of AITC-induced depression of wheel running was consistent following three repeated injections spaced 48 h apart. Administration of sumatriptan attenuated AITC-induced depressionof wheel running when a large dose (1 mg/kg) was administered immediately following AITC administration. Wheel running patterns did not change when sumatriptan was given to naïve rats. These data indicate that home cage wheel running is a sensitive, reliable, and clinically relevant method to assess migraine pain in the rat.

  12. Evaluation of phenoxybenzamine in the CFA model of pain following gene expression studies and connectivity mapping.

    PubMed

    Chang, Meiping; Smith, Sarah; Thorpe, Andrew; Barratt, Michael J; Karim, Farzana

    2010-09-16

    We have previously used the rat 4 day Complete Freund's Adjuvant (CFA) model to screen compounds with potential to reduce osteoarthritic pain. The aim of this study was to identify genes altered in this model of osteoarthritic pain and use this information to infer analgesic potential of compounds based on their own gene expression profiles using the Connectivity Map approach. Using microarrays, we identified differentially expressed genes in L4 and L5 dorsal root ganglia (DRG) from rats that had received intraplantar CFA for 4 days compared to matched, untreated control animals. Analysis of these data indicated that the two groups were distinguishable by differences in genes important in immune responses, nerve growth and regeneration. This list of differentially expressed genes defined a "CFA signature". We used the Connectivity Map approach to identify pharmacologic agents in the Broad Institute Build02 database that had gene expression signatures that were inversely related ('negatively connected') with our CFA signature. To test the predictive nature of the Connectivity Map methodology, we tested phenoxybenzamine (an alpha adrenergic receptor antagonist) - one of the most negatively connected compounds identified in this database - for analgesic activity in the CFA model. Our results indicate that at 10 mg/kg, phenoxybenzamine demonstrated analgesia comparable to that of Naproxen in this model. Evaluation of phenoxybenzamine-induced analgesia in the current study lends support to the utility of the Connectivity Map approach for identifying compounds with analgesic properties in the CFA model.

  13. Validity, reliability, and assessment sensitivity of the Japanese version of the short-form McGill pain questionnaire 2 in Japanese patients with neuropathic and non-neuropathic pain.

    PubMed

    Maruo, Tomoyuki; Nakae, Aya; Maeda, Lynn; Shi, Kenrin; Takahashi, Kayoko; Morris, Shayne; Hosomi, Koichi; Kanatani, Hiroshi; Matsuzaki, Taiga; Saitoh, Youichi

    2014-11-01

    The objective of this study was to define the validity, reliability, and assessment sensitivity of the Japanese version of the Short-Form McGill Pain Questionnaire 2 (SF-MPQ-2-J). This is a cross-sectional study. The original SF-MPQ-2 was translated into Japanese to create the SF-MPQ-2-J, and the cross-cultural equivalence of assessment tool for Japanese patients was validated. The reliability of the SF-MPQ-2-J was assessed using internal consistency, reliability coefficients (Cronbach's α), and reproducibility coefficients (intraclass correlation coefficient) obtained using 234 patients with chronic pain. SF-MPQ-2-J validity was assessed based on associations identified between total and subscale scores compared with other assessment methods. A confirmatory factor analysis (CFA) was also performed to test the theoretical structure of the SF-MPQ-2-J. The internal consistencies calculated included continuous pain, α=0.893; intermittent pain, α=0.875; predominantly neuropathic pain, α=0.917; affective descriptors, α=0.857; and total score, α=0.907. The reproducibility coefficients calculated included continuous pain, ρ=0.81; intermittent pain, ρ=0.78; predominantly neuropathic pain, ρ=0.85; affective descriptors, ρ=0.75; and total score, ρ=0.83. The CFA showed that the model fit of the readily interpretable subscales was acceptable, and the goodness of fit index value was 0.917. In addition, the mean predominantly neuropathic pain subscale score was found to be significantly higher for patients with neuropathic pain vs non-neuropathic pain. These findings suggest that the reliability and validity of the SF-MPQ-2-J are excellent, and the SF-MPQ-2-J represents a cross-cultural equivalent to SF-MPQ-2. Consequently, the latter is suitable for research and clinical use, and for discriminating neuropathic pain from non-neuropathic pain. Wiley Periodicals, Inc.

  14. Validity and reliability of guidelines for neck pain treatment in primary health care. A nationwide empirical analysis in Spain.

    PubMed

    Saturno, Pedro J; Medina, Francesc; Valera, Fermin; Montilla, Joaquina; Escolar, Pilar; Gascón, Juan J

    2003-12-01

    To assess the reliability and validity of existing clinical guidelines on neck-pain physiotherapy treatment and follow-up in Spain. We identified existing guidelines through a nationwide census and listed their recommendations, grouped according to the main steps of the process flow-chart. To assess reliability we analysed the variability of statements. To analyse validity we assessed the type of scientific evidence supporting the recommendations, and we compared them with a list of evidence-based recommendations that was elaborated for this study. Primary health care centres (n = 24) with guidelines for neck-pain treatment and follow-up. We quantified the number of recommendations, the proportion of valid statements, the frequencies of non-evidence-based recommendations, and the absence of the evidence-based recommendations we had identified. The 34 identified guidelines contained 325 recommendations, with great variation between guidelines with respect to the number, type (for up to 26 different clinical decisions), and content of the recommendations they provided. Direct assessment of the scientific evidence was not possible because no specific reference was given to support any recommendation. When compared with our list, only 20.9% of the recommendations could be considered evidence-based. No guideline contained all the eight evidence-based recommendations we identified. The results question the guidelines' reliability and validity, and their usefulness in ensuring quality. We conclude that guidelines should be reviewed and re-designed with greater scientific rigour.

  15. Comparison of the Reliability and Validity of Scores from Two Concept-Mapping Techniques.

    ERIC Educational Resources Information Center

    Ruiz-Primo, Maria Araceli; Schultz, Susan E.; Li, Min; Shavelson, Richard J.

    2001-01-01

    Reports the results of a study that compared two concept-mapping techniques, one high-directed, "fill-in-the-map" and one low-directed, "construct-a-map-from-scratch". Examines whether: (1) skeleton map scores were sensitive to the sample; (2) the two types of skeleton maps were equivalent; and (3) the two mapping techniques provided similar…

  16. Comparison of the Reliability and Validity of Scores from Two Concept-Mapping Techniques.

    ERIC Educational Resources Information Center

    Ruiz-Primo, Maria Araceli; Schultz, Susan E.; Li, Min; Shavelson, Richard J.

    2001-01-01

    Reports the results of a study that compared two concept-mapping techniques, one high-directed, "fill-in-the-map" and one low-directed, "construct-a-map-from-scratch". Examines whether: (1) skeleton map scores were sensitive to the sample; (2) the two types of skeleton maps were equivalent; and (3) the two mapping techniques provided similar…

  17. Temporal reliability of ultra-high field resting-state MRI for single-subject sensorimotor and language mapping.

    PubMed

    Branco, Paulo; Seixas, Daniela; Castro, São Luís

    2016-11-15

    Resting-state fMRI is a well-suited technique to map functional networks in the brain because unlike task-based approaches it requires little collaboration from subjects. This is especially relevant in clinical settings where a number of subjects cannot comply with task demands. Previous studies using conventional scanner fields have shown that resting-state fMRI is able to map functional networks in single subjects, albeit with moderate temporal reliability. Ultra-high resolution (7T) imaging provides higher signal-to-noise ratio and better spatial resolution and is thus well suited to assess the temporal reliability of mapping results, and to determine if resting-state fMRI can be applied in clinical decision making including preoperative planning. We used resting-state fMRI at ultra-high resolution to examine whether the sensorimotor and language networks are reliable over time - same session and one week after. Resting-state networks were identified for all subjects and sessions with good accuracy. Both networks were well delimited within classical regions of interest. Mapping was temporally reliable at short and medium time-scales as demonstrated by high values of overlap in the same session and one week after for both networks. Results were stable independently of data quality metrics and physiological variables. Taken together, these findings provide strong support for the suitability of ultra-high field resting-state fMRI mapping at the single-subject level.

  18. Problems of video-based pain detection in patients with dementia: a road map to an interdisciplinary solution.

    PubMed

    Kunz, Miriam; Seuss, Dominik; Hassan, Teena; Garbas, Jens U; Siebers, Michael; Schmid, Ute; Schöberl, Michael; Lautenbacher, Stefan

    2017-01-26

    Given the unreliable self-report in patients with dementia, pain assessment should also rely on the observation of pain behaviors, such as facial expressions. Ideal observers should be well trained and should observe the patient continuously in order to pick up any pain-indicative behavior; which are requisitions beyond realistic possibilities of pain care. Therefore, the need for video-based pain detection systems has been repeatedly voiced. Such systems would allow for constant monitoring of pain behaviors and thereby allow for a timely adjustment of pain management in these fragile patients, who are often undertreated for pain. In this road map paper we describe an interdisciplinary approach to develop such a video-based pain detection system. The development starts with the selection of appropriate video material of people in pain as well as the development of technical methods to capture their faces. Furthermore, single facial motions are automatically extracted according to an international coding system. Computer algorithms are trained to detect the combination and timing of those motions, which are pain-indicative. We hope to encourage colleagues to join forces and to inform end-users about an imminent solution of a pressing pain-care problem. For the near future, implementation of such systems can be foreseen to monitor immobile patients in intensive and postoperative care situations.

  19. The intra- and inter-rater reliability of five clinical muscle performance tests in patients with and without neck pain

    PubMed Central

    2013-01-01

    Background This study investigates the reliability of muscle performance tests using cost- and time-effective methods similar to those used in clinical practice. When conducting reliability studies, great effort goes into standardising test procedures to facilitate a stable outcome. Therefore, several test trials are often performed. However, when muscle performance tests are applied in the clinical setting, clinicians often only conduct a muscle performance test once as repeated testing may produce fatigue and pain, thus variation in test results. We aimed to investigate whether cervical muscle performance tests, which have shown promising psychometric properties, would remain reliable when examined under conditions similar to those of daily clinical practice. Methods The intra-rater (between-day) and inter-rater (within-day) reliability was assessed for five cervical muscle performance tests in patients with (n = 33) and without neck pain (n = 30). The five tests were joint position error, the cranio-cervical flexion test, the neck flexor muscle endurance test performed in supine and in a 45°-upright position and a new neck extensor test. Results Intra-rater reliability ranged from moderate to almost perfect agreement for joint position error (ICC ≥ 0.48-0.82), the cranio-cervical flexion test (ICC ≥ 0.69), the neck flexor muscle endurance test performed in supine (ICC ≥ 0.68) and in a 45°-upright position (ICC ≥ 0.41) with the exception of a new test (neck extensor test), which ranged from slight to moderate agreement (ICC = 0.14-0.41). Likewise, inter-rater reliability ranged from moderate to almost perfect agreement for joint position error (ICC ≥ 0.51-0.75), the cranio-cervical flexion test (ICC ≥ 0.85), the neck flexor muscle endurance test performed in supine (ICC ≥ 0.70) and in a 45°-upright position (ICC ≥ 0.56). However, only slight to fair agreement was found for the neck extensor test (ICC

  20. Reliability and validity of spinal coordination patterns during treadmill walking in persons with thoracic spine pain – a preliminary study

    PubMed Central

    2013-01-01

    Background Persons with low back pain fail to show the same transition as healthy individuals from in-phase to anti-phase rotation of the thorax and pelvis as walking speed increases. The purpose of this study was to determine if the relative phase of the thorax and pelvis during walking was a reliable (within day test-retest) and valid measure for persons with thoracic pain. Methods The time series motion of the spine over C7, T8 and sacrum were measured at five treadmill walking speeds (0.67, 0.89, 1.12, 1.34, 1.56 m/s) in 19 persons with thoracic spine pain and 19 healthy control subjects. After a 20 minute rest, all tests were repeated. The average relative phases of the transverse plane rotation between C7-T8, C7-sacrum and T8-sacrum during a one-minute walk were calculated. The standard error of measurement (SEM) and the intra-class correlation coefficient (ICC) were used to estimate test-retest reliability. Three-way repeated measures analyses of variance were performed to determine the influence of group, walking speed and session on the relative phases. Results The minimum transverse plane motion amplitudes, across all participants and speeds, for the C7-T8, C7-sacrum, and T8-sacrum were 2.9, 5.1 and 2.8 degrees, respectively. The C7-T8 relative phase changed little with speed. The C7-sacrum and T8-sacrum relative phases showed increases as subjects walked faster, but both groups had similar patterns of change. Only the C7-T8 relative phase at 0.67 and 0.89 m/s exhibited good reliability (ICC > 0.80, SEM 4.2-5.7, no significant time effects) for both groups. The C7-T8 and T8-sacrum relative phases demonstrated significant group by speed effects. Conclusions The C7-T8 relative phase showed reasonable reliability and some discrimination between groups, but changes in response to walking speed were small. The T8-sacrum relative phase showed some discriminative ability, but reliability was not adequate. PMID:24321275

  1. Quantitative Ultrasound Assessment of Myofascial Pain Syndrome Affecting the Trapezius: A Reliability Study.

    PubMed

    Kumbhare, Dinesh; Shaw, Saurabh; Grosman-Rimon, Liza; Noseworthy, Michael D

    2017-07-03

    Myofascial pain syndrome is one of the most common causes of chronic pain and is highlighted by the presence of myofascial trigger points. The current practice of diagnosing myofascial pain syndrome among clinicians involves manual detection of myofascial trigger points, which can be inconsistent. However, the detection process can be strengthened with the assistance of ultrasound (US). Therefore, this study aimed to characterize the upper trapezius by using quantitative techniques in healthy asymptomatic individuals with neck pain. Study participants were recruited on the basis of the inclusion and exclusion criteria established, and US images of the trapezius, along the axial and longitudinal orientations, were obtained. Each set was obtained by 2 investigators: experienced and inexperienced personnel. Fifteen participants were recruited. The mean gray scale US echo intensity distribution obtained was 41.9. A paired t test of the global mean echo intensity value obtained for each image from the US operators did not show any significant difference (P = .77). A t test was performed, comparing the echo intensity of the group of patients with neck pain and healthy control participants, and the difference was found to be significant (P = .052). The median blob area was 2.71. The quartile range for the blob area was 1.72 for the 25th percentile to 4.90 for the 75th percentile. This study demonstrated that quantitative analysis of the echo intensity of US images can provide important information. However, further research is necessary to explore the relationships among sex, age, blob area, count, body mass index, regional anatomy, and extent of training or exercise of the particular muscle. © 2017 by the American Institute of Ultrasound in Medicine.

  2. Validity and Reliability of Behavioral Pain Scale in Patients With Low Level of Consciousness Due to Head Trauma Hospitalized in Intensive Care Unit

    PubMed Central

    Dehghani, Hamideh; Tavangar, Hossein; Ghandehari, Akram

    2014-01-01

    Background: Estimating pain in patients of intensive care unit (ICU) is essential, but because of their special situation, verbal scales cannot be used. Therefore, to estimate the level of pain, behavioral pain scale was developed by Payen in 2001. Objectives: The aim of this study was to investigate the validity and reliability of behavioral pain scale in patients with low level of consciousness due to head trauma hospitalized in ICU. Patients and Methods: This descriptive prospective study was performed in Yazd in 2013. In this study, fifty patients, including thirteen women and thirty seven men, were involved. To collect the data a questionnaire including demographic and Glasgow coma scale (GCS) information as well as a list of behavioral pain scale (BPS) were used. SPSS software (version 18) was used to analyze the data. Results: There was no significant difference in reliability proving of average score of BPS recorded by two day and night assessors (P > 5). Cronbach’s alpha was 85 for painful procedures and 76 for non-painful procedures. In addition, known groups’ technique (painful and non-painful procedures) was used to assess validity. The average scores were 7.75 during painful procedures and 3.28 during non-painful procedures (P = 0.001). The results stated that BPS scores during these two procedures were significantly different. Conclusions: BPS in patients with low level of consciousness due to head trauma has strong reliability and validity. Therefore, this scale can be used for patients hospitalized in ICU to assess the level of pain. PMID:25032173

  3. Inter-rater reliability of the Shoulder Symptom Modification Procedure in people with shoulder pain

    PubMed Central

    Lewis, Jeremy S; McCreesh, Karen; Barratt, Eva; Hegedus, Eric J; Sim, Julius

    2016-01-01

    Background Musculoskeletal conditions involving the shoulder are common and, because of the importance of the upper limb and hand in daily function, symptoms in this region are commonly associated with functional impairment in athletic and non-athletic populations. Deriving a definitive diagnosis as to the cause of shoulder symptoms is fraught with difficulty. Limitations have been recognised for imaging and for orthopaedic special tests. 1 solution is to partially base management on the response to tests aimed at reducing the severity of the patient's perception of symptoms. 1 (of many) such tests is the Shoulder Symptom Modification Procedure (SSMP). The reliability of this procedure is unknown. Methods 37 clinician participants independently watched the videos of 11 patient participants undergoing the SSMP and recorded each patient's response as improved (partially or completely), no change or worse. Inter-rater reliability was assessed by Krippendorff's α, which ranges from 0 to 1. Results Krippendorff's α was found to range from 0.762 to 1.000, indicating moderate to substantial reliability. In addition, short (3-hour) and longer (1-day) durations of training were associated with similar levels of reliability across the techniques. Conclusions Deriving a definitive structural diagnosis for a person presenting with a musculoskeletal condition involving the shoulder is difficult. The findings of the present study suggest that the SSMP demonstrates a high level of reliability. More research is needed to better understand the relevance of such procedures. Trial registration number ISRCTN95412360. PMID:27900200

  4. Pressure pain mapping of the wrist extensors after repeated eccentric exercise at high intensity.

    PubMed

    Delfa de la Morena, José M; Samani, Afshin; Fernández-Carnero, Josué; Hansen, Ernst A; Madeleine, Pascal

    2013-11-01

    The purpose of this study was to investigate adaptation mechanisms after 2 test rounds consisting of eccentric exercise using pressure pain imaging of the wrist extensors. Pressure pain thresholds (PPTs) were assessed over 12 points forming a 3 × 4 matrix over the dominant elbow in 12 participants. From the PPT assessments, pressure pain maps were computed. Delayed onset muscle soreness was induced in an initial test round of high-intensity eccentric exercise. The second test round performed 7 days later aimed at resulting in adaptation. The PPTs were assessed before, immediately after, and 24 hours after the 2 test rounds of eccentric exercise. For the first test round, the mean PPT was significantly lower 24 hours after exercise compared with before exercise (389.5 ± 64.1 vs. 500.5 ± 66.4 kPa, respectively; p = 0.02). For the second test round, the PPT was similar before and 24 hours after (447.7 ± 51.3 vs. 458.0 ± 73.1 kPa, respectively; p = 1.0). This study demonstrated adaptive effects of the wrist extensors monitored by pain imaging technique in healthy untrained humans. A lack of hyperalgesia, i.e., no decrease in PPT underlined adaptation after the second test round of eccentric exercise performed 7 days after the initial test round. The present findings showed for the first time that repeated eccentric exercise performed twice over 2 weeks protects the wrist extensor muscles from developing exacerbated pressure pain sensitivity. Thus, the addition of eccentric components to training regimens should be considered to induce protective adaptation.

  5. Comparison of the Reliability and Validity of Scores from Two Concept-Mapping Techniques. Draft.

    ERIC Educational Resources Information Center

    Ruiz-Primo, Maria Araceli; Schultz, Susan E.; Li, Min; Shavelson, Richard J.

    A concept map is a graph in which the nodes represent concepts, the lines between the nodes represent relations, and the labels on the lines represent the nature of the relations. Concept maps have been used to assess students' knowledge structures, especially in science education. Two concept mapping techniques, constructing a map and filling in…

  6. The Modified painDETECT Questionnaire for Patients with Hip or Knee Osteoarthritis: Translation into Dutch, Cross-Cultural Adaptation and Reliability Assessment.

    PubMed

    Rienstra, Wietske; Blikman, Tim; Mensink, Frans B; van Raay, Jos J A M; Dijkstra, Baukje; Bulstra, Sjoerd K; Stevens, Martin; van den Akker-Scheek, Inge

    2015-01-01

    There is a growing amount of evidence that alteration in pain processing by the peripheral and central nervous system play a role in osteoarthritis pain, leading to neuropathic-like symptoms. It is essential to identify knee and hip osteoarthritis patients with a neuropathic pain profile in order to offer such patients education and additional treatment options besides conventional pain treatment. The painDETECT Questionnaire is a self-report questionnaire developed to discriminate between nociceptive and neuropathic pain. This questionnaire was modified to fit patients suffering from knee osteoarthritis. The aim of this study was to translate and cross-culturally adapt the modified painDETECT Questionnaire to the Dutch language and to provide a modified version to fit patients with hip osteoarthritis. Reliability for internal consistency, repeatability and floor and ceiling effects were subsequently assessed. A total of 278 patients were included in the reliability study and 123 patients in the repeatability analysis. The Dutch modified painDETECT Questionnaire shows good internal consistency and small relative measurement errors, represented by a good intraclass correlation coefficient. Absolute measurement error, represented by the Standard Error of Measurement, was acceptable. However, a measurement bias might be present when it comes to repeatability. To our knowledge, this study is the first to provide a Dutch modified painDETECT Questionnaire to fit hip and knee osteoarthritis patients and to assess internal consistency, reliability and agreement. International guidelines were followed in the translation process and this study has ample sample size with an adequate time interval for repeatability. Based on this study, the Dutch modified painDETECT Questionnaire seems to be fit as a discriminative tool to identify knee and hip osteoarthritis patients with a neuropathic pain profile. Whether it is also suitable as an evaluative tool to record changes over time

  7. Mapping, profiling and clustering of pressure pain threshold (PPT) in edentulous oral mucosa.

    PubMed

    Ogawa, T; Tanaka, M; Ogimoto, T; Okushi, N; Koyano, K; Takeuchi, K

    2004-03-01

    Edentulous oral mucosa involves different tissue types, various innervation and wound healing process. We hypothesized that pressure pain threshold (PPT) of edentulous oral mucosa varies significantly among different regions. The objective of this study is to examine regional differences and correlations of PPT in edentulous oral mucosa. Pain threshold (PPT) was measured at 112 sites in 15 edentulous patients using an electric-controlled pressure algometer. PPT mapping was created by the level of PPT, and PPT clustering was undertaken based on the inter-site correlation of PPT. PPT increased from the anterior to posterior alveolus in both maxilla and mandible, but decreased from the anterior palate to the posterior palate. PPT decreased from the ridge crest to the buccal vestibule. The inter-site difference was four fold within the maxilla and 2.4 fold within the mandible. Principal component analysis applied on PPT inter-site correlation matrix revealed that the maxilla and mandible could be differentiated statistically. The maxilla and mandible were divided into three and four clusters, respectively. These results demonstrate that different areas of edentulous oral mucosa have different PPT and that the PPT varies proportionally in selected areas, providing useful diagnostic and therapeutic information in removable prosthodontics and a new opportunity for understanding pain underneath the denture.

  8. Pathomechanism of Interstitial Cystitis/Bladder Pain Syndrome and Mapping the Heterogeneity of Disease

    PubMed Central

    2016-01-01

    Interstitial cystitis/bladder pain syndrome (IC/BPS) is a heterogeneous syndrome which is usually characterized by urinary frequency, nocturia, and bladder pain. Several pathomechanisms have been proposed, including uroepithelial dysfunction, mast cell activation, neurogenic inflammation, autoimmunity, and occult urinary tract infections. It is possible that an inflammatory process alters regulation of urothelial homeostasis and results in dysfunction of the bladder epithelium. Different phenotypes of IC/BPS have been explored including Hunner and non-Hunner type IC, hypersensitive bladder, and bladder pain both with and without functional somatic syndrome. Different gene expressions have also been found in different IC phenotypes. Abnormal expressions of uroplakin, chondroitin sulfate and adhesive protein E-cadherin, tight junction protein zonula occludens-1 in IC/BPS bladder suggest abnormal epithelial differentiation in this bladder disease. Analysis of inflammatory proteins, or cytokines in the urine or serum provides another diagnostic foundation forIC/BPS subtypes. The involvement of IC/BPS in systemic functional somatic syndrome and other pelvic organ diseases might also subdivide subtypes of IC/BPS. Chronic inflammation, increased urothelial apoptosis, and abnormal urothelial function are closely associated in IC bladders. This article reviews recent research on the pathomechanisms of IC, which might help us in mapping the heterogeneity of the disease. PMID:27915472

  9. Reliability of a seated three-dimensional passive intervertebral motion test for mobility, end-feel, and pain provocation in patients with cervicalgia

    PubMed Central

    Manning, Dana M; Dedrick, Gregory S; Sizer, Phillip S; Brismée, Jean-Michel

    2012-01-01

    Objectives: Neck pain can be evaluated with passive intervertebral motion (PIVM). No study has evaluated the reliability of three-dimensional (3D) segmental PIVM testing of the cervical spine in symptomatic subjects in a functional, seated position. The purpose of this study was to evaluate inter-rater reliability of such 3D PIVM technique for pain provocation, hypomobility, and end-feel detection. Methods: Subjects (n = 63), age 44±15·6 years, neck pain 3·4±1·6 cm with visual analog scale, were evaluated by two of three raters with varied manual therapy education and experience. To perform the test, the rater passively invoked side-bending motion at each cervical joint from C2–C3 to C6–C7, allowing segmental synkinetic rotation and extension to occur. Each joint was assessed for hypomobility, hard end-feel, and pain provocation. Kappa statistics were used to determine the inter-rater reliability for each variable for joints C2–C3 through C6–C7 for both the most painful and least painful sides. Results: Percent agreements for pain provocation, hypomobility, and end-feel ranged 65–83%, 62–84%, and 68–87%, respectively. Kappa values for pain provocation, hypomobility, and end-feel on the most painful side were fair to moderate (0·29–0·53, 0·21–0·48, and 0·25–0·50, respectively), and on the least painful side were fair to substantial (0·43–0·65, 0·33–0·58, and 0·28–0·60, respectively). Discussion: This is the first investigation to assess reliability of 3D cervical segmental testing in sitting and to assess reliability of end-feel. The seated 3D PIVM test has sufficient clinical reliability for use in patients with cervicalgia for the assessment of hypomobility, end-feel, and pain provocation. PMID:23904752

  10. Precise genetic mapping and integrative bioinformatics in Diversity Outbred mice reveals Hydin as a novel pain gene.

    PubMed

    Recla, Jill M; Robledo, Raymond F; Gatti, Daniel M; Bult, Carol J; Churchill, Gary A; Chesler, Elissa J

    2014-06-01

    Mouse genetics is a powerful approach for discovering genes and other genome features influencing human pain sensitivity. Genetic mapping studies have historically been limited by low mapping resolution of conventional mouse crosses, resulting in pain-related quantitative trait loci (QTL) spanning several megabases and containing hundreds of candidate genes. The recently developed Diversity Outbred (DO) population is derived from the same eight inbred founder strains as the Collaborative Cross, including three wild-derived strains. DO mice offer increased genetic heterozygosity and allelic diversity compared to crosses involving standard mouse strains. The high rate of recombinatorial precision afforded by DO mice makes them an ideal resource for high-resolution genetic mapping, allowing the circumvention of costly fine-mapping studies. We utilized a cohort of ~300 DO mice to map a 3.8 Mbp QTL on chromosome 8 associated with acute thermal pain sensitivity, which we have tentatively named Tpnr6. We used haplotype block partitioning to narrow Tpnr6 to a width of ~230 Kbp, reducing the number of putative candidate genes from 44 to 3. The plausibility of each candidate gene's role in pain response was assessed using an integrative bioinformatics approach, combining data related to protein domain, biological annotation, gene expression pattern, and protein functional interaction. Our results reveal a novel, putative role for the protein-coding gene, Hydin, in thermal pain response, possibly through the gene's role in ciliary motility in the choroid plexus-cerebrospinal fluid system of the brain. Real-time quantitative-PCR analysis showed no expression differences in Hydin transcript levels between pain-sensitive and pain-resistant mice, suggesting that Hydin may influence hot-plate behavior through other biological mechanisms.

  11. Ultrasonography in Diagnosis of Myofascial Pain Syndrome and Reliability of Novel Ultrasonic Indexes of Upper Trapezius Muscle.

    PubMed

    Taheri, Navid; Okhovatian, Farshad; Rezasoltani, Asghar; Karami, Mehdi; Hosseini, Sayed Mohsen; Mohammadi, Hosein Kouhzad

    2016-03-23

    Myofascial pain syndrome (MPS) is a common non-articular musculoskeletal disorder. It is characterized by local and referred pain due to the presence of myofascial trigger points (MTrPs). MTrPs most commonly involve the upper trapezius muscle and can be visualized using ultrasound imaging. This study was designed to determine the inter-rater reliability of some new ultrasonographic indices of the upper trapezius muscle and the sensitivity and specificity of 2D ultrasound imaging in the diagnosis of MPS. This semi-experimental study enrolled 15 participants of both genders (mean age: 40.60 ± 5.74 years) with suspected symptoms of MPS. In the first step of the study, the sensitivity and specificity of ultrasonography for diagnosis of MPS was determined in a double blind manner. In the second step, some ultrasonographic measurements, such as muscle thickness, area of MTrPs in longitudinal view, echogenicity of MTrPs in longitudinal view, echogenicity of muscle with MTrPs in longitudinal and transverse views, and the pennation angle of the upper trapezius muscle were measured twice and their reliability was determined using the value of the mean of the two measurements. The sensitivity and specificity of ultrasonographic diagnosis were 91% and 75%, respectively. The inter-rater reliability of upper trapezius muscle thickness, pennation angle, area of MTrPs, echogenicity of active MTrPs in longitudinal view, echogenicity of muscle with MTrPs in transverse view and echogenicity of muscle with MTrPs in longitudinal view were 0.91, 0.96, 0.93, 0.83, 0.93, and 0.91, respectively. 1. Our findings indicated that ultrasonography is a useful method for the diagnosis of MPS owing to its high sensitivity. 2. Appropriate reliability of the quantitative ultrasonographic indices of interest, especially the area of MTrPs and their echogenicity, could be useful for long-term monitoring and designing interventional studies for better management of the syndrome.

  12. Reliable Radiation Hybrid Maps: An Efficient Scalable Clustering-based Approach

    USDA-ARS?s Scientific Manuscript database

    The process of mapping markers from radiation hybrid mapping (RHM) experiments is equivalent to the traveling salesman problem and, thereby, has combinatorial complexity. As an additional problem, experiments typically result in some unreliable markers that reduce the overall quality of the map. We ...

  13. Reliability and Validity of a Computer-Based Knowledge Mapping System To Measure Content Understanding.

    ERIC Educational Resources Information Center

    Herl, H. E.; O'Neil, H. F., Jr.; Chung, G. K. W. K.; Schacter, J.

    1999-01-01

    Presents results from two computer-based knowledge-mapping studies developed by the National Center for Research on Evaluation, Standards, and Student Testing (CRESST): in one, middle and high school students constructed group maps while collaborating over a network, and in the second, students constructed individual maps while searching the Web.…

  14. Short-term test-retest-reliability of conditioned pain modulation using the cold-heat-pain method in healthy subjects and its correlation to parameters of standardized quantitative sensory testing.

    PubMed

    Gehling, Julia; Mainka, Tina; Vollert, Jan; Pogatzki-Zahn, Esther M; Maier, Christoph; Enax-Krumova, Elena K

    2016-08-05

    Conditioned Pain Modulation (CPM) is often used to assess human descending pain inhibition. Nine different studies on the test-retest-reliability of different CPM paradigms have been published, but none of them has investigated the commonly used heat-cold-pain method. The results vary widely and therefore, reliability measures cannot be extrapolated from one CPM paradigm to another. Aim of the present study was to analyse the test-retest-reliability of the common heat-cold-pain method and its correlation to pain thresholds. We tested the short-term test-retest-reliability within 40 ± 19.9 h using a cold-water immersion (10 °C, left hand) as conditioning stimulus (CS) and heat pain (43-49 °C, pain intensity 60 ± 5 on the 101-point numeric rating scale, right forearm) as test stimulus (TS) in 25 healthy right-handed subjects (12females, 31.6 ± 14.1 years). The TS was applied 30s before (TSbefore), during (TSduring) and after (TSafter) the 60s CS. The difference between the pain ratings for TSbefore and TSduring represents the early CPM-effect, between TSbefore and TSafter the late CPM-effect. Quantitative sensory testing (QST, DFNS protocol) was performed on both sessions before the CPM assessment. paired t-tests, Intraclass correlation coefficient (ICC), standard error of measurement (SEM), smallest real difference (SRD), Pearson's correlation, Bland-Altman analysis, significance level p < 0.05 with Bonferroni correction for multiple comparisons, when necessary. Pain ratings during CPM correlated significantly (ICC: 0.411…0.962) between both days, though ratings for TSafter were lower on day 2 (p < 0.005). The early (day 1: 16.7 ± 11.7; day 2: 19.5 ± 11.9; ICC: 0.618, SRD: 20.2) and late (day 1: 1.7 ± 9.2; day 2: 7.6 ± 11.5; ICC: 0.178, SRD: 27.0) CPM effect did not differ significantly between both days. Both early and late CPM-effects did not correlate with the pain thresholds. The short-term test-retest-reliability of the early CPM-effect using the

  15. Replicate effects and test-retest reliability of quantitative sensory threshold testing in dogs with and without chronic pain.

    PubMed

    Knazovicky, David; Helgeson, Erika S; Case, Beth; Thomson, Andrea; Gruen, Margaret E; Maixner, William; Lascelles, B Duncan X

    2017-05-01

    To evaluate replicate effects and test-retest reliability of mechanical and thermal quantitative sensory testing (QST) in normal dogs and dogs with osteoarthritis (OA)-associated pain. A prospective clinical study. A total of 54 client owned dogs (OA, n=31; controls, n=23). Mechanical [electronic von Frey (EVF) and blunt pressure] and thermal (hot and cold) sensory thresholds were obtained in dogs with OA-associated pain and control dogs at two visits, 7 days apart, to assess test-retest reliability. Thresholds were measured at the OA-affected joint (hip or stifle), over the tibial muscle and over the midpoint of the metatarsals. Five replicates were obtained for each modality at each site bilaterally. Overall, there was no significant effect of replicates on QST response. EVF thresholds were significantly lower at the second visit in OA dogs at the affected and metatarsal sites (p=0.0017 and p=0.0014, respectively). Similarly for control dogs, EVF thresholds were significantly lower at the second visit at the metatarsal site (p=0.001). Significantly higher hot thermal latencies were seen in OA dogs at the affected and tibial testing sites (p=0.014 and p=0.012, respectively), and in control dogs at the tibial site (p=0.004). In QST, a replicate does not show a strong effect. However, QST results show variability over time, particularly for EVF and hot thermal stimuli. If QST is to be used clinically to evaluate a sensitized state, the variability over time needs to be accounted for in the study design. Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.

  16. Prevalence of chronic pain among Libyan adults in Derna City: a pilot study to assess the reliability, linguistic validity, and feasibility of using an Arabic version of the structured telephone interviews questionnaire on chronic pain.

    PubMed

    Elzahaf, Raga A; Tashani, Osama A; Johnson, Mark I

    2013-06-01

    There are few studies estimating the prevalence of chronic pain in countries from the Middle East. We translated the Structured Telephone Interviews Questionnaire on Chronic Pain from English into Arabic and assessed its reliability and linguistic validity before using it in a telephone survey in Libya to gather preliminary prevalence data for chronic pain. Intraclass correlations for scaled items were high, and there were no differences in answers to nominal items between the first and second completions of the questionnaire. One hundred and 4 individuals participated in a telephone survey. The prevalence of chronic pain was 25.0% (95% CI, 16.7% to 33.3%) and 50.0% (95% CI: 30.8% to 69.2) of the participants with chronic pain scored ≥ 12 on the Arabic S-LANSS. Mean ± SD duration of pain was 2.8 ± 1.2 years, and pain was more frequent in women (P = 0.02). 53.8% of participants had taken prescription medication for their pain, and 76.9% had used nondrug methods of treatment including traditional Libyan methods such as Kamara, a local herbal concoction. Eighty percent believed that their doctor would rather treat their illness than their pain, and 35% reported that their doctor did not think that their pain was a problem. Some participants complained that the questionnaire was too long with a mean ± SD call duration of 20 ± 5.4 minutes. We conclude that the Arabic Structured Telephone Interviews Questionnaire on Chronic Pain was reliable and linguistically valid and could be used in a large-scale telephone survey on the Libyan population. Our preliminary estimate of prevalence should be considered with caution because of the small sample size.

  17. The test-retest reliability and concurrent validity of the Subjective Complaints Questionnaire for low back pain.

    PubMed

    Ford, Jon Joseph; Story, Ian; McMeeken, Joan

    2009-06-01

    Physiotherapists commonly record detailed patient information regarding subjective complaints for low back pain (LBP), particularly to assist in the process of classifying patients into specific subgroups. A self-administered Subjective Complaints Questionnaire for LBP (SCQ-LBP) measuring such information was developed for the purposes of future clinical research, particularly in the area of LBP classification. The development comprised literature review, feedback from experienced physiotherapists and pilot questionnaire testing in a patient population. Test-retest reliability of the questionnaire in a self administered format as well as concurrent validity against a suitable reference standard was evaluated. The agreement between the self administered questionnaire compared to when administered by a physiotherapist was also tested as the latter method is the most common form of retrieving subjective complaints in clinical practice. Thirty participants with LBP were recruited and at least moderate test-retest reliability was demonstrated in 56 of the 57 self administered questionnaire items. Preliminary evidence was found supporting the concurrent validity of selected items. At least moderate agreement was demonstrated in 51 of the 57 items when comparing between the self administered and physiotherapist administered conditions. The questionnaire is a useful tool for collecting subjective complaints information, particularly for clinical research on the classification of LBP, however, further research regarding validity is required.

  18. Reliability of MRSI brain temperature mapping at 1.5 and 3 T

    PubMed Central

    Thrippleton, Michael J; Parikh, Jehill; Harris, Bridget A; Hammer, Steven J; Semple, Scott I K; Andrews, Peter J D; Wardlaw, Joanna M; Marshall, Ian

    2014-01-01

    MRSI permits the non-invasive mapping of brain temperature in vivo, but information regarding its reliability is lacking. We obtained MRSI data from 31 healthy male volunteers [age range, 22–40 years; mean ± standard deviation (SD), 30.5 ± 5.0 years]. Eleven subjects (age range, 23–40 years; mean ± SD, 30.5 ± 5.2 years) were invited to receive four point-resolved spectroscopy MRSI scans on each of 3 days in both 1.5-T (TR/TE = 1000/144 ms) and 3-T (TR/TE = 1700/144 ms) clinical scanners; a further 20 subjects (age range, 22–40 years; mean ± SD, 30.5 ± 4.9 years) were scanned on a single occasion at 3 T. Data were fitted in the time domain to determine the water–N-acetylaspartate chemical shift difference, from which the temperature was estimated. Temperature data were analysed using a linear mixed effects model to determine variance components and systematic temperature changes during the scanning sessions. To characterise the effects of instrumental drift on apparent MRSI brain temperature, a temperature-controlled phantom was constructed and scanned on multiple occasions. Components of apparent in vivo temperature variability at 1.5 T/3 T caused by inter-subject (0.18/0.17 °C), inter-session (0.18/0.15 °C) and within-session (0.36/0.14 °C) effects, as well as voxel-to-voxel variation (0.59/0.54 °C), were determined. There was a brain cooling effect during in vivo MRSI of 0.10 °C [95% confidence interval (CI): –0.110, –0.094 °C; p < 0.001] and 0.051 °C (95% CI: –0.054, –0.048 °C; p < 0.001) per scan at 1.5 T and 3 T, respectively, whereas phantom measurements revealed minimal drift in apparent MRSI temperature relative to fibre-optic temperature measurements. The mean brain temperature at 3 T was weakly associated with aural (R = 0.55, p = 0.002) and oral (R = 0.62, p < 0.001) measurements of head temperature. In conclusion, the variability associated with MRSI brain temperature

  19. Reliability of MRSI brain temperature mapping at 1.5 and 3 T.

    PubMed

    Thrippleton, Michael J; Parikh, Jehill; Harris, Bridget A; Hammer, Steven J; Semple, Scott I K; Andrews, Peter J D; Wardlaw, Joanna M; Marshall, Ian

    2014-02-01

    MRSI permits the non-invasive mapping of brain temperature in vivo, but information regarding its reliability is lacking. We obtained MRSI data from 31 healthy male volunteers [age range, 22-40 years; mean ± standard deviation (SD), 30.5 ± 5.0 years]. Eleven subjects (age range, 23-40 years; mean ± SD, 30.5 ± 5.2 years) were invited to receive four point-resolved spectroscopy MRSI scans on each of 3 days in both 1.5-T (TR/TE = 1000/144 ms) and 3-T (TR/TE = 1700/144 ms) clinical scanners; a further 20 subjects (age range, 22-40 years; mean ± SD, 30.5 ± 4.9 years) were scanned on a single occasion at 3 T. Data were fitted in the time domain to determine the water-N-acetylaspartate chemical shift difference, from which the temperature was estimated. Temperature data were analysed using a linear mixed effects model to determine variance components and systematic temperature changes during the scanning sessions. To characterise the effects of instrumental drift on apparent MRSI brain temperature, a temperature-controlled phantom was constructed and scanned on multiple occasions. Components of apparent in vivo temperature variability at 1.5 T/3 T caused by inter-subject (0.18/0.17 °C), inter-session (0.18/0.15 °C) and within-session (0.36/0.14 °C) effects, as well as voxel-to-voxel variation (0.59/0.54 °C), were determined. There was a brain cooling effect during in vivo MRSI of 0.10 °C [95% confidence interval (CI): -0.110, -0.094 °C; p < 0.001] and 0.051 °C (95% CI: -0.054, -0.048 °C; p < 0.001) per scan at 1.5 T and 3 T, respectively, whereas phantom measurements revealed minimal drift in apparent MRSI temperature relative to fibre-optic temperature measurements. The mean brain temperature at 3 T was weakly associated with aural (R = 0.55, p = 0.002) and oral (R = 0.62, p < 0.001) measurements of head temperature. In conclusion, the variability associated with MRSI brain temperature mapping was

  20. Validity and reliability of the Spanish-language version of the self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale.

    PubMed

    López-de-Uralde-Villanueva, I; Gil-Martínez, A; Candelas-Fernández, P; de Andrés-Ares, J; Beltrán-Alacreu, H; La Touche, R

    2016-12-08

    The self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale is a tool designed to identify patients with pain with neuropathic features. To assess the validity and reliability of the Spanish-language version of the S-LANSS scale. Our study included a total of 182 patients with chronic pain to assess the convergent and discriminant validity of the S-LANSS; the sample was increased to 321 patients to evaluate construct validity and reliability. The validated Spanish-language version of the ID-Pain questionnaire was used as the criterion variable. All participants completed the ID-Pain, the S-LANSS, and the Numerical Rating Scale for pain. Discriminant validity was evaluated by analysing sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). Construct validity was assessed with factor analysis and by comparing the odds ratio of each S-LANSS item to the total score. Convergent validity and reliability were evaluated with Pearson's r and Cronbach's alpha, respectively. The optimal cut-off point for S-LANSS was ≥12 points (AUC=.89; sensitivity=88.7; specificity=76.6). Factor analysis yielded one factor; furthermore, all items contributed significantly to the positive total score on the S-LANSS (P<.05). The S-LANSS showed a significant correlation with ID-Pain (r=.734, α=.71). The Spanish-language version of the S-LANSS is valid and reliable for identifying patients with chronic pain with neuropathic features. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Pain Sensation and Postsurgical Complications in Posterior Mandibular Implant Placement Using Ridge Mapping, Panoramic Radiography, and Infiltration Anesthesia

    PubMed Central

    2013-01-01

    Objectives. The aim of this study was to investigate intrasurgical and after surgical, pain and the incidence of after surgical alteration of sensation in the mandible and lower lip when placing implants in the posterior mandible using ridge mapping, panoramic radiography, and infiltration anesthesia. Methods. This was a longitudinal clinical study of healthy patients needing implant placement in the posterior mandible. After thorough examination and treatment plan using ridge mapping and panoramic radiography, all patients received dental implants under local infiltration anesthesia. The patients were then given a questionnaire to assess the pain during anesthesia and implant surgery. Change of sensation in the lower lip was evaluated by standard neurosensory examination tests at 7 days and 1 and 4 months. Prosthetic treatment was carried out 4 months postsurgery and the patients were followed for an average of 28.5 months afterwards. Results. A total of 103 implants were placed in 62 patients. Patients reported very minor pain during injection. No pain was reported during either implant placement or bone grafting procedures. No alteration of sensation in the mandible or lower lip was recorded postsurgery. Conclusion. In most cases, ridge mapping, panoramic radiography, and infiltration anesthesia are sufficient for posterior mandibular implant placement without pain or complications. PMID:23762571

  2. Pain.

    PubMed

    Melzack, Ronald; Katz, Joel

    2013-01-01

    Pain has many valuable functions. It often signals injury or disease, generates a wide range of adaptive behaviors, and promotes healing through rest. Despite these beneficial aspects of pain, there are negative features that challenge our understanding of the puzzle of pain, including persistent phantom limb pain after amputation or total spinal cord transection. Pain is a personal, subjective experience influenced by cultural learning, the meaning of the situation, attention, and other psychological variables. Pain processes do not begin with the stimulation of receptors. Rather, injury or disease produces neural signals that enter an active nervous system that (in the adult organism) is the substrate of past experience, culture, and a host of other environmental and personal factors. These brain processes actively participate in the selection, abstraction, and synthesis of information from the total sensory input. Pain is not simply the end product of a linear sensory transmission system; it is a dynamic process that involves continuous interactions among complex ascending and descending systems. The neuromatrix theory guides us away from the Cartesian concept of pain as a sensation produced by injury, inflammation, or other tissue pathology and toward the concept of pain as a multidimensional experience produced by multiple influences. These influences range from the existing synaptic architecture of the neuromatrix-which is determined by genetic and sensory factors-to influences from within the body and from other areas in the brain. Genetic influences on synaptic architecture may determine-or predispose toward-the development of chronic pain syndromes. WIREs Cogn Sci 2013, 4:1-15. doi: 10.1002/wcs.1201 For further resources related to this article, please visit the WIREs website.

  3. An international road map to improve pain assessment in people with impaired cognition: the development of the Pain Assessment in Impaired Cognition (PAIC) meta-tool.

    PubMed

    Corbett, Anne; Achterberg, Wilco; Husebo, Bettina; Lobbezoo, Frank; de Vet, Henrica; Kunz, Miriam; Strand, Liv; Constantinou, Marios; Tudose, Catalina; Kappesser, Judith; de Waal, Margot; Lautenbacher, Stefan

    2014-12-10

    Pain is common in people with dementia, yet identification is challenging. A number of pain assessment tools exist, utilizing observation of pain-related behaviours, vocalizations and facial expressions. Whilst they have been developed robustly, these often lack sufficient evidence of psychometric properties, like reliability, face and construct validity, responsiveness and usability, and are not internationally implemented. The EU-COST initiative "Pain in impaired cognition, especially dementia" aims to combine the expertise of clinicians and researchers to address this important issue by building on previous research in the area, identifying existing pain assessment tools for dementia, and developing consensus for items for a new universal meta-tool for use in research and clinical settings. This paper reports on the initial phase of this collaboration task. All existing observational pain behaviour tools were identified and elements categorised using a three-step reduction process. Selection and refinement of items for the draft Pain Assessment in Impaired Cognition (PAIC) meta-tool was achieved through scrutiny of the evidence, consensus of expert opinion, frequency of use and alignment with the American Geriatric Society guidelines. The main aim of this process was to identify key items with potential empirical, rather than theoretical value to take forward for testing. 12 eligible assessment tools were identified, and pain items categorised according to behaviour, facial expression and vocalisation according to the AGS guidelines (Domains 1 - 3). This has been refined to create the PAIC meta-tool for validation and further refinement. A decision was made to create a supporting comprehensive toolkit to support the core assessment tool to provide additional resources for the assessment of overlapping symptoms in dementia, including AGS domains four to six, identification of specific types of pain and assessment of duration and location of pain. This

  4. Towards reliable mapping of biosecurity risk: incorporating uncertainty and decision-makers’ risk aversion

    Treesearch

    Denys Yemshanov; Frank H. Koch; Mark Ducey; Robert A. Haack

    2015-01-01

    Pest risk maps are an important source of decision support when devising strategies to minimize introductions of invasive organisms and mitigate their impacts. When possible management responses to an invader include costly or socially sensitive activities, decision makers tend to follow a more certain (i.e. risk-averse) course of action. We present a new mapping...

  5. Interrater and intrarater reliability of transverse abdominal and lumbar multifidus muscle thickness in subjects with and without low back pain.

    PubMed

    Djordjevic, Olivera; Djordjevic, Aleksandar; Konstantinovic, Ljubica

    2014-12-01

    Two-group, repeated-measures reliability study. To determine interrater and intrarater reliability of ultrasound measurements of transverse abdominal (TrA) and lumbar multifidus (LM) muscle thickness, during rest and contraction, in subjects with low back pain (LBP) and healthy subjects over 3 consecutive days, performed by an experienced and a novice rater. Previous reliability studies of TrA or LM thickness did not simultaneously account for muscle state, rater experience, and multiday assessment in large subject samples. The 2 raters measured TrA and LM thickness on 3 consecutive days in 42 healthy subjects and 56 subjects with LBP, during rest and contraction, and calculated the percent thickness change from rest to contraction. Intraclass correlation coefficients (ICC(2,k)) and 95% minimal detectable change in thickness were derived for a single measure (day 1) and an average measure (days 1-3). The interrater ICC(2,1) values for single-measure thickness (LBP group, 0.71-0.87; healthy group, 0.94-1.00) were similar to those for average-measure thickness (LBP group, 0.73-0.84; healthy group, 0.93-1.00). Both interrater ICC(2,1) and ICC(2,3) were lower for the relative thickness change (0.61-0.96). Intrarater ICC(2,1) values across 3 consecutive days were high for both raters across the 2 groups (LBP group, 0.95-1.00; healthy group, 0.93-1.00), albeit lower for the relative thickness change (0.79-0.99). The 95% minimal detectable changes were < 0.3 mm for the TrA and < 2 mm for the LM (but, in most cases, less than 10% of average thickness). Both experienced and trained novice raters provided reliable measurements of TrA and LM thickness in participants with LBP and healthy participants, during rest and contraction. One-time measurements were similar to averaged measurements. Small absolute errors were observed. Public trial registry: Australian New Zealand Clinical Trials Registry ACTRN12613001077752.

  6. Habitual pelvic posture and time spent sitting: Measurement test-retest reliability for the LUMOback device and preliminary evidence for slouched posture in individuals with low back pain.

    PubMed

    Takasaki, Hiroshi

    2017-01-01

    It has been difficult to monitor the pelvic position during actual daily life. However, recent developments in wearable device technologies, such as the LUMOback device, provide the possibility to evaluate habitual pelvic posture and time spent sitting during daily life. The current study aimed (1) to investigate test-retest reliability for habitual pelvic posture and time spent sitting with the LUMOback in individuals with prolonged low back pain (low back pain group) and without low back pain (control group), and (2) to preliminarily investigate differences in those measures between groups. Fifteen individuals in each group wore the LUMOback daily for 2 weeks. Intraclass correlation coefficients were calculated in each group by comparing the mean from the first week with the mean from the second week: (1) for the posture score, which is a proportion of time with neutral posture, and (2) for time spent sitting. The two measures for the first week were compared between the low back pain and control groups. The intraclass correlation coefficients for the posture score were .82 in the low back pain group and .91 in the control group. The intraclass correlation coefficients for time spent sitting were .75 in the low back pain group and .85 in the control group. The posture score in the low back pain group (mean ± SD: 37.5% ± 10.3%) was less than that in the control group (49.6% ± 6.0%; p < .001), but there was no difference in time spent sitting between the groups (p > .05). The current study found (1) acceptable test-retest reliability for the posture score and time spent sitting evaluated by the LUMOback device, and (2) preliminary evidence of a difference in the posture score, indicating a more slouched lumbopelvic posture in individuals with prolonged low back pain than those without low back pain.

  7. Habitual pelvic posture and time spent sitting: Measurement test–retest reliability for the LUMOback device and preliminary evidence for slouched posture in individuals with low back pain

    PubMed Central

    Takasaki, Hiroshi

    2017-01-01

    Objectives: It has been difficult to monitor the pelvic position during actual daily life. However, recent developments in wearable device technologies, such as the LUMOback device, provide the possibility to evaluate habitual pelvic posture and time spent sitting during daily life. The current study aimed (1) to investigate test–retest reliability for habitual pelvic posture and time spent sitting with the LUMOback in individuals with prolonged low back pain (low back pain group) and without low back pain (control group), and (2) to preliminarily investigate differences in those measures between groups. Methods: Fifteen individuals in each group wore the LUMOback daily for 2 weeks. Intraclass correlation coefficients were calculated in each group by comparing the mean from the first week with the mean from the second week: (1) for the posture score, which is a proportion of time with neutral posture, and (2) for time spent sitting. The two measures for the first week were compared between the low back pain and control groups. Results: The intraclass correlation coefficients for the posture score were .82 in the low back pain group and .91 in the control group. The intraclass correlation coefficients for time spent sitting were .75 in the low back pain group and .85 in the control group. The posture score in the low back pain group (mean ± SD: 37.5% ± 10.3%) was less than that in the control group (49.6% ± 6.0%; p < .001), but there was no difference in time spent sitting between the groups (p > .05). Conclusions: The current study found (1) acceptable test–retest reliability for the posture score and time spent sitting evaluated by the LUMOback device, and (2) preliminary evidence of a difference in the posture score, indicating a more slouched lumbopelvic posture in individuals with prolonged low back pain than those without low back pain. PMID:28951781

  8. Is One Trial Sufficient to Obtain Excellent Pressure Pain Threshold Reliability in the Low Back of Asymptomatic Individuals? A Test-Retest Study

    PubMed Central

    2016-01-01

    The assessment of pressure pain threshold (PPT) provides a quantitative value related to the mechanical sensitivity to pain of deep structures. Although excellent reliability of PPT has been reported in numerous anatomical locations, its absolute and relative reliability in the lower back region remains to be determined. Because of the high prevalence of low back pain in the general population and because low back pain is one of the leading causes of disability in industrialized countries, assessing pressure pain thresholds over the low back is particularly of interest. The purpose of this study study was (1) to evaluate the intra- and inter- absolute and relative reliability of PPT within 14 locations covering the low back region of asymptomatic individuals and (2) to determine the number of trial required to ensure reliable PPT measurements. Fifteen asymptomatic subjects were included in this study. PPTs were assessed among 14 anatomical locations in the low back region over two sessions separated by one hour interval. For the two sessions, three PPT assessments were performed on each location. Reliability was assessed computing intraclass correlation coefficients (ICC), standard error of measurement (SEM) and minimum detectable change (MDC) for all possible combinations between trials and sessions. Bland-Altman plots were also generated to assess potential bias in the dataset. Relative reliability for both intra- and inter- session was almost perfect with ICC ranged from 0.85 to 0.99. With respect to the intra-session, no statistical difference was reported for ICCs and SEM regardless of the conducted comparisons between trials. Conversely, for inter-session, ICCs and SEM values were significantly larger when two consecutive PPT measurements were used for data analysis. No significant difference was observed for the comparison between two consecutive measurements and three measurements. Excellent relative and absolute reliabilities were reported for both intra

  9. Online versus in-person comparison of Microscale Audit of Pedestrian Streetscapes (MAPS) assessments: reliability of alternate methods.

    PubMed

    Phillips, Christine B; Engelberg, Jessa K; Geremia, Carrie M; Zhu, Wenfei; Kurka, Jonathan M; Cain, Kelli L; Sallis, James F; Conway, Terry L; Adams, Marc A

    2017-08-04

    An online version of the Microscale Audit of Pedestrian Streetscapes (Abbreviated) tool was adapted to virtually audit built environment features supportive of physical activity. The current study assessed inter-rater reliability of MAPS Online between in-person raters and online raters unfamiliar with the regions. In-person and online audits were conducted for a total of 120 quarter-mile routes (60 per site) in Phoenix, AZ and San Diego, CA. Routes in each city included 40 residential origins stratified by walkability and SES, and 20 commercial centers. In-person audits were conducted by raters residing in their region. Online audits were conducted by raters in the alternate location using Google Maps (Aerial and Street View) images. The MAPS Abbreviated Online tool consisted of four sections: overall route, street segments, crossings and cul-de-sacs. Items within each section were grouped into subscales, and inter-rater reliability (ICCs) was assessed for subscales at multiple levels of aggregation. Online and in-person audits showed excellent agreement for overall positive microscale (ICC = 0.86, 95% CI [0.80, 0.90]) and grand scores (ICC = 0.93, 95% CI [0.89, 0.95]). Substantial to near-perfect agreement was found for 21 of 30 (70%) subscales, valence, and subsection scores, with ICCs ranging from 0.62, 95% CI [0.50, 0.72] to 0.95, 95% CI [0.93, 0.97]. Lowest agreement was found for the aesthetics and social characteristics scores, with ICCs ranging from 0.07, 95% CI [-0.12, 0.24] to 0.27, 95% CI [0.10, 0.43]. Results support use of the MAPS Abbreviated Online tool to reliably assess microscale neighborhood features that support physical activity and may be used by raters residing in different geographic regions and unfamiliar with the audit areas.

  10. The simple query "Do you want more pain medication?" is not a reliable way to assess acute pain relief in patients in the emergency department.

    PubMed

    Chauny, Jean-Marc; Marquis, Martin; Paquet, Jean; Lavigne, Gilles; Cournoyer, Alexis; Manzini, Christiane; Daoust, Raoul

    2017-03-15

    The management of acute pain constitutes an essential skill of emergency department (ED) physicians. However, the accurate assessment of pain intensity and relief represents a clinically challenging undertaking. Some studies have proposed to define effective pain relief as the patient's refusal for additional analgesic administration. The aim of this study was to verify whether such a refusal is effectively indicative of pain relief. This prospective cohort study included ED patients who received single or multiple doses of pain medication for an acute pain problem. Patients were evaluated for pain relief using one Likert scale and two dichotomous questions: Is your pain relieved? and Do you want more analgesics? Non-relieved patients were further analysed using a checklist as to the reasons behind their refusal for supplemental pain medication. We have recruited 378 adult patients with a mean age of 50.3 years (±19.1); 60% were women and had an initial mean pain level of 7.3 (±2.0) out of 10. We observed that 68 out of 244 patients who were adequately relieved from pain asked for more analgesics (28%), whereas 51 out of 134 patients who were not relieved from pain refused supplemental drugs (38%). Reasons for refusal included wanting to avoid side effects, feeling sufficiently relieved, and disliking the medication's effects. Over a third of ED patients in acute pain were not relieved but refused supplemental pain medication. Patients have reported legitimate reasons to decline further analgesics, and this refusal cannot be used as an indication of pain relief.

  11. Reliability of Potential Pain Biomarkers in the Saliva of Healthy Subjects: Inter-Individual Differences and Intersession Variability

    PubMed Central

    Sobas, Eva M.; Reinoso, Roberto; Cuadrado-Asensio, Rubén; Fernández, Itziar; Maldonado, Miguel J.; Pastor, José C.

    2016-01-01

    Aim Salivary cortisol, α-amylase (sAA), secretory IgA (sIgA), testosterone, and soluble fraction of receptor II of TNFα (sTNFαRII) could serve as objective pain measures, but the normal variability of these potential biomarkers is unknown. Patients & Methods Saliva was collected with the passive secretion method from 34, pain-free subjects in two single samples at least 24 hours apart. Biomarker variation and intersession reliability were assessed with the intraclass correlation coefficient (ICC). Also, we calculated the within-subject standard deviation (Sw) and the reproducibility (2.77 × Sw) of intersession measures. Results Salivary cortisol, sAA, sIgA, testosterone, and sTNFαRII yielded the following ICCs: 0.53, 0.003, 0.88, 0.42 and 0.83, respectively. We found no statistically significant systematic differences between sessions in any biomarker except for testosterone, which showed a decrease on the second day (p<0.001). The reproducibility for salivary cortisol, sAA, sIgA, testosterone, and sTNFαRII were 0.46 ng/ml, 12.88 U/ml, 11.7 μg/ml, 14.54 pg/ml and 18.29 pg/ml, respectively. Cortisol, testosterone and TNFαRII measurement variability showed a positive correlation with the magnitude (p<0.002), but no relationship was found for sAA and sIgA. Conclusions Salivary sIgA and sTNFαRII show a remarkable good reproducibility and, therefore, could be useful as pain biomarkers. When using the passive secretion method, intersession variations in salivary sIgA of more than 11.7 μg/ml may reflect true biomarker change. In the case of sTNFαRII this will depend of the magnitude. The estimates herein provided should help investigators and clinicians differentiate actual biomarker modification from measurement variability. PMID:27907037

  12. An evaluation tool for myofascial adhesions in patients after breast cancer (MAP-BC evaluation tool): Development and interrater reliability.

    PubMed

    De Groef, An; Van Kampen, Marijke; Vervloesem, Nele; De Geyter, Sophie; Dieltjens, Evi; Christiaens, Marie-Rose; Neven, Patrick; Geraerts, Inge; Devoogdt, Nele

    2017-01-01

    To develop a tool to evaluate myofascial adhesions objectively in patients with breast cancer and to investigate its interrater reliability. 1) Development of the evaluation tool. Literature was searched, experts in the field of myofascial therapy were consulted and pilot testing was performed. 2) Thirty patients (63% had a mastectomy, 37% breast-conserving surgery and 97% radiotherapy) with myofascial adhesions were evaluated using the developed tool by 2 independent raters. The Weighted Kappa (WK) and the intra-class correlation coefficient (ICC) were calculated. 1) The evaluation tool for Myofascial Adhesions in Patients with Breast Cancer (MAP-BC evaluation tool) consisted of the assessment of myofascial adhesions at 7 locations: axillary and breast region scars, musculi pectorales region, axilla, frontal chest wall, lateral chest wall and the inframammary fold. At each location the degree of the myofascial adhesion was scored at three levels (skin, superficial and deep) on a 4-points scale (between no adhesions and very stiff adhesions). Additionally, a total score (0-9) was calculated, i.e. the sum of the different levels of each location. 2) Interrater agreement of the different levels separately was moderate for the axillary and mastectomy scar (WK 0.62-0.73) and good for the scar on the breast (WK >0.75). Moderate agreement was reached for almost all levels of the non-scar locations. Interrater reliability of the total scores was the highest for the scars (ICC 0.82-0.99). At non-scar locations good interrater reliability was reached, except for the inframammary fold (ICC = 0.71). The total scores of all locations of the MAP-BC evaluation tool had good to excellent interrater reliability, except for the inframammary fold which only reached moderate reliability.

  13. An evaluation tool for myofascial adhesions in patients after breast cancer (MAP-BC evaluation tool): Development and interrater reliability

    PubMed Central

    De Groef, An; Van Kampen, Marijke; Vervloesem, Nele; De Geyter, Sophie; Dieltjens, Evi; Christiaens, Marie-Rose; Neven, Patrick; Geraerts, Inge; Devoogdt, Nele

    2017-01-01

    Purpose To develop a tool to evaluate myofascial adhesions objectively in patients with breast cancer and to investigate its interrater reliability. Methods 1) Development of the evaluation tool. Literature was searched, experts in the field of myofascial therapy were consulted and pilot testing was performed. 2) Thirty patients (63% had a mastectomy, 37% breast-conserving surgery and 97% radiotherapy) with myofascial adhesions were evaluated using the developed tool by 2 independent raters. The Weighted Kappa (WK) and the intra-class correlation coefficient (ICC) were calculated. Results 1) The evaluation tool for Myofascial Adhesions in Patients with Breast Cancer (MAP-BC evaluation tool) consisted of the assessment of myofascial adhesions at 7 locations: axillary and breast region scars, musculi pectorales region, axilla, frontal chest wall, lateral chest wall and the inframammary fold. At each location the degree of the myofascial adhesion was scored at three levels (skin, superficial and deep) on a 4-points scale (between no adhesions and very stiff adhesions). Additionally, a total score (0–9) was calculated, i.e. the sum of the different levels of each location. 2) Interrater agreement of the different levels separately was moderate for the axillary and mastectomy scar (WK 0.62–0.73) and good for the scar on the breast (WK >0.75). Moderate agreement was reached for almost all levels of the non-scar locations. Interrater reliability of the total scores was the highest for the scars (ICC 0.82–0.99). At non-scar locations good interrater reliability was reached, except for the inframammary fold (ICC = 0.71). Conclusions The total scores of all locations of the MAP-BC evaluation tool had good to excellent interrater reliability, except for the inframammary fold which only reached moderate reliability. PMID:28598978

  14. Measurement of acute nonspecific low back pain perception in primary care physical therapy: reliability and validity of the brief illness perception questionnaire.

    PubMed

    Hallegraeff, Joannes M; van der Schans, Cees P; Krijnen, Wim P; de Greef, Mathieu H G

    2013-02-01

    The eight-item Brief Illness Perception Questionnaire is used as a screening instrument in physical therapy to assess mental defeat in patients with acute low back pain, besides patient perception might determine the course and risk for chronic low back pain. However, the psychometric properties of the Brief Illness Perception Questionnaire in common musculoskeletal disorders like acute low back pain have not been adequately studied. Patients' perceptions vary across different populations and affect coping styles. Thus, our aim was to determine the internal consistency, test-retest reliability and validity of the Dutch language version of the Brief Illness Perception Questionnaire in acute non-specific low back pain patients in primary care physical therapy. A non-experimental cross-sectional study with two measurements was performed. Eighty-four acute low back pain patients, in multidisciplinary health care center in Dutch primary care with a sample mean (SD) age of 42 (12) years, participated in the study. Internal consistency (Cronbach's α) and test-retest procedures (Intraclass Correlation Coefficients and limits of agreement) were evaluated at a one-week interval. The concurrent validity of the Brief Illness Perception Questionnaire was examined by using the Mental Health Component of the Short Form 36 Health Survey. The Cronbach's α for internal consistency was 0.73 (95% CI, 0.67 - 0.83); and the Intraclass Correlation Coefficient test-retest reliability was acceptable: 0.72 (95% CI, 0.53 - 0.82), however, the limits of agreement were large. The Intraclass Correlation Coefficient measuring concurrent validity 0.65 (95% CI, 0.46 - 0.80). The Dutch version of the Brief Illness Perception Questionnaire is an appropriate instrument for measuring patients' perceptions in acute low back pain patients, showing acceptable internal consistency and reliability. Concurrent validity is adequate, however, the instrument may be unsuitable for detecting changes in low

  15. Reliability and validity of the Persian versions of the fear avoidance beliefs questionnaire and Tampa Scale of Kinesiophobia in patients with neck pain.

    PubMed

    Askary-Ashtiani, Ahmadreza; Ebrahimi-Takamejani, Ismail; Torkaman, Giti; Amiri, Mohsen; Mousavi, Seyed Javad

    2014-08-15

    Validation of 2 self-report questionnaires. To evaluate the internal consistency, reliability, and construct validity of the Persian versions of the fear avoidance beliefs questionnaire (FABQ) and the Tampa Scale of Kinesiophobia (TSK) in patients with acute and chronic neck pain. The FABQ and TSK are 2 important measures to evaluate fear of pain and fear avoidance beliefs in patients with spinal pain. To date, the psychometric properties of these questionnaires have not been demonstrated in Persian-speaking patients with neck pain in Iran. One hundred sixty-six patients with acute and chronic neck pain participated in the study. The construct validity of the questionnaires was evaluated by measuring convergent and known-groups validity. The visual analogue scale measure of pain, neck disability index, hospital anxiety and depression scale, and the physical (PCS-12) and mental (MCS-12) summary scores of the Short Form health survey (SF-12) were used to test construct validity of the Persian FABQ and TSK. In addition, 50 randomly selected patients with chronic neck pain were asked to complete the questionnaires 48 hours later for the second time. Cronbach α coefficient for the FABQ and TSK in patients with acute and chronic pain was in the range from 0.77 to 0.92 and 0.77 to 0.78, respectively. The Persian FABQ and TSK showed satisfactory test-retest reliability with intraclass correlation coefficient of more than 0.80. There were moderate to strong correlations between the Persian FABQ and TSK scores and the neck disability index (r = 0.44-0.55), Depression subscales of the hospital anxiety and depression scale (r = 0.42-0.48), and PCS-12 (r =-0.34 to -0.62). The Persian FABQ and TSK have acceptable reliability and validity for measuring pain related fear and avoidance beliefs among Persian-speaking patients with acute and chronic neck pain. However, considering the study limitations, the findings should be interpreted with caution. 3.

  16. Reliability of the Non-Communicating Adult Pain Checklist (NCAPC), Assessed by Different Groups of Health Workers

    ERIC Educational Resources Information Center

    Lotan, M.; Moe-Nilssen, R.; Ljunggren, A. E.; Strand, L. I.

    2009-01-01

    Evaluating pain in adults with intellectual and developmental disability (IDD) is a challenge. The Non-Communicating Adults Pain Checklist (NCAPC) was recently developed from the Non-Communicating Children's Pain Checklist (NCCPC) and examined in a group of adults with IDD (N = 228) and found to hold satisfactory construct validity, internal…

  17. Reliability of the Non-Communicating Adult Pain Checklist (NCAPC), Assessed by Different Groups of Health Workers

    ERIC Educational Resources Information Center

    Lotan, M.; Moe-Nilssen, R.; Ljunggren, A. E.; Strand, L. I.

    2009-01-01

    Evaluating pain in adults with intellectual and developmental disability (IDD) is a challenge. The Non-Communicating Adults Pain Checklist (NCAPC) was recently developed from the Non-Communicating Children's Pain Checklist (NCCPC) and examined in a group of adults with IDD (N = 228) and found to hold satisfactory construct validity, internal…

  18. Reliable in silico identification of sequence polymorphisms and their application for extending the genetic map of sugar beet (Beta vulgaris).

    PubMed

    Holtgräwe, Daniela; Sörensen, Thomas Rosleff; Viehöver, Prisca; Schneider, Jessica; Schulz, Britta; Borchardt, Dietrich; Kraft, Thomas; Himmelbauer, Heinz; Weisshaar, Bernd

    2014-01-01

    Molecular markers are a highly valuable tool for creating genetic maps. Like in many other crops, sugar beet (Beta vulgaris L.) breeding is increasingly supported by the application of such genetic markers. Single nucleotide polymorphism (SNP) based markers have a high potential for automated analysis and high-throughput genotyping. We developed a bioinformatics workflow that uses Sanger and 2nd-generation sequence data for detection, evaluation and verification of new transcript-associated SNPs from sugar beet. RNAseq data from one parent of an established mapping population were produced by 454-FLX sequencing and compared to Sanger ESTs derived from the other parent. The workflow established for SNP detection considers the quality values of both types of reads, provides polymorphic alignments as well as selection criteria for reliable SNP detection and allows painless generation of new genetic markers within genes. We obtained a total of 14,323 genic SNPs and InDels. According to empirically optimised settings for the quality parameters, we classified these SNPs into four usability categories. Validation of a subset of the in silico detected SNPs by genotyping the mapping population indicated a high success rate of the SNP detection. Finally, a total of 307 new markers were integrated with existing data into a new genetic map of sugar beet which offers improved resolution and the integration of terminal markers.

  19. Reliable In Silico Identification of Sequence Polymorphisms and Their Application for Extending the Genetic Map of Sugar Beet (Beta vulgaris)

    PubMed Central

    Holtgräwe, Daniela; Sörensen, Thomas Rosleff; Viehöver, Prisca; Schneider, Jessica; Schulz, Britta; Borchardt, Dietrich; Kraft, Thomas; Himmelbauer, Heinz; Weisshaar, Bernd

    2014-01-01

    Molecular markers are a highly valuable tool for creating genetic maps. Like in many other crops, sugar beet (Beta vulgaris L.) breeding is increasingly supported by the application of such genetic markers. Single nucleotide polymorphism (SNP) based markers have a high potential for automated analysis and high-throughput genotyping. We developed a bioinformatics workflow that uses Sanger and 2nd-generation sequence data for detection, evaluation and verification of new transcript-associated SNPs from sugar beet. RNAseq data from one parent of an established mapping population were produced by 454-FLX sequencing and compared to Sanger ESTs derived from the other parent. The workflow established for SNP detection considers the quality values of both types of reads, provides polymorphic alignments as well as selection criteria for reliable SNP detection and allows painless generation of new genetic markers within genes. We obtained a total of 14,323 genic SNPs and InDels. According to empirically optimised settings for the quality parameters, we classified these SNPs into four usability categories. Validation of a subset of the in silico detected SNPs by genotyping the mapping population indicated a high success rate of the SNP detection. Finally, a total of 307 new markers were integrated with existing data into a new genetic map of sugar beet which offers improved resolution and the integration of terminal markers. PMID:25302600

  20. Reliably Flattened Radar Backscatter For Wet Snow Mapping From Wide-Swath Sensors

    NASA Astrophysics Data System (ADS)

    Small, David; Miranda, Nuno; Ewen, Tracy; Jonas, Tobias

    2013-12-01

    Retrieval of wet snow extent with high temporal resolution over large areas that include topography requires use of wide swath SAR and radiometric terrain correction to enable backscatter comparisons across different orbital tracks. We report on springtime wet snow mapping using a time series of Envisat ASAR wide swath (WS) images covering the Swiss Alps. The ASAR observations were used to constrain a runoff model for a local catchment; performance was assessed with and without integration of the radar data. Our EOPI project began an unprecedentedly dense series of ASAR WS acquisitions over Switzerland in March 2012. Wet snow maps at the national scale were generated and integrated for the first time on an operational basis within the Swiss Institute for Snow and Avalanche Research SLF. Lessons learned from this initial operational integration test are discussed, with a view toward the monitoring possibilities coming soon with the Sentinel-1 radar satellites.

  1. Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part I: Asymptomatic volunteers.

    PubMed

    Fortin, J D; Dwyer, A P; West, S; Pier, J

    1994-07-01

    Pain pattern mapping of the sacroiliac joint in asymptomatic volunteers was investigated. Prospective evaluation of 10 volunteers who received sacroiliac joint injections was performed. The injections consisted of contrast material followed by Xylocaine. To determine the pain referral pattern of the sacroiliac joint in asymptomatic individuals. All 10 individuals experienced discomfort upon initial injection, with the most significant sensation felt directly around the injection site. Subsequent sensory examination revealed an area of hypesthesia running caudally from the posterior superior iliac spine. Volunteers were asked to describe the nature and location of the sensation upon sacroiliac injection. Sensory examination immediately followed the injection to determine referral patterns. Sensory examination immediately after sacroiliac injection revealed an area of buttock hypesthesia extending approximately 10 cm caudally and 3 cm laterally from the posterior superior iliac spine. This area of hypesthesia corresponded to the area of maximal pain noted upon injection. A pain referral map was successfully generated using provocative injections into the right sacroiliac joint in asymptomatic volunteers.

  2. Reliability and validity of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in evaluations of chronic low back pain patients.

    PubMed

    Tarescavage, Anthony M; Scheman, Judith; Ben-Porath, Yossef S

    2015-06-01

    The purpose of the current study was to investigate the reliability and concurrent validity of Minnesota Multiphasic Personality Inventory (MMPI)-2-Restructured Form (2-RF) (Ben-Porath & Tellegen, 2008/2011) scores in a sample of 811 chronic low back pain patients (346 males, 529 females) beginning treatment in a short-term interdisciplinary pain rehabilitation program. We calculated internal consistency coefficients, mean-item correlations, and SEM for all substantive scales, as well as zero-order correlations with collateral medical record information and self-report testing. Results indicated reliability and validity for most of the MMPI-2-RF substantive scales. Implications of these findings and limitations of this study are discussed.

  3. Cross-Cultural Adaptation, Validation, and Reliability Testing of the Modified Oswestry Disability Questionnaire in Persian Population with Low Back Pain.

    PubMed

    Baradaran, Aslan; Ebrahimzadeh, Mohammad H; Birjandinejad, Ali; Kachooei, Amir Reza

    2016-04-01

    Prospective study. We aimed to validate the Persian version of the modified Oswestry disability questionnaire (MODQ) in patients with low back pain. Modified Oswestry low back pain disability questionnaire is a well-known condition-specific outcome measure that helps quantify disability in patients with lumbar syndromes. To test the validity in a pilot study, the Persian MODQ was administered to 25 individuals with low back pain. We then enrolled 200 consecutive patients with low back pain to fill the Persian MODQ as well as the short form 36 (SF-36) questionnaire. Convergent validity of the MODQ was tested using the Spearman's correlation coefficient between the MODQ and SF-36 subscales. Intraclass correlation coefficient (ICC) and Cronbach's α coefficient were measured to test the reliability between test and retest and internal consistency of all items, respectively. ICC for individual items ranged from 0.43 to 0.80 showing good reliability and reproducibility of each individual item. Cronbach's α coefficient was 0.69 showing good internal consistency across all 10 items of the Persian MODQ. Total MODQ score showed moderate to strong correlation with the eight subscales and the two domains of the SF-36. The highest correlation was between the MODQ and the physical functioning subscale of the SF-36 (r=-0.54, p<0.001) and the physical component domain of the SF-36 (r=-0.55, p<0.001) showing that MODQ is measuring what it is supposed to measure in terms of disability and physical function. Persian version of the MODQ is a valid and reliable tool for the assessment of the disability following low back pain.

  4. Improving the reliability of the background extrapolation in transmission electron microscopy elemental maps by using three pre-edge windows.

    PubMed

    Heil, Tobias; Gralla, Benedikt; Epping, Michael; Kohl, Helmut

    2012-07-01

    Over the last decades, elemental maps have become a powerful tool for the analysis of the spatial distribution of the elements within specimen. In energy-filtered transmission electron microscopy (EFTEM) one commonly uses two pre-edge and one post-edge image for the calculation of elemental maps. However, this so called three-window method can introduce serious errors into the extrapolated background for the post-edge window. Since this method uses only two pre-edge windows as data points to calculate a background model that depends on two fit parameters, the quality of the extrapolation can be estimated only statistically assuming that the background model is correct. In this paper, we will discuss a possibility to improve the accuracy and reliability of the background extrapolation by using a third pre-edge window. Since with three data points the extrapolation becomes over-determined, this change permits us to estimate not only the statistical uncertainly of the fit, but also the systematic error by using the experimental data. Furthermore we will discuss in this paper the acquisition parameters that should be used for the energy windows to reach an optimal signal-to-noise ratio (SNR) in the elemental maps.

  5. [Validation of the questionnaire for adolescents concerning ailments of lumbosacral region. Part I: reliability of questions about presence and character of pain].

    PubMed

    Baczkiewicz, Maja; Demczuk-Włodarczyk, Ewa

    2011-01-01

    The first part of the series of articles is dedicated to the process and the results of reliability testing of the questionnaire designed for pupils aged 13-18, the tested questions concerning ailments of the lumbosacral region (LBP) and their characteristics. 124 persons aged 13-17 took part in the research. The "test-retest" method was used, the questionannaires being filled in twice by every pupil in no more than 7-day period. Questions were asked about LBP, the accompanying ailments, the intensity of pain, the length of the episode, the cause of the beginning, the constant pain, the activities that worsen or reduce symptoms, the necessity of therapy, the presence of functional disorders connected with LBP, height, weight and basic ,,red flags" which could indicate pain of specific origin. Results that were obtained in the process of testing indicated that reasoning was invalid when based on questions about the length of episode (60% repeatable, rank correlation 0.3) and on questions about activities that worsen or reduce pain (respectively 34 i 35% repeatable answers). The rest of questions were found acceptably reliable.

  6. Differences in Topographical Pressure Pain Sensitivity Maps of the Scalp Between Patients With Migraine and Healthy Controls.

    PubMed

    Barón, Johanna; Ruiz, Marina; Palacios-Ceña, María; Madeleine, Pascal; Guerrero, Ángel L; Arendt-Nielsen, Lars; Fernández-de-Las-Peñas, César

    2017-02-01

    To investigate differences in topographical pressure pain sensitivity maps of the scalp between patients with migraine and healthy controls considering the chronicity (episodic/chronic) and side (strictly unilateral/bilateral) of the symptoms. It seems that the trigeminal area is sensitized in migraine. No study has investigated topographical pressure sensitivity maps of the scalp in patients with migraine. Pressure pain thresholds (PPTs) were assessed from 21 points distributed over the scalp in 86 patients with episodic migraine, 76 with chronic migraine, and 42 healthy age and matched healthy controls in a blinded design. Topographical pressure pain sensitivity maps based on interpolation of the PPTs were constructed. Clinical features of migraine, anxiety, and depression (Hospital Anxiety and Depression Scale, HADS) were collected. The multivariate ANCOVA revealed significant differences in PPT between points (F = 55.674; P < .001) and groups (F = 5.316; P = .006), but not sides (F = 0.880; P = .417). No significant effect of gender (F = 0.897; P = .656), depression (F = 1.109; P = .220), or anxiety (F = 0.981; F = 0.569) was found. Post hoc comparisons revealed: (1) lower PPTs in both migraine groups than in healthy controls in all points (P < .001); (2) no significant differences between chronic or episodic migraine (P > .335) except for Fp1 (P = .045) and Fp2 (P = .017) points where subjects with chronic migraine had lower PPTs than those with episodic migraine; (3) no differences between bilateral/unilateral migraine (P > .417). An anterior to posterior gradient was found, with the lowest PPTs located in frontal regions and the highest PPTs in occipital areas (all groups, P < .001). We found that patients with migraine exhibited generalized pressure pain hypersensitivity in the head as compared to healthy controls and that hypersensitivity was similar between episodic/chronic and

  7. Gradient-based reliability maps for ACM-based segmentation of hippocampus.

    PubMed

    Zarpalas, Dimitrios; Gkontra, Polyxeni; Daras, Petros; Maglaveras, Nicos

    2014-04-01

    Automatic segmentation of deep brain structures, such as the hippocampus (HC), in MR images has attracted considerable scientific attention due to the widespread use of MRI and to the principal role of some structures in various mental disorders. In this literature, there exists a substantial amount of work relying on deformable models incorporating prior knowledge about structures' anatomy and shape information. However, shape priors capture global shape characteristics and thus fail to model boundaries of varying properties; HC boundaries present rich, poor, and missing gradient regions. On top of that, shape prior knowledge is blended with image information in the evolution process, through global weighting of the two terms, again neglecting the spatially varying boundary properties, causing segmentation faults. An innovative method is hereby presented that aims to achieve highly accurate HC segmentation in MR images, based on the modeling of boundary properties at each anatomical location and the inclusion of appropriate image information for each of those, within an active contour model framework. Hence, blending of image information and prior knowledge is based on a local weighting map, which mixes gradient information, regional and whole brain statistical information with a multi-atlas-based spatial distribution map of the structure's labels. Experimental results on three different datasets demonstrate the efficacy and accuracy of the proposed method.

  8. Pressure pain sensitivity topographical maps reveal bilateral hyperalgesia of the hands in patients with unilateral carpal tunnel syndrome.

    PubMed

    Fernández-de-Las-Peñas, César; Madeleine, Pascal; Martínez-Perez, Almudena; Arendt-Nielsen, Lars; Jiménez-García, Rodrigo; Pareja, Juan A

    2010-08-01

    To assess topographical pressure pain sensitivity maps of the hand in patients with unilateral carpal tunnel syndrome (CTS) as compared with healthy subjects. A total of 20 women with CTS (ages 32-52 years) and 20 healthy matched women (ages 32-51 years) were recruited. Pressure pain thresholds (PPTs) were measured bilaterally over 30 locations of the palm of each hand by an assessor blinded to the subjects' conditions. Patients showed lower PPTs in both hands in all of the measurement points as compared with controls (P < 0.001 for all). PPTs were lower in those points over the proximal phalanx of the fingers and the thenar eminency as compared with those points located over the distal phalanx of the fingers (P < 0.001). CTS patients showed lower PPT levels in dermatomes C6, C7, and C8 when compared with healthy controls (P < 0.001 for all), but without differences between dermatomes (P = 0.4). PPT was negatively correlated with both hand pain intensity and duration of symptoms (P < 0.001 for all). Our findings revealed bilateral generalized pressure pain hyperalgesia in unilateral CTS because lower PPT levels were found in all of the points. The pressure pain hyperalgesia was not uniformly distributed since PPTs were lower in points over the proximal phalanx of the fingers and the thenar eminency as compared with those points located over the distal phalanx of the fingers. The decrease in PPT levels was associated with the intensity and the duration of the pain symptoms, supporting a role of both peripheral and central sensitization mechanisms in this pain condition.

  9. Mapping of the spontaneous deletion in the Ap3d1 gene of mocha mice: fast and reliable genotyping

    PubMed Central

    Drasbek, Kim Ryun; Holm, Mai Marie; Delenclos, Marion; Jensen, Kimmo

    2008-01-01

    Background The mocha mouse carries a spontaneous deletion in the Ap3d1 gene, encoding the delta 1 subunit of the adaptor related protein complex 3, (Ap3d1), and subsequently lack the expression of functional AP-3. This leads to a deficiency in vesicle transport and storage, which affects neurotransmitter vesicle turnover and release in the central nervous system. Since the genomic sequence of the Ap3d1 gene of mocha mouse is not known, precise mapping of the deletion as well as reliable genotyping protocols are lacking. Findings We sequenced the Ap3d1 gene (HGNC GeneID: 8943) around the deletion site in the mocha mouse and revealed a 10639 bp deletion covering exon 2 to 6. Subsequently, new PCR primers were designed yielding a reliable genotyping protocol of both newborn and adult tissue. To examine the genotypes further, hippocampal neurons were cultured from mocha and control mice. Patch-clamp recordings showed that mocha neurons had a higher input resistance, and that autaptic EPSC in mocha cultures depressed faster and stronger as compared with control cultures. Conclusion Our study reports the sequence of the deleted part of the Ap3d1 gene in mocha mice, as well as a reliable PCR-based genotyping protocol. We cultured hippocampal neurons from control and mocha mice, and found a difference in input resistance of the neurons, and in the synaptic short-term plasticity of glutamatergic autapses showing a larger synaptic depression than controls. The described procedures may be useful for the future utilization of the mocha mouse as a model of defective vesicle biogenesis. Importantly, as genotyping by eye color is complicated in newborn mice, the designed protocol is so fast and reliable that newborn mice could rapidly be genotyped and hippocampal neurons dissociated and cultured, which is normally best done at P0-P2. PMID:19032734

  10. Development of the Italian version of the Pain Stages of Change Questionnaire in patients with chronic low back pain: cross-cultural adaptation, confirmatory factor analysis, reliability and validity.

    PubMed

    Monticone, Marco; Ferrante, Simona; Ferrari, Silvano; Mugnai, Raffaele; Pillastrini, Paolo; Rocca, Barbara; Vanti, Carla; Foti, Calogero

    2014-09-01

    Translating, culturally adapting and validating the Italian version of the Pain Stages of Change Questionnaire (PSOCQ-I) to allow its use with Italian-speaking patients with low back pain. The PSOCQ-I was developed by forward-backward translation, a final review by an expert committee and a test of the prefinal version to establish its correspondence with the original English version. Psychometric testing included confirmatory factor analysis, reliability by internal consistency (Cronbach's α) and test-retest reliability (intraclass coefficient correlation), and construct validity by comparing PSOCQ-I with the Pain Catastrophising Scale (PCS), the Tampa Scale of Kinesiophobia (TSK), the Roland Morris Disability Scale (RMDQ), a pain Numerical Rating Scale (NRS), and the Hospital Anxiety and Depression Scale (Pearson's correlation). The questionnaire was administered to 308 patients with chronic low back pain. Factor analysis confirmed a four-factor solution (namely, Precontemplation, Contemplation, Action, and Maintenance), achieving an acceptable data-model fit. Internal consistency (α=0.91-93) and test-retest reliability (intraclass coefficient correlation=0.74-0.81) were satisfactory. Construct validity showed moderate correlations between Precontemplation and PCS (r=0.318), TSK (r=0.385), RMDQ (r=0.320) and NRS (r=0.335); low correlations were found between the other PSOCQ subscales and PCS (r=-0.062; 0.039), TSK (r=-0.164; 0.024), RMDQ (r=-0.073; 0.004) and NRS (r=-0.170; 0.020). Low correlations were found between the PSOCQ-I subscales and anxiety (r=-0.132; 0.150) and depression (r=-0.113; 0.186). The PSOCQ was translated successfully into Italian, and proved to have a good factorial structure and psychometric properties that replicated the results of other versions. Its use is recommended for research purposes.

  11. Test-Retest Reliability of 10 Hz Conditioning Electrical Stimulation Inducing Long-Term Potentiation (LTP)-Like Pain Amplification in Humans

    PubMed Central

    Xia, Weiwei; Mørch, Carsten Dahl; Andersen, Ole Kæseler

    2016-01-01

    Background 10 Hz conditioning electrical stimulation (CES) has been shown to induce long-term potentiation (LTP)-like pain amplification similar to traditional 100 Hz CES in healthy humans. The aim of this study was to assess the test-retest reliability and to estimate sample sizes required for future crossover and parallel study designs. Methods The 10 Hz paradigm (500 rectangular pulses lasting 50 s) was repeated on two separate days with one week interval in twenty volunteers. Perceptual intensities to single electrical stimulation (SES) at the conditioned skin site and to mechanical stimuli (pinprick and light stroking) in immediate vicinity to the conditioned skin site were recorded. Superficial blood flow (SBF) was assessed as indicator of neurogenic inflammation. All outcome measures were assessed with 10 min interval three times before and six times after the CES. The coefficient of variation and intra-class correlation coefficient were calculated within session and between sessions. Sample sizes were estimated for future crossover (Ncr) and parallel (Np) drug testing studies expected to detect a 30% decrease for the individual outcome measure following 10 Hz CES. Results Perceptual intensity ratings to light stroking (Ncr = 2, Np = 33) and pinprick stimulation (491 mN) (Ncr = 6, Np = 54) increased after CES and showed better reliability in crossover than parallel design. The SBF increased after CES, and then declined until reaching a plateau 20 minutes postCES. SBF showed acceptable reliability both in crossover and parallel designs (Ncr = 3, Np = 13). Pain ratings to SES were reliable, but with large estimated sample sizes (Ncr = 634, Np = 11310) due to the minor pain amplification. Conclusions The reliability of 10 Hz CES was acceptable in inducing LTP-like effects in the assessments of superficial blood flow, heterotopic mechanical hyperalgesia, and dysesthesia in terms of sample sizes for future crossover study designs. PMID:27529175

  12. Reliability Fusion of Time-of-Flight Depth and Stereo Geometry for High Quality Depth Maps.

    PubMed

    Zhu, Jiejie; Wang, Liang; Yang, Ruigang; Davis, James E; Pan, Zhigeng

    2011-07-01

    Time-of-flight range sensors have error characteristics, which are complementary to passive stereo. They provide real-time depth estimates in conditions where passive stereo does not work well, such as on white walls. In contrast, these sensors are noisy and often perform poorly on the textured scenes where stereo excels. We explore their complementary characteristics and introduce a method for combining the results from both methods that achieve better accuracy than either alone. In our fusion framework, the depth probability distribution functions from each of these sensor modalities are formulated and optimized. Robust and adaptive fusion is built on a pixel-wise reliability weighting function calculated for each method. In addition, since time-of-flight devices have primarily been used as individual sensors, they are typically poorly calibrated. We introduce a method that substantially improves upon the manufacturer's calibration. We demonstrate that our proposed techniques lead to improved accuracy and robustness on an extensive set of experimental results.

  13. Mechanical and biochemical mapping of human auricular cartilage for reliable assessment of tissue-engineered constructs.

    PubMed

    Nimeskern, Luc; Pleumeekers, Mieke M; Pawson, Duncan J; Koevoet, Wendy L M; Lehtoviita, Iina; Soyka, Michael B; Röösli, Christof; Holzmann, David; van Osch, Gerjo J V M; Müller, Ralph; Stok, Kathryn S

    2015-07-16

    It is key for successful auricular (AUR) cartilage tissue-engineering (TE) to ensure that the engineered cartilage mimics the mechanics of the native tissue. This study provides a spatial map of the mechanical and biochemical properties of human auricular cartilage, thus establishing a benchmark for the evaluation of functional competency in AUR cartilage TE. Stress-relaxation indentation (instantaneous modulus, Ein; maximum stress, σmax; equilibrium modulus, Eeq; relaxation half-life time, t1/2; thickness, h) and biochemical parameters (content of DNA; sulfated-glycosaminoglycan, sGAG; hydroxyproline, HYP; elastin, ELN) of fresh human AUR cartilage were evaluated. Samples were categorized into age groups and according to their harvesting region in the human auricle (for AUR cartilage only). AUR cartilage displayed significantly lower Ein, σmax, Eeq, sGAG content; and significantly higher t1/2, and DNA content than NAS cartilage. Large amounts of ELN were measured in AUR cartilage (>15% ELN content per sample wet mass). No effect of gender was observed for either auricular or nasoseptal samples. For auricular samples, significant differences between age groups for h, sGAG and HYP, and significant regional variations for Ein, σmax, Eeq, t1/2, h, DNA and sGAG were measured. However, only low correlations between mechanical and biochemical parameters were seen (R<0.44). In conclusion, this study established the first comprehensive mechanical and biochemical map of human auricular cartilage. Regional variations in mechanical and biochemical properties were demonstrated in the auricle. This finding highlights the importance of focusing future research on efforts to produce cartilage grafts with spatially tunable mechanics.

  14. Electronic visual analogue scales for pain, fatigue, anxiety and quality of life in people with multiple sclerosis using smartphone and tablet: a reliability and feasibility study.

    PubMed

    Kos, D; Raeymaekers, J; Van Remoortel, A; D'hooghe, M B; Nagels, G; D'Haeseleer, M; Peeters, E; Dams, T; Peeters, T

    2017-09-01

    To explore the reliability and feasibility of electronic visual analogue scales in people with multiple sclerosis (MS) and healthy individuals. Cross-sectional observational study Setting: Clinical setting Subjects: Convenience sample of 52 people with MS and 52 matched healthy controls Interventions: NA Main measures: Participants scored 15 statements assessing fatigue, pain, anxiety and quality of life on an electronic visual analogue scale (eVAS), either using a smartphone or a tablet (randomly allocated). To check for test-retest reliability, statements were administered in two separate randomly ordered groups. Subjects completed a feasibility questionnaire. Mean (SD) eVAS scores ranged from 35 (28.1) to 80 (22.1) in MS group, and from 57 (28.0) to 86 (13.2) in controls. Intra Class Correlations ranged from 0.73 to 0.95 in MS sample; 0.61 to 0.92 in controls. For most statements, Bland-Altman plots indicated no systematic error, but relatively large random error of the eVAS scores (exceeding 20mm). Considerable ceiling effects (i.e. better health) were found in healthy controls. Similar reliability was found among smartphone or tablet, different demographic groups and the experience-groups. Electronic visual analogue scales are reliable and useful for people with MS to register fatigue, pain, anxiety and quality of life.

  15. Inter-rater reliability of a modified version of Delitto et al.'s classification-based system for low back pain: a pilot study.

    PubMed

    Apeldoorn, Adri T; van Helvoirt, Hans; Ostelo, Raymond W; Meihuizen, Hanneke; Kamper, Steven J; van Tulder, Maurits W; de Vet, Henrica C W

    2016-05-01

    Observational inter-rater reliability study. To examine: (1) the inter-rater reliability of a modified version of Delitto et al.'s classification-based algorithm for patients with low back pain; (2) the influence of different levels of familiarity with the system; and (3) the inter-rater reliability of algorithm decisions in patients who clearly fit into a subgroup (clear classifications) and those who do not (unclear classifications). Patients were examined twice on the same day by two of three participating physical therapists with different levels of familiarity with the system. Patients were classified into one of four classification groups. Raters were blind to the others' classification decision. In order to quantify the inter-rater reliability, percentages of agreement and Cohen's Kappa were calculated. A total of 36 patients were included (clear classification n = 23; unclear classification n = 13). The overall rate of agreement was 53% and the Kappa value was 0·34 [95% confidence interval (CI): 0·11-0·57], which indicated only fair inter-rater reliability. Inter-rater reliability for patients with a clear classification (agreement 52%, Kappa value 0·29) was not higher than for patients with an unclear classification (agreement 54%, Kappa value 0·33). Familiarity with the system (i.e. trained with written instructions and previous research experience with the algorithm) did not improve the inter-rater reliability. Our pilot study challenges the inter-rater reliability of the classification procedure in clinical practice. Therefore, more knowledge is needed about factors that affect the inter-rater reliability, in order to improve the clinical applicability of the classification scheme.

  16. Inter-rater reliability of a modified version of Delitto et al.’s classification-based system for low back pain: a pilot study

    PubMed Central

    Apeldoorn, Adri T.; van Helvoirt, Hans; Ostelo, Raymond W.; Meihuizen, Hanneke; Kamper, Steven J.; van Tulder, Maurits W.; de Vet, Henrica C. W.

    2016-01-01

    Study design Observational inter-rater reliability study. Objectives To examine: (1) the inter-rater reliability of a modified version of Delitto et al.’s classification-based algorithm for patients with low back pain; (2) the influence of different levels of familiarity with the system; and (3) the inter-rater reliability of algorithm decisions in patients who clearly fit into a subgroup (clear classifications) and those who do not (unclear classifications). Methods Patients were examined twice on the same day by two of three participating physical therapists with different levels of familiarity with the system. Patients were classified into one of four classification groups. Raters were blind to the others’ classification decision. In order to quantify the inter-rater reliability, percentages of agreement and Cohen’s Kappa were calculated. Results A total of 36 patients were included (clear classification n = 23; unclear classification n = 13). The overall rate of agreement was 53% and the Kappa value was 0·34 [95% confidence interval (CI): 0·11–0·57], which indicated only fair inter-rater reliability. Inter-rater reliability for patients with a clear classification (agreement 52%, Kappa value 0·29) was not higher than for patients with an unclear classification (agreement 54%, Kappa value 0·33). Familiarity with the system (i.e. trained with written instructions and previous research experience with the algorithm) did not improve the inter-rater reliability. Conclusion Our pilot study challenges the inter-rater reliability of the classification procedure in clinical practice. Therefore, more knowledge is needed about factors that affect the inter-rater reliability, in order to improve the clinical applicability of the classification scheme. PMID:27559279

  17. Test-retest and interobserver reliability of quantitative sensory testing according to the protocol of the German Research Network on Neuropathic Pain (DFNS): a multi-centre study.

    PubMed

    Geber, Christian; Klein, Thomas; Azad, Shahnaz; Birklein, Frank; Gierthmühlen, Janne; Huge, Volker; Lauchart, Meike; Nitzsche, Dorothee; Stengel, Maike; Valet, Michael; Baron, Ralf; Maier, Christoph; Tölle, Thomas; Treede, Rolf-Detlef

    2011-03-01

    Quantitative sensory testing (QST) is an instrument to assess positive and negative sensory signs, helping to identify mechanisms underlying pathologic pain conditions. In this study, we evaluated the test-retest reliability (TR-R) and the interobserver reliability (IO-R) of QST in patients with sensory disturbances of different etiologies. In 4 centres, 60 patients (37 male and 23 female, 56.4±1.9years) with lesions or diseases of the somatosensory system were included. QST comprised 13 parameters including detection and pain thresholds for thermal and mechanical stimuli. QST was performed in the clinically most affected test area and a less or unaffected control area in a morning and an afternoon session on 2 consecutive days by examiner pairs (4 QSTs/patient). For both, TR-R and IO-R, there were high correlations (r=0.80-0.93) at the affected test area, except for wind-up ratio (TR-R: r=0.67; IO-R: r=0.56) and paradoxical heat sensations (TR-R: r=0.35; IO-R: r=0.44). Mean IO-R (r=0.83, 31% unexplained variance) was slightly lower than TR-R (r=0.86, 26% unexplained variance, P<.05); the difference in variance amounted to 5%. There were no differences between study centres. In a subgroup with an unaffected control area (n=43), reliabilities were significantly better in the test area (TR-R: r=0.86; IO-R: r=0.83) than in the control area (TR-R: r=0.79; IO-R: r=0.71, each P<.01), suggesting that disease-related systematic variance enhances reliability of QST. We conclude that standardized QST performed by trained examiners is a valuable diagnostic instrument with good test-retest and interobserver reliability within 2days. With standardized training, observer bias is much lower than random variance. Quantitative sensory testing performed by trained examiners is a valuable diagnostic instrument with good interobserver and test-retest reliability for use in patients with sensory disturbances of different etiologies to help identify mechanisms of neuropathic and non

  18. Indicating spinal joint mobilisations or manipulations in patients with neck or low-back pain: protocol of an inter-examiner reliability study among manual therapists

    PubMed Central

    2014-01-01

    Background Manual spinal joint mobilisations and manipulations are widely used treatments in patients with neck and low-back pain. Inter-examiner reliability of passive intervertebral motion assessment of the cervical and lumbar spine, perceived as important for indicating these interventions, is poor within a univariable approach. The diagnostic process as a whole in daily practice in manual therapy has a multivariable character, however, in which the use and interpretation of passive intervertebral motion assessment depend on earlier results from the diagnostic process. To date, the inter-examiner reliability among manual therapists of a multivariable diagnostic decision-making process in patients with neck or low-back pain is unknown. Methods This study will be conducted as a repeated-measures design in which 14 pairs of manual therapists independently examine a consecutive series of a planned total of 165 patients with neck or low-back pain presenting in primary care physiotherapy. Primary outcome measure is therapists’ decision about whether or not manual spinal joint mobilisations or manipulations, or both, are indicated in each patient, alone or as part of a multimodal treatment. Therapists will largely be free to conduct the full diagnostic process based on their formulated examination objectives. For each pair of therapists, 2×2 tables will be constructed and reliability for the dichotomous decision will be expressed using Cohen’s kappa. In addition, observed agreement, prevalence of positive decisions, prevalence index, bias index, and specific agreement in positive and negative decisions will be calculated. Univariable logistic regression analysis of concordant decisions will be performed to explore which demographic, professional, or clinical factors contributed to reliability. Discussion This study will provide an estimate of the inter-examiner reliability among manual therapists of indicating spinal joint mobilisations or manipulations in

  19. Reliability and Comparison of Spinal End-Range Motion Assessment Using a Skin-Surface Device in Participants With and Without Low Back Pain.

    PubMed

    Zafereo, Jason; Wang-Price, Sharon; Brown, Jace; Carson, Evan

    2016-01-01

    The purposes of this study were to determine the reliability of using a skin-surface device to measure global and segmental thoracic and lumbar spine motion in participants with and without low back pain (LBP) and to compare global thoracic and lumbar motion between the 2 groups. Forty participants were included in the study (20 adults with LBP and 20 age- and sex-matched adults without LBP). On the same day, 2 raters independently measured thoracic and lumbar spine motion by rolling a skin-surface device along the spine from C7 to S3, with participants at their end range of standing flexion and extension. In participants with LBP, global thoracic and lumbar flexion and extension end-range motion testing yielded fair-to-high intrarater reliability (intraclass correlation coefficient [ICC] = 0.76-0.96) and good-to-high interrater reliability (ICC = 0.82-0.98). Interrater reliability was fair to high (ICC = 0.77-0.93) for segmental lumbar flexion measurements in participants with LBP. No significant differences were found in global thoracic and lumbar flexion or extension end-range mobility between participants with and without LBP. Global thoracic and lumbar end-range motion measurement using a skin-surface device has acceptable reliability for participants with LBP. Reliability for segmental end-range motion measurement was only acceptable for lumbar flexion in participants with LBP. Copyright © 2016. Published by Elsevier Inc.

  20. TEM illumination settings study for optimum spatial resolution and indexing reliability in crystal orientation mappings.

    PubMed

    Valery, A; Pofelski, A; Clément, L; Lorut, F; Rauch, E F

    2017-01-01

    The spatial resolution and the indexing quality obtained with an automated orientation and phase mapping tool are analyzed for different Transmission Electron Microscope (TEM) illumination settings. The electron probe size and convergence angle are studied for two TEM configuration modes referred as microprobe and nanoprobe modes. Using a 10μmC2 aperture in a FEI Tecnai F20 (S)TEM, the nanoprobe mode is used to get a small convergent electron beam while the microprobe mode provides a nearly parallel illumination at the cost of a larger probe size. The nanoprobe configuration enables to increase the spatial resolution (∼1nm vs 3nm) but also affects the fraction of mis-indexed points (15% vs 1%). Indexing errors are attributed to the increase by a factor of three of the convergence angle with respect to the microprobe mode. While intermediate optimum settings may be found and are potentially achievable on electron microscopes providing a 'free lens' control or a larger choice of C2 apertures, it is emphasized that the spatial resolution cannot be considered without reference to the indexing quality and, consequently to the convergence angle. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. The 27-item Coping Strategies Questionnaire – Revised: Confirmatory factor analysis, reliability and validity in Italian-speaking subjects with chronic pain

    PubMed Central

    Monticone, Marco; Ferrante, Simona; Giorgi, Ines; Galandra, Caterina; Rocca, Barbara; Foti, Calogero

    2014-01-01

    BACKGROUND: Increasing attention is being devoted to cognitive-behavioural measures to improve interventions for chronic pain. OBJECTIVE: To develop an Italian version of the Coping Strategies Questionnaire – Revised (CSQ-R), and to validate it in a study involving 345 Italian subjects with chronic pain. METHODS: The questionnaire was developed following international recommendations. The psychometric analyses included confirmatory factor analysis; reliability, assessed by internal consistency (Cronbach’s alpha) and test-retest reliability (intraclass correlation coefficients); and construct validity, assessed by calculating the correlations between the subscales of the CSQ-R and measures of pain (numerical rating scale), disability (Sickness Impact Profile – Roland Scale), depression (Center for Epidemiological Studies – Depression Scale) and coping (Chronic Pain Coping Inventory) (Pearson’s correlation). RESULTS: Confirmatory factor analysis revealed that the CSQ-R model had an acceptable data-model fit (comparative fit index and normed fit index ≤0.90, root mean square error of approximation ≥0.08). Cronbach’s alpha was satisfactory (CSQ-R 0.914 to 0.961), and the intraclass correlation coefficients were good/excellent (CSQ-R 0.850 to 0.918). As expected, the correlations with the numerical rating scale, Sickness Impact Profile – Roland Scale, Center for Epidemiological Studies – Depression Scale and Chronic Pain Coping Inventory highlighted the adaptive and maladaptive properties of most of the CSQ-R subscales. CONCLUSION: The CSQ-R was successfully translated into Italian. The translation proved to have good factorial structure, and its psychometric properties are similar to those of the original and other adapted versions. Its use is recommended for clinical and research purposes in Italy and abroad. PMID:24761430

  2. Self-reported disability according to the International Classification of Functioning, Disability and Health Low Back Pain Core Set: Test-retest agreement and reliability.

    PubMed

    Bagraith, Karl S; Strong, Jenny; Meredith, Pamela J; McPhail, Steven M

    2017-01-06

    The International Classification of Functioning, Disability and Health (ICF) Low Back Pain Core Set (LBP-CS) has been proposed as a tool to facilitate the description and measurement of chronic low back pain (CLBP) related disability. Patient ratings of ICF categories may serve as a practical and effective method for acquiring patient input on activity limitations and participation restrictions. To investigate the test-retest agreement and reliability of patient ratings of activity and participation according to the LBP-CS. A cross-sectional repeated-measures questionnaire study was undertaken with thirty-one medically stable adults with CLBP who presented for treatment at two public Australian hospitals. Participants completed the LBP-CS Self-Report Checklist (LBP-CS-SRC) on two occasions (mean = 12.5 (SD = 4.5) days between administrations). The LBP-CS-SRC permits patients to self-rate their functioning according to the LBP-CS activity and participation categories and enables the derivation of activity limitation and participation restriction scales. Patient ratings of individual LBP-CS categories generally exhibited good - excellent test-retest agreement (percentage exact agreement: 74.19-100.00%) and reliability (kappa: 0.53-1.00). The test-retest reliability coefficients of the LBP-CS-SRC activity (ICC = 0.94) and participation (ICC = 0.90) scales were excellent. The minimum detectable change values for the activity and participation scales were 8.11 and 15.26, respectively. This study is the first to demonstrate that patients can provide reliable ratings of functioning using the LBP-CS. The LBP-CS-SRC was shown to be acceptably reliable and precise to support understanding of patients' perspectives on disability in rehabilitation practice and research. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Reliability of ultrasound in combination with surface electromyogram for evaluating the activity of abdominal muscles in individuals with and without low back pain.

    PubMed

    Yang, Kyung-Hye; Park, Du-Jin

    2014-08-01

    This study investigated the reliability of ultrasound in combination with surface electromyogram (EMG) for evaluating the activity of the abdominal muscles in individuals with and without low back pain during the abdominal drawing-in maneuver (ADIM). The study recruited ten individuals with or without low back pain, respectively. While the participants were performing the ADIM, the activities of the transversus abdominis (TrA) and the internal oblique (IO) were measured using ultra-sound, while the activities of the external oblique (EO) and the rectus abdominis (RA) were measured using surface EMG. Intra-class correlation coefficients (ICC) were used to verify the inter-rater reliability of ultrasound in combination with surface EMG at rest and during the ADIM, and Bland-Altman plots were used to verify intra-rater reliability. The inter-rater reliability for the two groups at rest and during the ADIM was excellent (ICC2,1 = 0.77-0.95). In the Bland-Altman plots, the mean differences and 95% limits of agreement in the abdominal muscles of the two groups at rest were -0.03∼0.03 mm (-0.66 to 0.60 mm) and -0.12∼ -0.05 (-0.58 to 0.48% MVIC), respectively. The mean differences and 95% limits of agreement in the abdominal muscles of the two groups during the ADIM were -0.04∼0.02 mm (-0.73 to 0.65 mm) and -0.19∼0.05% MVIC (-1.24 to 1.34% MVIC), respectively. The ultrasound in combination with surface EMG showed excellent inter-rater and intra-rater reliability at rest and during the ADIM.

  4. Reliability of ultrasound in combination with surface electromyogram for evaluating the activity of abdominal muscles in individuals with and without low back pain

    PubMed Central

    Yang, Kyung-Hye; Park, Du-Jin

    2014-01-01

    This study investigated the reliability of ultrasound in combination with surface electromyogram (EMG) for evaluating the activity of the abdominal muscles in individuals with and without low back pain during the abdominal drawing-in maneuver (ADIM). The study recruited ten individuals with or without low back pain, respectively. While the participants were performing the ADIM, the activities of the transversus abdominis (TrA) and the internal oblique (IO) were measured using ultra-sound, while the activities of the external oblique (EO) and the rectus abdominis (RA) were measured using surface EMG. Intra-class correlation coefficients (ICC) were used to verify the inter-rater reliability of ultrasound in combination with surface EMG at rest and during the ADIM, and Bland-Altman plots were used to verify intra-rater reliability. The inter-rater reliability for the two groups at rest and during the ADIM was excellent (ICC2,1 = 0.77–0.95). In the Bland-Altman plots, the mean differences and 95% limits of agreement in the abdominal muscles of the two groups at rest were −0.03∼0.03 mm (−0.66 to 0.60 mm) and −0.12∼ −0.05 (−0.58 to 0.48% MVIC), respectively. The mean differences and 95% limits of agreement in the abdominal muscles of the two groups during the ADIM were −0.04∼0.02 mm (−0.73 to 0.65 mm) and −0.19∼0.05% MVIC (−1.24 to 1.34% MVIC), respectively. The ultrasound in combination with surface EMG showed excellent inter-rater and intra-rater reliability at rest and during the ADIM. PMID:25210698

  5. Acute lower back pain mapped by dermatomal scarification in urban Malawi.

    PubMed

    Lo, Tammy; Tindall, Alistair

    2012-11-30

    Lower back pain is a problem that affects many and generates an economic burden on the National Health Service. In modern days, although it is tempting to rely on specialist imaging for the initial investigation of back pain, it is often unnecessary. Comprehensive clinical examination is immediately available and should detect neurological impairments where they exist. A 32-year-old man from Malawi presented to clinic with lower back pain radiating to the right leg. Inspection revealed traditional scarification marks along the classical path of lumbar nerve root, which coincided with his L5 dermatomal pain. The distribution of his 'Mphini' along the typical path of lumbar nerve was identical to his myelography. This report strongly illustrates that in the Western medical setting, accurate history and examination would have allowed correct interpretation of these symptoms and correctly indicated the need for myelography.

  6. Acute lower back pain mapped by dermatomal scarification in urban Malawi

    PubMed Central

    Lo, Tammy; Tindall, Alistair

    2012-01-01

    Lower back pain is a problem that affects many and generates an economic burden on the National Health Service. In modern days, although it is tempting to rely on specialist imaging for the initial investigation of back pain, it is often unnecessary. Comprehensive clinical examination is immediately available and should detect neurological impairments where they exist. A 32-year-old man from Malawi presented to clinic with lower back pain radiating to the right leg. Inspection revealed traditional scarification marks along the classical path of lumbar nerve root, which coincided with his L5 dermatomal pain. The distribution of his ‘Mphini’ along the typical path of lumbar nerve was identical to his myelography. This report strongly illustrates that in the Western medical setting, accurate history and examination would have allowed correct interpretation of these symptoms and correctly indicated the need for myelography. PMID:23203164

  7. Reliability and responsiveness of the Dutch version of the Neck Disability Index in patients with acute neck pain in general practice.

    PubMed

    Vos, Cees J; Verhagen, Arianne P; Koes, Bart W

    2006-11-01

    A prospective cohort study with a 1 week follow-up. To examine the reliability and responsiveness of the Dutch version of the Neck Disability Index (NDI) in patients with acute neck pain in general practice. An increasing number of studies on treatment options is published in which the NDI is used. Reports of the ability of the NDI to detect change over time, often called responsiveness, however have not yet been published. At baseline 187 patients (119 women, 68 men) were included. They completed a questionnaire on demographic variables, self-reported cause of their complaints and the NDI. After 1 week, 86 patients were sent the NDI again together with the perceived recovery scale which was used as our external criterion. The scale ranged from 1 (complete recovery) to 7 (complaints are worse than ever). Response rate was 93%. Test-retest scores on reliability were good (ICC = 0.90). A Bland and Altman plot and a graph of total sum score differences showed no visible tendency towards unequal spreading of the data. For patients that reported on the perceived recovery scale that they were "stable" we found a responsiveness ratio of 1.82. The standard error of measurement (SEM) was 0.60 what resulted in a minimal detectable change (MDC) of 1.66. The NDI has shown to be a reliable and responsive instrument in patients with acute neck pain in general practice.

  8. Postural balance in low back pain patients: Intra-session reliability of center of pressure on a portable force platform and of the one leg stand test.

    PubMed

    Maribo, Thomas; Stengaard-Pedersen, Kristian; Jensen, Lone Donbæk; Andersen, Niels Trolle; Schiøttz-Christensen, Berit

    2011-06-01

    Low back pain (LBP) patients have poorer postural control compared to healthy controls, and the importance of assessing and addressing balance is a matter of debate. In the clinic, balance is often tested by means of the one leg stand test (OLST) while research often employs center of pressure (CoP) on a force platform. Portable force platforms might be of clinical relevance, but their reliability for LBP patients in a clinical setting has not been demonstrated. As LBP patients are more dependent on vision compared to healthy controls, the ratio of tests performed with eyes open and eyes closed (Romberg Ratio) might be of clinical interest. This study aimed to assess postural balance in LBP patients by analyzing intra-session reliability of CoP parameters on a portable force platform, the Romberg Ratio, and the OLST. Furthermore, we aimed to determine whether CoP parameters and OLST measure identical aspects of postural stability. We examined 49 LBP patients and found acceptable reliability of the CoP parameters' trace length and velocity, whereas reliability regarding C90 area, the Romberg Ratio, and the OLST was poor. Correlations between the CoP parameters and OLST were insignificant. Reliability of trace length and velocity is acceptable and can be used as parameters when assessing CoP in LBP patients. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Reliability of the Timed Up and Go test and Ten-Metre Timed Walk Test in Pregnant Women with Pelvic Girdle Pain.

    PubMed

    Evensen, Natalie M; Kvåle, Alice; Braekken, Ingeborg H

    2015-09-01

    There is a lack of functional objective tests available to measure functional status in women with pelvic girdle pain (PGP). The purpose of this study was to establish test-retest and intertester reliability of the Timed Up and Go (TUG) test and Ten-metre Timed Walk Test (10mTWT) in pregnant women with PGP. A convenience sample of women was recruited over a 4-month period and tested on two occasions, 1 week apart to determine test-retest reliability. Intertester reliability was established between two assessors at the first testing session. Subjects were instructed to undertake the TUG and 10mTWT at maximum speed. One practise trial and two timed trials for each walking test was undertaken on Day 1 and one practise trial and one timed trial on Day 2. Seventeen women with PGP aged 31.1 years (SD [standard deviation] = 2.3) and 28.7 weeks pregnant (SD = 7.4) completed gait testing. Test-retest reliability using the intraclass correlation coefficient (ICC) was excellent for the TUG (0.88) and good for the 10mTWT (0.74). Intertester reliability was determined in the first 13 participants with excellent ICC values being found for both walking tests (TUG: 0.95; 10mTWT: 0.94). This study demonstrated that the TUG and 10mTWT undertaken at fast pace are reliable, objective functional tests in pregnant women with PGP. While both tests are suitable for use in the clinical and research settings, we would recommend the TUG given the findings of higher test-retest reliability and as this test requires less space and time to set up and score. Future studies in a larger sample size are warranted to confirm the results of this study. Copyright © 2015 John Wiley & Sons, Ltd.

  10. Systematic review of the Face, Legs, Activity, Cry and Consolability scale for assessing pain in infants and children: is it reliable, valid, and feasible for use?

    PubMed

    Crellin, Dianne J; Harrison, Denise; Santamaria, Nick; Babl, Franz E

    2015-11-01

    The Face, Legs, Activity, Cry and Consolability (FLACC) scale is one of the most widely used behavioural observation pain scales. However, the psychometrics of the scale have not been adequately summarised and evaluated to provide clear recommendations regarding its use. The aim of this study was to rigorously evaluate the reliability, validity, feasibility, and utility of the scale for clinical and research purposes and provide recommendations regarding appropriate use of the scale. Databases searched were MEDLINE, CINAHL, Embase, PsycINFO (using the Ovid, PubMed, and Ebscohost platforms), The Cochrane Database of Systematic reviews and Cochrane Controlled Trials, and Google Scholar. Psychometric evaluation studies reporting feasibility, reliability, validity, or utility data for the FLACC scale applied to children (birth to 18 years) and randomised controlled trials (RCT) using the FLACC scale to measure a study outcome in infants and children. Data extraction included study design, population demographics, and psychometric data. Analysis involved in this study are quality assessment of the psychometric evaluation studies and the RCTs using the COSMIN checklist and the Jadad scale, respectively, and narrative synthesis of all results. Twenty-five psychometric evaluations studies and 52 RCTs were included. The study population, circumstances, and quality of the studies varied greatly. Sufficient data addressing postoperative pain assessment in infants and children exist. Some positive data support the psychometrics of the scale used to assess postoperative pain in children with cognitive impairment. Limited and conflicting data addressing procedural pain assessment exist. Content validity and scale feasibility have had limited psychometric evaluation. There are insufficient data to support the FLACC scale for use in all circumstances and populations to which is currently applied.

  11. Trigonometric Regressive Spectral Analysis Reliably Maps Dynamic Changes in Baroreflex Sensitivity and Autonomic Tone: The Effect of Gender and Age

    PubMed Central

    Reimann, Manja; Friedrich, Constanze; Gasch, Julia; Reichmann, Heinz; Rüdiger, Heinz; Ziemssen, Tjalf

    2010-01-01

    Background The assessment of baroreflex sensitivity (BRS) has emerged as prognostic tool in cardiology. Although available computer-assisted methods, measuring spontaneous fluctuations of heart rate and blood pressure in the time and frequency domain are easily applicable, they do not allow for quantification of BRS during cardiovascular adaption processes. This, however, seems an essential criterion for clinical application. We evaluated a novel algorithm based on trigonometric regression regarding its ability to map dynamic changes in BRS and autonomic tone during cardiovascular provocation in relation to gender and age. Methodology/Principal Findings We continuously recorded systemic arterial pressure, electrocardiogram and respiration in 23 young subjects (25±2 years) and 22 middle-aged subjects (56±4 years) during cardiovascular autonomic testing (metronomic breathing, Valsalva manoeuvre, head-up tilt). Baroreflex- and spectral analysis was performed using the algorithm of trigonometric regressive spectral analysis. There was an age-related decline in spontaneous BRS and high frequency oscillations of RR intervals. Changes in autonomic tone evoked by cardiovascular provocation were observed as shifts in the ratio of low to high frequency oscillations of RR intervals and blood pressure. Respiration at 0.1 Hz elicited an increase in BRS while head-up tilt and Valsalva manoeuvre resulted in a downregulation of BRS. The extent of autonomic adaption was in general more pronounced in young individuals and declined stronger with age in women than in men. Conclusions/Significance The trigonometric regressive spectral analysis reliably maps age- and gender-related differences in baroreflex- and autonomic function and is able to describe adaption processes of baroreceptor circuit during cardiovascular stimulation. Hence, this novel algorithm may be a useful screening tool to detect abnormalities in cardiovascular adaption processes even when resting values appear to

  12. Development of the Italian Version of the Pain Vigilance and Awareness Questionnaire in Subjects with Chronic Low Back Pain: Cross-cultural Adaptation, Confirmatory Factor Analysis, Reliability and Validity.

    PubMed

    Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Nava, Tiziana; Terragni, Erica; Cerri, Cesare; McCracken, Lance M

    2016-04-01

    Growing attention is being given to cognitive-behavioural measures to improve interventions for spinal disorders. The Pain Vigilance and Awareness Questionnaire (PVAQ) has never been validated in Italian subjects with chronic low back pain (LBP). The purpose of this study is translating, culturally adapting and validating the Italian version of PVAQ (PVAQ-I). A cross-sectional evaluation of the psychometric properties of the PVAQ-I on patients with chronic LBP was conducted. The questionnaire was culturally adapted in accordance with international standards. The psychometric testing included confirmatory factor analysis, reliability by internal consistency (Cronbach's alpha) and test-retest reliability (intra-class correlation coefficient, ICC); construct validity by comparing the PVAQ-I with the Pain Catastrophising Scale (PCS), the Tampa Scale of Kinesiophobia (TSK), the Hospital Anxiety and Depression Score (HADS), the Chronic Pain Acceptance Questionnaire (CPAQ), a Numerical Rating Scale of pain intensity (NRS) and the Oswestry Disability Questionnaire (ODI); and sensitivity to change by calculating the smallest detectable change. The PVAQ-I was administered to 131 subjects with chronic LBP (77 females, mean age of 48 ± 16 years, median symptoms duration of 12 months). Factor analysis confirmed a two-factor (passive awareness and active vigilance), 13-item solution, which led to an acceptable data-model fit. Internal consistency (α = 0.91) and test-retest reliability (ICC = 0.92) were good. As a priori hypothesized, construct validity showed moderate correlations between the PVAQ-I and PCS (r = 0.60), TSK (r = 0.44) and HADS-Anxiety (r = 0.53) and low correlations with HADS-Depression (r = 0.28), NRS (r = 0.28), ODI (r = 0.23) and CPAQ (r = -0.12). The smallest detectable change was 9. The PVAQ was successfully translated into Italian and proved to have satisfactory psychometric properties. Its use is recommended for

  13. Reliability of assessment of upper trapezius morphology, its mechanical properties and blood flow in female patients with myofascial pain syndrome using ultrasonography.

    PubMed

    Adigozali, Hakimeh; Shadmehr, Azadeh; Ebrahimi, Esmail; Rezasoltani, Asghar; Naderi, Farrokh

    2017-01-01

    In the present study, the intra-rater reliability of upper trapezius morphology, its mechanical properties and intramuscular blood circulation in females with myofascial pain syndrome were assessed using ultrasonography. A total of 37 patients (31.05 ± 10 years old) participated in this study. Ultrasonography producer was set up in three stages: a) Gray-scale: to measure muscle thickness, size and area of trigger points; b) Ultrasound elastography: to measure muscle stiffness; and c) Doppler imaging: to assess blood flow indices. According to data analysis, all variables, except End Diastolic Velocity (EDV), had excellent reliability (>0.806). Intra-class Correlation Coefficient (ICC) for EDV was 0.738, which was considered a poor to good reliability. The results of this study introduced a reliable method for developing details of upper trapezius features using muscular ultrasonography in female patients. These variables could be used for objective examination and provide guidelines for treatment plans in clinical settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. The inter-tester reliability of physical therapists classifying low back pain problems based on the Movement System Impairment classification system

    PubMed Central

    Harris-Hayes, Marcie; Van Dillen, Linda R.

    2009-01-01

    Objective Classification of patients with LBP may be important for improving clinical outcomes and research efficiency. The purpose of this study was to examine the inter-tester reliability of two trained physical therapists to classify patients with low back pain (LBP) using the standardized Movement System Impairment (MSI) classification system. The five proposed MSI classifications are based on the most consistent patterns of movement and alignment observed throughout the examination that correlate with the patient’s symptom behavior. Design Test-retest to assess reliability Setting Academic healthcare center outpatient facility Participants Thirty subjects with chronic, recurrent LBP (mean age 31.1 ± 12.9 years, 21 F:9 M) were examined independently by two experienced physical therapists. Methods Training consisted of self-study of a procedure manual, supervised practice of examination procedures and classification rules and discussion. Subjects were examined independently by each therapist using a test-retest design. Each therapist assigned a LBP classification upon completion of the examination. Both therapists were blinded to the other therapist’s findings. Main Outcome Measures Inter-tester reliability of therapists classifying the LBP problems was indexed by the percent agreement and kappa coefficient. Results Overall percent agreement on the classification assigned was 83% with kappa =.75 (95% CI =.51 to.99; P<.0001). Conclusion Inter-tester reliability of classification of patients with LBP using a standardized clinical examination based on the MSI classification system is substantial. PMID:19627885

  15. Validity and reliability of a system to measure passive tissue characteristics of the lumbar region during trunk lateral bending in people with and people without low back pain.

    PubMed

    Gombatto, Sara P; Klaesner, Joseph W; Norton, Barbara J; Minor, Scott D; Van Dillen, Linda R

    2008-01-01

    The current study examined the validity and reliability of a new system that was developed to measure lumbar region passive stiffness and end range of motion during a trunk lateral bending movement in vivo. Variables measured included force, end range lumbar region motion, torque, lumbar region stiffness, and passive elastic energy. Validity of the force measurements was examined using standard weights. Validity of lumbar region angle measurements was examined using an instrumented trunk with an electrogoniometer. Reliability of the measurements between trials within a session was examined in a sample of 50 people (25 men, 25 women; mean +/- standard deviation age = 30.7 +/- 8.9 yr); 31 people reported a history of chronic or recurrent low back pain (LBP) and 19 reported no prior history of LBP. The end range lumbar region motion and force measurements demonstrated an excellent linear relationship with the criterion standard measures. Average error between the criterion standard and observed measurements was minimal for all measurements. For reliability testing, the majority of intraclass correlation coefficient values were >0.75. The validity and reliability of the current system are sufficient to examine lumbar region stiffness and end range of motion in people with and people without LBP.

  16. Inter-tester Reliability in Classifying Acute and Subacute Low Back Pain Patients into Clinical Subgroups: A Comparison of Specialists and Non-Specialists. A Pilot Study.

    PubMed

    Paatelma, Markku; Karvqnen, Eira; Heinqnen, Ari

    2009-01-01

    Many systems have been suggested for classifying low back pain (LBP); the most commonly used among physiotherapists involves a pathoanatomical/pathophysiological tissue classification system. Few studies have examined whether this form of classification of LBP disorders can be performed in a reliable manner between specialists with advanced training, or between specialists with advanced training and non-specialists who lack advanced training. The purpose of this paper was to examine the inter-tester reliability of two specialists, and the ability of a specialist and non-specialist to independently classify patients with LBP, utilizing clinical tests and history-based classification methods after a short educational course on the classification system. Subjects were acute or sub-acute patients with LBP who visited their occupational healthcare or municipal healthcare center. Inter-tester reliability between the specialist and non-specialists was at almost the same level: overall Kappa 0.60 (95%CI; 0.40 to 0.85), overall agreement 70%, as between the two specialists: overall Kappa 0.65 (95%CI; 0.33-0.86), overall agreement 77%. The findings suggest that a short educational course can provide rather reliable examination tools to allow non-specialized physiotherapists to classify patients according to tissue origination.

  17. An Investigation of the Reliability of Knowledge Measures Through Relational Mapping in Joint Military Environments: Knowledge, Models and Tools to Improve the Effectiveness of Naval Distance Learning

    DTIC Science & Technology

    2006-06-01

    Reliability and validity of a computer-based knowledge mapping system to measure content understanding. Computers in Human Behavior , 15, 315-334. Joint Special...Jr. (1999). Computer-based performance assessments: A solution to the narrow measurement and reporting of problem-solving. Computers in Human Behavior , 15,403

  18. Brain Mapping-Based Model of Δ(9)-Tetrahydrocannabinol Effects on Connectivity in the Pain Matrix.

    PubMed

    Walter, Carmen; Oertel, Bruno G; Felden, Lisa; Kell, Christian A; Nöth, Ulrike; Vermehren, Johannes; Kaiser, Jochen; Deichmann, Ralf; Lötsch, Jörn

    2016-05-01

    Cannabinoids receive increasing interest as analgesic treatments. However, the clinical use of Δ(9)-tetrahydrocannabinol (Δ(9)-THC) has progressed with justified caution, which also owes to the incomplete mechanistic understanding of its analgesic effects, in particular its interference with the processing of sensory or affective components of pain. The present placebo-controlled crossover study therefore focused on the effects of 20 mg oral THC on the connectivity between brain areas of the pain matrix following experimental stimulation of trigeminal nocisensors in 15 non-addicted healthy volunteers. A general linear model (GLM) analysis identified reduced activations in the hippocampus and the anterior insula following THC administration. However, assessment of psychophysiological interaction (PPI) revealed that the effects of THC first consisted in a weakening of the interaction between the thalamus and the secondary somatosensory cortex (S2). From there, dynamic causal modeling (DCM) was employed to infer that THC attenuated the connections to the hippocampus and to the anterior insula, suggesting that the reduced activations in these regions are secondary to a reduction of the connectivity from somatosensory regions by THC. These findings may have consequences for the way THC effects are currently interpreted: as cannabinoids are increasingly considered in pain treatment, present results provide relevant information about how THC interferes with the affective component of pain. Specifically, the present experiment suggests that THC does not selectively affect limbic regions, but rather interferes with sensory processing which in turn reduces sensory-limbic connectivity, leading to deactivation of affective regions.

  19. Brain Mapping-Based Model of Δ9-Tetrahydrocannabinol Effects on Connectivity in the Pain Matrix

    PubMed Central

    Walter, Carmen; Oertel, Bruno G; Felden, Lisa; Kell, Christian A; Nöth, Ulrike; Vermehren, Johannes; Kaiser, Jochen; Deichmann, Ralf; Lötsch, Jörn

    2016-01-01

    Cannabinoids receive increasing interest as analgesic treatments. However, the clinical use of Δ9-tetrahydrocannabinol (Δ9-THC) has progressed with justified caution, which also owes to the incomplete mechanistic understanding of its analgesic effects, in particular its interference with the processing of sensory or affective components of pain. The present placebo-controlled crossover study therefore focused on the effects of 20 mg oral THC on the connectivity between brain areas of the pain matrix following experimental stimulation of trigeminal nocisensors in 15 non-addicted healthy volunteers. A general linear model (GLM) analysis identified reduced activations in the hippocampus and the anterior insula following THC administration. However, assessment of psychophysiological interaction (PPI) revealed that the effects of THC first consisted in a weakening of the interaction between the thalamus and the secondary somatosensory cortex (S2). From there, dynamic causal modeling (DCM) was employed to infer that THC attenuated the connections to the hippocampus and to the anterior insula, suggesting that the reduced activations in these regions are secondary to a reduction of the connectivity from somatosensory regions by THC. These findings may have consequences for the way THC effects are currently interpreted: as cannabinoids are increasingly considered in pain treatment, present results provide relevant information about how THC interferes with the affective component of pain. Specifically, the present experiment suggests that THC does not selectively affect limbic regions, but rather interferes with sensory processing which in turn reduces sensory-limbic connectivity, leading to deactivation of affective regions. PMID:26514581

  20. Reliability and Construct Validity of the Psychopathic Personality Inventory-Revised in a Swedish Non-Criminal Sample - A Multimethod Approach including Psychophysiological Correlates of Empathy for Pain.

    PubMed

    Sörman, Karolina; Nilsonne, Gustav; Howner, Katarina; Tamm, Sandra; Caman, Shilan; Wang, Hui-Xin; Ingvar, Martin; Edens, John F; Gustavsson, Petter; Lilienfeld, Scott O; Petrovic, Predrag; Fischer, Håkan; Kristiansson, Marianne

    2016-01-01

    Cross-cultural investigation of psychopathy measures is important for clarifying the nomological network surrounding the psychopathy construct. The Psychopathic Personality Inventory-Revised (PPI-R) is one of the most extensively researched self-report measures of psychopathic traits in adults. To date however, it has been examined primarily in North American criminal or student samples. To address this gap in the literature, we examined PPI-R's reliability, construct validity and factor structure in non-criminal individuals (N = 227) in Sweden, using a multimethod approach including psychophysiological correlates of empathy for pain. PPI-R construct validity was investigated in subgroups of participants by exploring its degree of overlap with (i) the Psychopathy Checklist: Screening Version (PCL:SV), (ii) self-rated empathy and behavioral and physiological responses in an experiment on empathy for pain, and (iii) additional self-report measures of alexithymia and trait anxiety. The PPI-R total score was significantly associated with PCL:SV total and factor scores. The PPI-R Coldheartedness scale demonstrated significant negative associations with all empathy subscales and with rated unpleasantness and skin conductance responses in the empathy experiment. The PPI-R higher order Self-Centered Impulsivity and Fearless Dominance dimensions were associated with trait anxiety in opposite directions (positively and negatively, respectively). Overall, the results demonstrated solid reliability (test-retest and internal consistency) and promising but somewhat mixed construct validity for the Swedish translation of the PPI-R.

  1. Evaluation of the reliability and validity of the Medical Outcomes Study sleep scale in patients with painful diabetic peripheral neuropathy during an international clinical trial

    PubMed Central

    Viala-Danten, Muriel; Martin, Susan; Guillemin, Isabelle; Hays, Ron D

    2008-01-01

    Background Sleep is an important element of functioning and well-being. The Medical Outcomes Study Sleep Scale (MOS-Sleep) includes 12 items assessing sleep disturbance, sleep adequacy, somnolence, quantity of sleep, snoring, and awakening short of breath or with a headache. A sleep problems index, grouping items from each of the former domains, is also available. This study evaluates the psychometric properties of MOS-Sleep Scale in a painful diabetic peripheral neuropathic population based on a clinical trial conducted in six countries. Methods Clinical data and health-related quality of life data were collected at baseline and after 12 weeks of follow-up. Overall, 396 patients were included in the analysis. Psychometric properties of the MOS-Sleep were assessed in the overall population and per country when the sample size was sufficient. Internal consistency reliability was assessed by Cronbach's alpha; the structure of the instrument was assessed by verifying item convergent and discriminant criteria; construct validity was evaluated by examining the relationships between MOS-Sleep scores and sleep interference and pain scores, and SF-36 scores; effect-sizes were used to assess the MOS-Sleep responsiveness. The study was conducted in compliance with United States Food and Drug Administration regulations for informed consent and protection of patient rights. Results Cronbach's alpha ranged from 0.71 to 0.81 for the multi-item dimensions and the sleep problems index. Item convergent and discriminant criteria were satisfied with item-scale correlations for hypothesized dimensions higher than 0.40 and tending to exceed the correlations of items with other dimensions, respectively. Taken individually, German, Polish and English language versions had good internal consistency reliability and dimension structure. Construct validity was supported with lower sleep adequacy score and greater sleep problems index scores associated with measures of sleep interference and

  2. The reliability of prayer-based self-efficacy scale to assess self-confidence of Muslims with low back pain.

    PubMed

    Al-Obaidi, Saud; Wall, James C; Mulekar, Madhuri S; Al-Mutairie, Rebecca

    2012-06-01

    Low back pain (LBP) may challenge an individual's self-confidence to perform usual daily activities such as Islamic daily prayer. Existing self-efficacy scales may not be appropriate to assess individual's self-confidence to perform Islamic prayers. This study aimed to develop a scale to assess self-confidence to prepare and perform Islamic prayer in the presence of LBP, the Islamic Prayer-based Self-efficacy Scale (IpbSeS), and to determine its consistency. The IpbSeS consists of three parts: pre-prayer preparation, getting to and from the mosque, and positions and movements during prayer. On a scale of 0 to 6, 0 indicates 'not at all confident' and 6 'fully confident'. Sixty individuals with LBP gave their responses on two different visits. Pain intensity was assessed by the Visual Analogue Scale (VAS), and the pain intensity changes were assessed using a seven-point global patient rating scale. Descriptive statistics, Pearson's correlation coefficient, Wilcoxon test and t-test were used in the analysis (alpha set at 0.05). VAS scores did not differ significantly between visits. No association was found between VAS and age (r = 0.039, p = 0.77) and between VAS and body mass index (BMI; r = 0.06, p = 0. 67). All 28 questions have consistent responses on two visits (0.75 ≤ r ≤ 0.99, p < 0.001 for all) indicating a very high reliability. IpbSeS appears to be a reliable instrument to assess the self-confidence of Muslims in the presence of LBP to pray. Copyright © 2011 John Wiley & Sons, Ltd.

  3. Reliability of novice raters in using the movement system impairment approach to classify people with low back pain

    PubMed Central

    Henry, Sharon M.; Van Dillen, Linda R.; Trombley, Andrea R.; Dee, Justine M.; Bunn, Janice Y.

    2013-01-01

    Observational cross sectional study. To examine the inter-rater reliability of novice raters in using the Movement System Impairment (MSI) approach system and to explore the patterns of disagreement in classification errors. The inter-rater reliability of individual tests items used in the MSI approach is moderate to good; however, the reliability of the classification algorithm has been tested only preliminarily. Using previously recorded patient data (n = 21), 13 novice raters classified patients according to the MSI schema. The overall percent agreement using the kappa statistic as well as the agreement/disagreement among pair-wise comparisons in classification assignments were examined. There was an overall 87.4% agreement in the pairs of classification judgments with a kappa coefficient of 0.81 (95% CI: 0.79, 0.83). Raters were most likely to agree on the classification of Flexion (100%) and least likely to agree on the classification of Rotation (84%). The MSI classification algorithm can be learned by novice users and with training, their inter-rater reliability in applying the algorithm for classification judgments is good and similar to that reported in other studies. However, some degree of error persists in the classification decision-making associated with the MSI system, in particular for the Rotation category. PMID:22796388

  4. Pain catastrophizing and cortical responses in amputees with varying levels of phantom limb pain: a high-density EEG brain-mapping study.

    PubMed

    Vase, Lene; Egsgaard, Line Lindhardt; Nikolajsen, Lone; Svensson, Peter; Jensen, Troels Staehelin; Arendt-Nielsen, Lars

    2012-05-01

    Pain catastrophizing has been associated with phantom limb pain, but so far the cortical processes and the brain regions involved in this relationship have not been investigated. It was therefore tested whether catastrophizing was related to (1) spontaneous pain, (2) somatosensory activity and (3) cortical responses in phantom limb pain patients. The cortical responses were investigated via electroencephalography (EEG) as it has a high temporal resolution which may be ideal for investigating especially the attentional and hypervigilance aspect of catastrophizing to standardized acute stimuli. Eighteen upper limb amputees completed the pain catastrophizing scale. Patients' spontaneous pain levels (worst and average pain, numerical rating scales) and thresholds to electrical stimulation (sensory detection and VRS2: intense but not painful) were determined. Non-painful electrical stimuli were applied to both the affected and non-affected arm, while high-resolution (128 channels) EEG signals were recorded. Catastrophizing accounted for significant amounts of the variance in relation to spontaneous pain, especially worst pain (64.1%), and it was significantly associated with thresholds. At the affected side, catastrophizing was significantly related to the power RMS of the N/P135 dipole located in the area around the secondary somatosensory cortex which has been shown to be associated with arousal and expectations. These findings corroborate the attentional model of pain catastrophizing by indicating that even non-painful stimuli are related to enhanced attention to and negative expectations of stimuli, and they suggest that memory processes may be central to understanding the link between catastrophizing and pain.

  5. Is the self-report of recent cocaine or methamphetamine use reliable in illicit stimulant drug users who present to the Emergency Department with chest pain?

    PubMed

    Lee, Moon O; Vivier, Patrick M; Diercks, Deborah B

    2009-08-01

    Use of illicit drugs results in an increased risk of morbidity and mortality, which is often seen in the Emergency Department (ED). Chest pain is frequently associated with cocaine and methamphetamine use. To determine if the self-report of recent cocaine or methamphetamine use is reliable in illicit stimulant drug users who present to the ED with chest pain. A retrospective review of patients presenting to the ED from July 1, 2004 through June 30, 2006 was undertaken. Inclusion criteria were: age >or= 18 years, chief complaint of chest pain, documented social history of drug abuse, positive urine toxicology screen and myoglobin and troponin levels measured, sent from the ED. For the 318 patients who met the inclusion criteria, the self-report rate of cocaine or methamphetamine use was 51.8% (95% confidence interval [CI] 0.46-0.57). No difference was found in the self-report rate between users of methamphetamine vs. cocaine (odds ratio [OR] 1.12, 95% CI 0.7-1.7). There also was no difference in the self-report rate by patient age < 50 years compared to patient age >or= 50 years (OR 0.67, 95% CI 0.42-1.08). The self-report rate for males compared to females was not significantly different (OR 0.87, 95% CI 0.54-1.4). Patients who had a positive troponin were not significantly more likely to self-report drug use than patients who did not have a positive troponin (OR 1.1, 95% CI 0.55-2.2). The self-report rate among cocaine- or methamphetamine-using patients presenting to the ED with chest pain was 51.8%. There seems to be no significant difference in the self-report rate among those who use methamphetamine vs. those who use cocaine, nor by gender, nor stratified by age over 50 years.

  6. Reliability of a Simple Physical Therapist Screening Tool to Assess Errors during Resistance Exercises for Musculoskeletal Pain

    PubMed Central

    Sundstrup, Emil

    2014-01-01

    The main objective was to investigate the intra- and intertester reliability of a simple screening tool assessing errors in exercise execution by visual observation. 38 participants with no previous resistance exercise experience practiced for two weeks four typical upper limb exercises using elastic tubing. At 2-week follow-up, the participants were invited for a test-retest assessment on errors in technical execution. The assessment was based on ordinal deviation of joint position from neutral of the shoulder, elbow, and wrist in a single plane by visual observation. Moderate intratester reliability weighted kappa (wΚ) score ranging from 0.50 (0.21–0.71) to 0.57 (0.24–0.82) for observer 1 and a fair to moderate intratester reliability wΚ score ranging from 0.27 (0.09–0.43) to 0.52 (0.15–0.86) for observer 2 across the four exercises was observed. For intertester reliability moderate to substantial mean wΚ scores were found between the two observers, slightly improving from round one to round two ranging from 0.40 (0.20–0.59) to 0.68 (0.45–0.91) in round one to 0.52 (0.20–0.80) to 0.69 (0.39–0.86) in round two. The exercise error assessment demonstrated fair to substantial intratester and intertester reliability, which is congruent with previously published studies. Hence the simplicity of defining a neutral joint position for each of the involved joints in the exercise and categorizing the deviation in “some deviation” and “substantial deviation” to either side in a single plane is a viable and inexpensive solution when assessing for errors during exercise. PMID:24738079

  7. Quantifying the test–retest reliability of cerebral blood flow measurements in a clinical model of on-going post-surgical pain: A study using pseudo-continuous arterial spin labelling☆

    PubMed Central

    Hodkinson, Duncan J.; Krause, Kristina; Khawaja, Nadine; Renton, Tara F.; Huggins, John P.; Vennart, William; Thacker, Michael A.; Mehta, Mitul A.; Zelaya, Fernando O.; Williams, Steven C.R.; Howard, Matthew A.

    2013-01-01

    Arterial spin labelling (ASL) is increasingly being applied to study the cerebral response to pain in both experimental human models and patients with persistent pain. Despite its advantages, scanning time and reliability remain important issues in the clinical applicability of ASL. Here we present the test–retest analysis of concurrent pseudo-continuous ASL (pCASL) and visual analogue scale (VAS), in a clinical model of on-going pain following third molar extraction (TME). Using ICC performance measures, we were able to quantify the reliability of the post-surgical pain state and ΔCBF (change in CBF), both at the group and individual case level. Within-subject, the inter- and intra-session reliability of the post-surgical pain state was ranked good-to-excellent (ICC > 0.6) across both pCASL and VAS modalities. The parameter ΔCBF (change in CBF between pre- and post-surgical states) performed reliably (ICC > 0.4), provided that a single baseline condition (or the mean of more than one baseline) was used for subtraction. Between-subjects, the pCASL measurements in the post-surgical pain state and ΔCBF were both characterised as reliable (ICC > 0.4). However, the subjective VAS pain ratings demonstrated a significant contribution of pain state variability, which suggests diminished utility for interindividual comparisons. These analyses indicate that the pCASL imaging technique has considerable potential for the comparison of within- and between-subjects differences associated with pain-induced state changes and baseline differences in regional CBF. They also suggest that differences in baseline perfusion and functional lateralisation characteristics may play an important role in the overall reliability of the estimated changes in CBF. Repeated measures designs have the important advantage that they provide good reliability for comparing condition effects because all sources of variability between subjects are excluded from the experimental error. The

  8. Designing a workplace return-to-work program for occupational low back pain: an intervention mapping approach

    PubMed Central

    Ammendolia, Carlo; Cassidy, David; Steensta, Ivan; Soklaridis, Sophie; Boyle, Eleanor; Eng, Stephanie; Howard, Hamer; Bhupinder, Bains; Côté, Pierre

    2009-01-01

    Background Despite over 2 decades of research, the ability to prevent work-related low back pain (LBP) and disability remains elusive. Recent research suggests that interventions that are focused at the workplace and incorporate the principals of participatory ergonomics and return-to-work (RTW) coordination can improve RTW and reduce disability following a work-related back injury. Workplace interventions or programs to improve RTW are difficult to design and implement given the various individuals and environments involved, each with their own unique circumstances. Intervention mapping provides a framework for designing and implementing complex interventions or programs. The objective of this study is to design a best evidence RTW program for occupational LBP tailored to the Ontario setting using an intervention mapping approach. Methods We used a qualitative synthesis based on the intervention mapping methodology. Best evidence from systematic reviews, practice guidelines and key articles on the prognosis and management of LBP and improving RTW was combined with theoretical models for managing LBP and changing behaviour. This was then systematically operationalized into a RTW program using consensus among experts and stakeholders. The RTW Program was further refined following feedback from nine focus groups with various stakeholders. Results A detailed five step RTW program was developed. The key features of the program include; having trained personnel coordinate the RTW process, identifying and ranking barriers and solutions to RTW from the perspective of all important stakeholders, mediating practical solutions at the workplace and, empowering the injured worker in RTW decision-making. Conclusion Intervention mapping provided a useful framework to develop a comprehensive RTW program tailored to the Ontario setting. PMID:19508728

  9. Designing a workplace return-to-work program for occupational low back pain: an intervention mapping approach.

    PubMed

    Ammendolia, Carlo; Cassidy, David; Steensta, Ivan; Soklaridis, Sophie; Boyle, Eleanor; Eng, Stephanie; Howard, Hamer; Bhupinder, Bains; Côté, Pierre

    2009-06-09

    Despite over 2 decades of research, the ability to prevent work-related low back pain (LBP) and disability remains elusive. Recent research suggests that interventions that are focused at the workplace and incorporate the principals of participatory ergonomics and return-to-work (RTW) coordination can improve RTW and reduce disability following a work-related back injury. Workplace interventions or programs to improve RTW are difficult to design and implement given the various individuals and environments involved, each with their own unique circumstances. Intervention mapping provides a framework for designing and implementing complex interventions or programs. The objective of this study is to design a best evidence RTW program for occupational LBP tailored to the Ontario setting using an intervention mapping approach. We used a qualitative synthesis based on the intervention mapping methodology. Best evidence from systematic reviews, practice guidelines and key articles on the prognosis and management of LBP and improving RTW was combined with theoretical models for managing LBP and changing behaviour. This was then systematically operationalized into a RTW program using consensus among experts and stakeholders. The RTW Program was further refined following feedback from nine focus groups with various stakeholders. A detailed five step RTW program was developed. The key features of the program include; having trained personnel coordinate the RTW process, identifying and ranking barriers and solutions to RTW from the perspective of all important stakeholders, mediating practical solutions at the workplace and, empowering the injured worker in RTW decision-making. Intervention mapping provided a useful framework to develop a comprehensive RTW program tailored to the Ontario setting.

  10. Student-Centered Reliability, Concurrent Validity and Instructional Sensitivity in Scoring of Students' Concept Maps in a University Science Laboratory

    ERIC Educational Resources Information Center

    Kaya, Osman Nafiz; Kilic, Ziya

    2004-01-01

    Student-centered approach of scoring the concept maps consisted of three elements namely symbol system, individual portfolio and scoring scheme. We scored student-constructed concept maps based on 5 concept map criteria: validity of concepts, adequacy of propositions, significance of cross-links, relevancy of examples, and interconnectedness. With…

  11. A new iPhone(®) application for measuring active craniocervical range of motion in patients with non-specific neck pain: a reliability and validity study.

    PubMed

    Pourahmadi, Mohammad Reza; Bagheri, Rasool; Taghipour, Morteza; Takamjani, Ismail Ebrahimi; Sarrafzadeh, Javad; Mohseni-Bandpei, Mohammad Ali

    2017-09-07

    Measurement of cervical spine range of motion (ROM) is often considered to be an essential component of cervical spine physiotherapy assessment. To investigate the reliability and validity of an iPhone(®) app (Goniometer Pro(©)) for measuring active craniocervical ROM (ACCROM) in patients with non-specific neck pain. A cross-sectional study was conducted at the musculoskeletal biomechanics laboratory located at Iran University of Medical Sciences. Forty non-specific neck pain patients participated in this study. ACCROM including flexion, extension, lateral flexion, and rotation. Following the recruitment process, ACCROM was measured using a universal goniometer and iPhone(®) 7 app. Two blinded examiners each utilized the universal goniometer and iPhone(®) to measure ACCROM in the following sequences: flexion, extension, lateral flexion, and rotation. The second (2 h later) and third (48 h later) sessions were carried out in the same manner as the first session. Intraclass correlation coefficient (ICC) models were used to determine the intra-rater and inter-rater reliability. The Pearson's correlation coefficients were used to establish concurrent validity of the iPhone(®) app. Minimum detectable change at the 95% confidence level (MDC95) was also computed. Good intra-rater and inter-rater reliability was demonstrated for the goniometer with ICC values of ≥ 0.66 and ≥ 0.70 and the iPhone(®) app with ICC values of ≥ 0.62 and ≥ 0.65, respectively. The MDC95 ranged from 2.21° to 12.50° for the intra-rater analysis and from 3.40° to 12.61° for the inter-rater analysis. The concurrent validity between the two instruments was high, with r values of ≥ 0.63. The magnitude of the differences between the UG and iPhone(®) app values (effect sizes) was small with Cohen's d values of ≤ 0.17. The iPhone(®) app possesses good reliability and high validity. It seems that this app can be used for measuring ACCROM. Copyright © 2017 Elsevier Inc. All rights

  12. Reliability of MR-Based Volumetric 3-D Analysis of Pelvic Muscles among Subjects with Low Back with Leg Pain and Healthy Volunteers

    PubMed Central

    Skorupska, Elżbieta; Keczmer, Przemysław; Łochowski, Rafał M.; Tomal, Paulina; Rychlik, Michał; Samborski, Włodzimierz

    2016-01-01

    Aim Lately, the diagnostic value of magnetic resonance imaging, Lasègue sign and classic neurological signs have been considered not accurate enough to distinguish the radicular from non-radicular low back with leg pain (LBLP) and a calculation of the symptomatic side muscle volume has been indicated as a probable valuable marker. However, only the multifidus muscle volume has been calculated so far. The main objective of the study was to verify whether LBLP subjects presented symptomatic side pelvic muscle atrophy compared to healthy volunteers. The second aim was to assess the inter-rater reliability of 3-D manual method for segmenting and measuring the volume of the gluteus maximus, gluteus medius, gluteus minimus and piriformis muscles in both LBLP patients and healthy subjects. Method Two independent raters analyzed MR images of LBLP and healthy subjects towards muscle volume of four pelvic muscles, i.e. the piriformis, gluteus minimus, gluteus medius and gluteus maximus. For both sides, the MR images of the muscles without adipose tissue infiltration were manually segmented in 3-D medical images. Results Symptomatic muscle atrophy was confirmed in only over 50% of LBLP subjects (gluteus maximus (p<0.001), gluteus minimus (p<0.01) and piriformis (p<0.05)). The ICC values indicated that the inter-rater reproducibility was greater than 0.90 for all measurements (LBLP and healthy subjects), except for the measurement of the right gluteus medius muscle in LBLP patients, which was equal to 0.848. Conclusion More than 50% of LBLP subjects presented symptomatic gluteus maximus, gluteus minimus and piriformis muscle atrophy. 3-D manual segmentation reliably measured muscle volume in all the measured pelvic muscles in both healthy and LBLP subjects. To answer the question of what kind of muscle atrophy is indicative of radicular or non-radicular pain further studies are required. PMID:27459688

  13. Mapping.

    ERIC Educational Resources Information Center

    Kinney, Douglas M.; McIntosh, Willard L.

    1979-01-01

    The area of geological mapping in the United States in 1978 increased greatly over that reported in 1977; state geological maps were added for California, Idaho, Nevada, and Alaska last year. (Author/BB)

  14. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: a prospective study in non-specific low back pain patients and controls in general practice.

    PubMed

    Njoo, K H; Van der Does, E

    1994-09-01

    The presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger point symptoms. Using the symptoms and signs as described by Simons' 1990 definition and two other former sets of criteria, 61 non-specific low back pain patients and 63 controls were examined in general practice by 5 observers, working in pairs. From the two major criteria of Simons' 1990 definition only 'localized tenderness' has good discriminative ability and inter-rater reliability (kappa > 0.5). This study does not find proof for the clinical usefulness of 'referred pain', which has neither of these two abilities. The criteria 'jump sign' and 'recognition', on the condition that localized tenderness is present, also have good discriminative ability and inter-rater reliability. Trigger points defined by the criteria found eligible in this study allow significant distinction between non-specific low back pain patients and controls. This is not the case with trigger points defined by Simons' 1990 criteria. Concerning reliability there is also a significant difference between the two different criteria sets. This study suggests that the clinical usefulness of trigger points is increased when localized tenderness and the presence of either jump sign or patient's recognition of his pain complaint are used as criteria for the presence of trigger points in the M. quadratus lumborum and the M. gluteus medius.

  15. Reliability of retrospective clinical data to evaluate the effectiveness of lumbar fusion in chronic low back pain.

    PubMed

    Pellisé, Ferran; Vidal, Xavier; Hernández, Alejandro; Cedraschi, Christine; Bagó, Joan; Villanueva, Carlos

    2005-02-01

    Patients in whom a posterior spinal fusion instrumentation had been performed to treat low back pain were asked to recall their preoperative clinical status by retrospectively filling out the same 3 self-evaluation scales they had completed before surgery in a prospective fashion. To evaluate the impact of recollection error and compare outcomes using retrospective versus prospective methodologies among a cohort of patients treated with posterior spinal fusion instrumentation. Literature on spine surgery from 1990 to 2000 shows a greater increase in retrospective studies as compared to randomized controlled trials and other prospective studies. Cross-sectional studies evaluate therapeutic effectiveness by comparing the current condition with the recalled (retrospectively recorded) pretreatment condition. There are no studies analyzing the characteristics of recalled data in a cohort of patients with chronic low back pain treated with posterior spinal fusion instrumentation. The preoperative clinical status of 58 patients, 33 women and 25 men, with a mean age of 48.3 years (22-84 years) was assessed prospectively with 3 self evaluation questionnaires and retrospectively at a mean of 37.5 months (2-58 months) after surgery using the same questionnaires. The Wilcoxon test was used to compare prospective and retrospective preoperative data and to compare prospective outcomes with outcomes determined from cross-sectional data. Agreement between prospective and retrospective measures was estimated with intraclass correlation coefficients for absolute agreement and consistency. Comparisons between prospective and recalled data showed significant differences, demonstrating a worse preoperative situation when using retrospective data. Assessment of treatment effectiveness showed that cross-sectional evaluation significantly improved the real surgical outcome. Both absolute agreement and consistency intraclass correlation coefficients showed poor agreement between

  16. Reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders: Part 1-A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Collaboration.

    PubMed

    Lemeunier, Nadège; da Silva-Oolup, S; Chow, N; Southerst, D; Carroll, L; Wong, J J; Shearer, H; Mastragostino, P; Cox, J; Côté, E; Murnaghan, K; Sutton, D; Côté, P

    2017-06-12

    To determine the reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. We updated the systematic review of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders. We also searched the literature to identify studies on the reliability and validity of Doppler velocimetry for the evaluation of cervical arteries. Two independent reviewers screened and critically appraised studies. We conducted a best evidence synthesis of low risk of bias studies and ranked the phases of investigations using the classification proposed by Sackett and Haynes. We screened 9022 articles and critically appraised 8 studies; all 8 studies had low risk of bias (three reliability and five validity Phase II-III studies). Preliminary evidence suggests that the extension-rotation test may be reliable and has adequate validity to rule out pain arising from facet joints. The evidence suggests variable reliability and preliminary validity for the evaluation of cervical radiculopathy including neurological examination (manual motor testing, dermatomal sensory testing, deep tendon reflexes, and pathological reflex testing), Spurling's and the upper limb neurodynamic tests. No evidence was found for doppler velocimetry. Little evidence exists to support the use of clinical tests to evaluate the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. We found preliminary evidence to support the use of the extension-rotation test, neurological examination, Spurling's and the upper limb neurodynamic tests.

  17. Johne's disease: reliability of environmental sampling to characterize Mycobacterium avium subspecies paratuberculosis (MAP) infection in beef cow-calf herds.

    PubMed

    Klawonn, W; Einax, E; Pützschel, R; Schmidt, M; Donat, K

    2016-08-01

    Environmental samples are considered to be a cost-effective method of identifying Mycobacterium avium subsp. paratuberculosis (MAP)-positive dairy herds, but evidence for beef cow-calf herds is weak. This study aims at evaluating this approach in a total of 20 German herds that were characterized by individual faecal samples (n = 2545) of all cows. For 14 MAP-positive herds having at least one MAP-positive animal, the within-herd prevalence was calculated from concurrent individual faecal culture-based testing. Six herds certified as 'MAP free' based on the negative results of previous years served as MAP-negative controls. On average, six environmental samples were taken at the end of winter from areas with high cow traffic and tested for MAP by faecal culture. According to the environmental samples, nine (64·3%) out of the 14 MAP-positive cow-calf herds were infected. The percentage of positive environmental samples and the apparent within-herd prevalence (Spearman's P = 0·73, P < 0·001) as well as the herd-level test results (positive and negative) and the herd's status based on individual testing (Fisher's exact test, P = 0·014) showed a positive association. Considering limitations in low-prevalence herds, MAP-positive beef cow-calf herds are detectable by environmental samples in temperate climate zones.

  18. Validity and reliability of the Spanish version of the DN4 (Douleur Neuropathique 4 questions) questionnaire for differential diagnosis of pain syndromes associated to a neuropathic or somatic component

    PubMed Central

    Perez, Concepcion; Galvez, Rafael; Huelbes, Silvia; Insausti, Joaquin; Bouhassira, Didier; Diaz, Silvia; Rejas, Javier

    2007-01-01

    Background This study assesses the validity and reliability of the Spanish version of DN4 questionnaire as a tool for differential diagnosis of pain syndromes associated to a neuropathic (NP) or somatic component (non-neuropathic pain, NNP). Methods A study was conducted consisting of two phases: cultural adaptation into the Spanish language by means of conceptual equivalence, including forward and backward translations in duplicate and cognitive debriefing, and testing of psychometric properties in patients with NP (peripheral, central and mixed) and NNP. The analysis of psychometric properties included reliability (internal consistency, inter-rater agreement and test-retest reliability) and validity (ROC curve analysis, agreement with the reference diagnosis and determination of sensitivity, specificity, and positive and negative predictive values in different subsamples according to type of NP). Results A sample of 164 subjects (99 women, 60.4%; age: 60.4 ± 16.0 years), 94 (57.3%) with NP (36 with peripheral, 32 with central, and 26 with mixed pain) and 70 with NNP was enrolled. The questionnaire was reliable [Cronbach's alpha coefficient: 0.71, inter-rater agreement coefficient: 0.80 (0.71–0.89), and test-retest intra-class correlation coefficient: 0.95 (0.92–0.97)] and valid for a cut-off value ≥ 4 points, which was the best value to discriminate between NP and NNP subjects. Discussion This study, representing the first validation of the DN4 questionnaire into another language different than the original, not only supported its high discriminatory value for identification of neuropathic pain, but also provided supplemental psychometric validation (i.e. test-retest reliability, influence of educational level and pain intensity) and showed its validity in mixed pain syndromes. PMID:18053212

  19. The Motivation and Pleasure Scale-Self-Report (MAP-SR): reliability and validity of a self-report measure of negative symptoms.

    PubMed

    Llerena, Katiah; Park, Stephanie G; McCarthy, Julie M; Couture, Shannon M; Bennett, Melanie E; Blanchard, Jack J

    2013-07-01

    The Clinical Assessment Interview for Negative Symptoms (CAINS) is an empirically developed interview measure of negative symptoms. Building on prior work, this study examined the reliability and validity of a self-report measure based on the CAINS-the Motivation and Pleasure Scale-Self-Report (MAP-SR)-that assesses the motivation and pleasure domain of negative symptoms. Thirty-seven participants with schizophrenia or schizoaffective disorder completed the 18-item MAP-SR, the CAINS, and other measures of functional outcome. Item analyses revealed three items that performed poorly. The revised 15-item MAP-SR demonstrated good internal consistency and convergent validity with the clinician-rated Motivation and Pleasure scale of the CAINS, as well as good discriminant validity, with little association with psychotic symptoms or depression/anxiety. MAP-SR scores were related to social anhedonia, social closeness, and clinician-rated social functioning. The MAP-SR is a promising self-report measure of severity of negative symptoms. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Neck Flexor and Extensor Muscle Endurance in Subclinical Neck Pain: Intrarater Reliability, Standard Error of Measurement, Minimal Detectable Change, and Comparison With Asymptomatic Participants in a University Student Population.

    PubMed

    Lourenço, Ana S; Lameiras, Carina; Silva, Anabela G

    2016-01-01

    The aims of this study were to assess intrarater reliability and to calculate the standard error of measurement (SEM) and minimal detectable change (MDC) for deep neck flexor and neck extensor muscle endurance tests, and compare the results between individuals with and without subclinical neck pain. Participants were students of the University of Aveiro reporting subclinical neck pain and asymptomatic participants matched for sex and age to the neck pain group. Data on endurance capacity of the deep neck flexors and neck extensors were collected by a blinded assessor using the deep neck flexor endurance test and the extensor endurance test, respectively. Intraclass correlation coefficients (ICCs), SEM, and MDC were calculated for measurements taken within a session by the same assessor. Differences between groups for endurance capacity were investigated using a Mann-Whitney U test. The deep neck flexor endurance test (ICC = 0.71; SEM = 6.91 seconds; MDC = 19.15 seconds) and neck extensor endurance test (ICC = 0.73; SEM = 9.84 minutes; MDC = 2.34 minutes) are reliable. No significant differences were found between participants with and without neck pain for both tests of muscle endurance (P > .05). The endurance capacity of the deep neck flexors and neck extensors can be reliably measured in participants with subclinical neck pain. However, the wide SEM and MDC might limit the sensitivity of these tests. Copyright © 2016. Published by Elsevier Inc.

  1. Generalized neck-shoulder hyperalgesia in chronic tension-type headache and unilateral migraine assessed by pressure pain sensitivity topographical maps of the trapezius muscle.

    PubMed

    Fernández-de-las-Peñas, C; Madeleine, P; Caminero, A B; Cuadrado, M L; Arendt-Nielsen, L; Pareja, J A

    2010-01-01

    Spatial changes in pressure pain hypersensitivity are present throughout the cephalic region (temporalis muscle) in both chronic tension-type headache (CTTH) and unilateral migraine. The aim of this study was to assess pressure pain sensitivity topographical maps on the trapezius muscle in 20 patients with CTTH and 20 with unilateral migraine in comparison with 20 healthy controls in a blind design. For this purpose, a pressure algometer was used to assess pressure pain thresholds (PPT) over 11 points of the trapezius muscle: four points in the upper part of the muscle, two over the levator scapulae muscle, two in the middle part, and the remaining three points in the lower part of the muscle. Pressure pain sensitivity maps of both sides (dominant/non-dominant; symptomatic/non-symptomatic) were depicted for patients and controls. CTTH patients showed generalized lower PPT levels compared with both migraine patients (P = 0.03) and controls (P < 0.001). The migraine group had also lower PPT than healthy controls (P < 0.001). The most sensitive location for the assessment of PPT was the neck portion of the upper trapezius muscle in both patient groups and healthy controls (P < 0.001). PPT was negatively related to some clinical pain features in both CTTH and unilateral migraine patients (all P < 0.05). Side-to-side differences were found in strictly unilateral migraine, but not in those subjects with bilateral pain, i.e. CTTH. These data support the influence of muscle hyperalgesia in both CTTH and unilateral migraine patients and point towards a general pressure pain hyperalgesia of neck-shoulder muscles in headache patients, particularly in CTTH.

  2. Manual unloading of the lumbar spine: can it identify immediate responders to mechanical traction in a low back pain population? A study of reliability and criterion referenced predictive validity

    PubMed Central

    Swanson, Brian T.; Riley, Sean P.; Cote, Mark P.; Leger, Robin R.; Moss, Isaac L.; Carlos,, John

    2016-01-01

    Background To date, no research has examined the reliability or predictive validity of manual unloading tests of the lumbar spine to identify potential responders to lumbar mechanical traction. Purpose To determine: (1) the intra and inter-rater reliability of a manual unloading test of the lumbar spine and (2) the criterion referenced predictive validity for the manual unloading test. Methods Ten volunteers with low back pain (LBP) underwent a manual unloading test to establish reliability. In a separate procedure, 30 consecutive patients with LBP (age 50·86±11·51) were assessed for pain in their most provocative standing position (visual analog scale (VAS) 49·53±25·52 mm). Patients were assessed with a manual unloading test in their most provocative position followed by a single application of intermittent mechanical traction. Post traction, pain in the provocative position was reassessed and utilized as the outcome criterion. Results The test of unloading demonstrated substantial intra and inter-rater reliability K = 1·00, P = 0·002, K = 0·737, P = 0·001, respectively. There were statistically significant within group differences for pain response following traction for patients with a positive manual unloading test (P<0·001), while patients with a negative manual unloading test did not demonstrate a statistically significant change (P>0·05). There were significant between group differences for proportion of responders to traction based on manual unloading response (P = 0·031), and manual unloading response demonstrated a moderate to strong relationship with traction response Phi = 0·443, P = 0·015. Discussion and conclusion The manual unloading test appears to be a reliable test and has a moderate to strong correlation with pain relief that exceeds minimal clinically important difference (MCID) following traction supporting the validity of this test. PMID:27559274

  3. MAPS

    Atmospheric Science Data Center

    2014-07-03

    ... Measurement of Air Pollution from Satellites (MAPS) data were collected during Space Shuttle flights in 1981, ... Facts Correlative Data  - CDIAC - Spring & Fall 1994 - Field and Aircraft Campaigns SCAR-B Block:  ...

  4. CXCL13/CXCR5 enhances sodium channel Nav1.8 current density via p38 MAP kinase in primary sensory neurons following inflammatory pain.

    PubMed

    Wu, Xiao-Bo; Cao, De-Li; Zhang, Xin; Jiang, Bao-Chun; Zhao, Lin-Xia; Qian, Bin; Gao, Yong-Jing

    2016-10-06

    CXCL13 is a B lymphocyte chemoattractant and activates CXCR5 receptor in the immune system. Here we investigated whether CXCL13/CXCR5 mediates inflammatory pain in dorsal root ganglia (DRG) and the underlying mechanisms. Peripheral injection of complete Freund's Adjuvant (CFA) increased the expression of CXCL13 and CXCR5 in DRG neurons. In Cxcr5(-/-) mice, CFA-induced pain hypersensitivity were attenuated. Whole-cell patch-clamp recording showed that the excitability of dissociated DRG neurons was increased after CFA injection or CXCL13 incubation from wild-type (WT) mice, but not from Cxcr5(-/-) mice. Additionally, sodium channel Nav1.8 was co-expressed with CXCR5 in dissociated DRG neurons, and the increased neuronal excitability induced by CFA or CXCL13 was reduced by Nav1.8 blocker. Intrathecal injection of Nav1.8 blocker also attenuated intrathecal injection of CXCL13-induced pain hypersensitivity. Furthermore, CXCL13 increased Nav1.8 current density in DRG neurons, which was inhibited by p38 MAP kinase inhibitor. CFA and CXCL13 increased p38 phosphorylation in the DRG of WT mice but not Cxcr5(-/-) mice. Finally, intrathecal p38 inhibitor alleviated CXCL13-induced pain hypersensitivity. Taken together, these results demonstrated that CXCL13, upregulated by peripheral inflammation, acts on CXCR5 on DRG neurons and activates p38, which increases Nav1.8 current density and further contributes to the maintenance of inflammatory pain.

  5. Accuracy and reliability of map-matched GPS coordinates: the dependence on terrain model resolution and interpolation algorithm

    NASA Astrophysics Data System (ADS)

    Li, Jing; Taylor, George; Kidner, David B.

    2005-03-01

    The global positioning system (GPS) has become the most extensively used positioning and navigation tool in the world. Applications of GPS abound in surveying, mapping, transportation, agriculture, military planning, GIS, and the geosciences. However, the positional and elevation accuracy of any given GPS location is prone to error, due to a number of factors. This has serious implications for some applications, such as real-time navigational systems. GPS accuracy can be significantly improved with additional data, possibly from multiple sources, and especially from multiple receivers. In the case of a single GPS receiver, its position and elevation can be considerably improved with the use of spatial data. For vehicle tracking, map matching can be employed to intelligently snap the GPS location to a road centreline, while height aiding can augment the GPS solution by utilising a digital terrain model (DTM), thereby reducing the number of satellites required to determine a position. This paper describes the use of map matching and height aiding, and examines the effect of different terrain resolutions (Ordnance Survey 1:50,000 and 1:10,000 scale DTMs) on plan position and elevation accuracy for vehicle tracking. Furthermore, the user's choice of interpolation algorithm for estimating heights from the DTM is investigated. The results of the experiments described in this paper demonstrate that height aiding alone reduces the mean error in elevation from 22.5 to 17.5 m for of a single GPS receiver, and the mean error in plan position from 6 to 5 m. However, map matching and height aiding combined, reduces the elevation RMSE of a single GPS receiver from 22.5 m to approximately 4 m (1:50,000 scale DTM) and down to 0.8 m (1:10,000 scale DTM), while the plan position RMSE is reduced from 5.9 to 3.2 m (either DTM). It is also demonstrated that when the number of satellites visible to the receiver is reduced, or the satellite geometry is poor, map matching and height

  6. Algoplus® Scale in Older Patients with Dementia: A Reliable Real-World Pain Assessment Tool.

    PubMed

    Monacelli, Fiammetta; Signori, Alessio; Roffredo, Laura; Pace, Katiuscia; Nencioni, Alessio; Pickering, Gisele; Nicolas, Macian; Odetti, Patrizio

    2017-01-01

    Pain is still a neglected clinical issue in elderly people with dementia and/or communicative disorders, with an unacceptable higher rate of under diagnosis and under treatment. Cognitive deficit and emotional and psychological disturbances entangle pain symptoms, affecting patient self-report. So far, observational pain tools do not have fully adequate clinimetric properties and quality requirements for easy-to-use daily rating. Older patients with dementia represent a clinical challenge. The assessment of pain is important for improving clinical outcomes, such as functional status, frailty trajectories, comorbidity, and quality of life. The PAINAID scale appears to be the most accurate pain tool in people with dementia along with the Algoplus® scale, a recently developed tool to rapidly assess acute pain in hospitals settings. The present study aimed to assess the clinimetric properties of the Algoplus®, as compared to PAINAID, for detecting acute pain in a real-world cohort of hospitalized older patients with dementia.

  7. Use of a Google Map Tool Embedded in an Internet Survey Instrument: Is it a Valid and Reliable Alternative to Geocoded Address Data?

    PubMed

    Dasgupta, Sharoda; Vaughan, Adam S; Kramer, Michael R; Sanchez, Travis H; Sullivan, Patrick S

    2014-04-10

    Men who have sex with men (MSM) in the United States are at high risk for human immunodeficiency virus (HIV) and poor HIV related outcomes. Maps can be used to identify, quantify, and address gaps in access to HIV care among HIV-positive MSM, and tailor intervention programs based on the needs of patients being served. The objective of our study was to assess the usability of a Google map question embedded in a Web-based survey among Atlanta-based, HIV-positive MSM, and determine whether it is a valid and reliable alternative to collection of address-based data on residence and last HIV care provider. Atlanta-based HIV-positive MSM were recruited through Facebook and from two ongoing studies recruiting primarily through venue-based sampling or peer referral (VBPR). Participants were asked to identify the locations of their residence and last attended HIV care provider using two methods: (1) by entering the street address (gold standard), and (2) "clicking" on the locations using an embedded Google map. Home and provider addresses were geocoded, mapped, and compared with home and provider locations from clicked map points to assess validity. Provider location error values were plotted against home location error values, and a kappa statistic was computed to assess agreement in degree of error in identifying residential location versus provider location. The median home location error across all participants was 0.65 miles (interquartile range, IQR, 0.10, 2.5 miles), and was lower among Facebook participants (P<.001), whites (P<.001), and those reporting higher annual household income (P=.04). Median home location error was lower, although not statistically significantly, among older men (P=.08) and those with higher educational attainment (P=.05). The median provider location error was 0.32 miles (IQR, 0.12, 1.2 miles), and did not vary significantly by age, recruitment method, race, income, or level of educational attainment. Overall, the kappa was 0.20, indicating

  8. Use of a Google Map Tool Embedded in an Internet Survey Instrument: Is it a Valid and Reliable Alternative to Geocoded Address Data?

    PubMed Central

    Vaughan, Adam S; Kramer, Michael R; Sanchez, Travis H; Sullivan, Patrick S

    2014-01-01

    Background Men who have sex with men (MSM) in the United States are at high risk for human immunodeficiency virus (HIV) and poor HIV related outcomes. Maps can be used to identify, quantify, and address gaps in access to HIV care among HIV-positive MSM, and tailor intervention programs based on the needs of patients being served. Objective The objective of our study was to assess the usability of a Google map question embedded in a Web-based survey among Atlanta-based, HIV-positive MSM, and determine whether it is a valid and reliable alternative to collection of address-based data on residence and last HIV care provider. Methods Atlanta-based HIV-positive MSM were recruited through Facebook and from two ongoing studies recruiting primarily through venue-based sampling or peer referral (VBPR). Participants were asked to identify the locations of their residence and last attended HIV care provider using two methods: (1) by entering the street address (gold standard), and (2) “clicking” on the locations using an embedded Google map. Home and provider addresses were geocoded, mapped, and compared with home and provider locations from clicked map points to assess validity. Provider location error values were plotted against home location error values, and a kappa statistic was computed to assess agreement in degree of error in identifying residential location versus provider location. Results The median home location error across all participants was 0.65 miles (interquartile range, IQR, 0.10, 2.5 miles), and was lower among Facebook participants (P<.001), whites (P<.001), and those reporting higher annual household income (P=.04). Median home location error was lower, although not statistically significantly, among older men (P=.08) and those with higher educational attainment (P=.05). The median provider location error was 0.32 miles (IQR, 0.12, 1.2 miles), and did not vary significantly by age, recruitment method, race, income, or level of educational attainment

  9. Multiple active myofascial trigger points and pressure pain sensitivity maps in the temporalis muscle are related in women with chronic tension type headache.

    PubMed

    Fernández-de-las-Peñas, César; Caminero, Ana B; Madeleine, Pascal; Guillem-Mesado, Amparo; Ge, Hong-You; Arendt-Nielsen, Lars; Pareja, Juan A

    2009-01-01

    To describe the common locations of active trigger points (TrPs) in the temporalis muscle and their referred pain patterns in chronic tension type headache (CTTH), and to determine if pressure sensitivity maps of this muscle can be used to describe the spatial distribution of active TrPs. Forty women with CTTH were included. An electronic pressure algometer was used to assess pressure pain thresholds (PPT) from 9 points over each temporalis muscle: 3 points in the anterior, medial and posterior part, respectively. Both muscles were examined for the presence of active TrPs over each of the 9 points. The referred pain pattern of each active TrP was assessed. Two-way analysis of variance detected significant differences in mean PPT levels between the measurement points (F=30.3; P<0.001), but not between sides (F=2.1; P=0.2). PPT scores decreased from the posterior to the anterior column (P<0.001). No differences were found in the number of active TrPs (F=0.3; P=0.9) between the dominant side the nondominant side. Significant differences were found in the distribution of the active TrPs (chi2=12.2; P<0.001): active TrPs were mostly found in the anterior column and in the middle of the muscle belly. The analysis of variance did not detect significant differences in the referred pain pattern between active TrPs (F=1.1, P=0.4). The topographical pressure pain sensitivity maps showed the distinct distribution of the TrPs indicated by locations with low PPTs. Multiple active TrPs in the temporalis muscle were found, particularly in the anterior column and in the middle of the muscle belly. Bilateral posterior to anterior decreased distribution of PPTs in the temporalis muscle in women with CTTH was found. The locations of active TrPs in the temporalis muscle corresponded well to the muscle areas with lower PPT, supporting the relationship between multiple active muscle TrPs and topographical pressure sensitivity maps in the temporalis muscle in women with CTTH.

  10. CXCL13/CXCR5 enhances sodium channel Nav1.8 current density via p38 MAP kinase in primary sensory neurons following inflammatory pain

    PubMed Central

    Wu, Xiao-Bo; Cao, De-Li; Zhang, Xin; Jiang, Bao-Chun; Zhao, Lin-Xia; Qian, Bin; Gao, Yong-Jing

    2016-01-01

    CXCL13 is a B lymphocyte chemoattractant and activates CXCR5 receptor in the immune system. Here we investigated whether CXCL13/CXCR5 mediates inflammatory pain in dorsal root ganglia (DRG) and the underlying mechanisms. Peripheral injection of complete Freund’s Adjuvant (CFA) increased the expression of CXCL13 and CXCR5 in DRG neurons. In Cxcr5−/− mice, CFA-induced pain hypersensitivity were attenuated. Whole-cell patch-clamp recording showed that the excitability of dissociated DRG neurons was increased after CFA injection or CXCL13 incubation from wild-type (WT) mice, but not from Cxcr5−/− mice. Additionally, sodium channel Nav1.8 was co-expressed with CXCR5 in dissociated DRG neurons, and the increased neuronal excitability induced by CFA or CXCL13 was reduced by Nav1.8 blocker. Intrathecal injection of Nav1.8 blocker also attenuated intrathecal injection of CXCL13-induced pain hypersensitivity. Furthermore, CXCL13 increased Nav1.8 current density in DRG neurons, which was inhibited by p38 MAP kinase inhibitor. CFA and CXCL13 increased p38 phosphorylation in the DRG of WT mice but not Cxcr5−/− mice. Finally, intrathecal p38 inhibitor alleviated CXCL13-induced pain hypersensitivity. Taken together, these results demonstrated that CXCL13, upregulated by peripheral inflammation, acts on CXCR5 on DRG neurons and activates p38, which increases Nav1.8 current density and further contributes to the maintenance of inflammatory pain. PMID:27708397

  11. The reliability and validity of a modified total neuropathy score-reduced and neuropathic pain severity items when used to measure chemotherapy-induced peripheral neuropathy in patients receiving taxanes and platinums.

    PubMed

    Smith, Ellen M Lavoie; Cohen, Jeffrey A; Pett, Marjorie A; Beck, Susan L

    2010-01-01

    Assessment of chemotherapy-induced peripheral neuropathy signs and symptoms has been hampered because of the lack of simple, reliable, and valid measures. The study objective was to examine the internal consistency and interrater reliability as well as the structural validity of a 5-component total neuropathy score-reduced (TNSr) variant and a chemotherapy-induced neuropathy-specific Neuropathic Pain Scale. One hundred seventeen outpatients receiving taxanes or platinums were assessed by a consistent nurse practitioner using the 2 instruments. Ten subjects participated in interrater reliability testing. Mean scores and SDs for individual items were low. The strength item was deleted because of low interitem correlations and a floor effect. The reflex item was deleted because of low interitem correlations and its negative influence on Cronbach alpha. Pin sensibility was deleted because of low factor loadings. The TNSr-short form and the chemotherapy-induced neuropathy-specific Neuropathic Pain Scale formed 2 distinct factors, providing evidence of structural validity. Cronbach alpha's for the 2 instruments were .80 and .96, respectively. The TNSr interrater reliability results suggested acceptable rater concordance, but minor revisions could further improve scoring precision. Clinimetric evidence supports the use of 2 new instruments when monitoring taxane- and platinum-related neuropathy and pain. Further instrument modifications are recommended, followed by additional testing in diverse populations. With these new instruments, nurses can more easily incorporate prospective neuropathy assessment into daily clinical practice. The outcome will be improved symptom awareness by oncology clinicians and patients, leading to fewer chemotherapy-induced peripheral neuropathy-related devastating effects on functionality and quality of life.

  12. CISN Display Progress to Date - Reliable Delivery of Real-Time Earthquake Information, and ShakeMap to Critical End Users

    NASA Astrophysics Data System (ADS)

    Rico, H.; Hauksson, E.; Thomas, E.; Friberg, P.; Frechette, K.; Given, D.

    2003-12-01

    The California Integrated Seismic Network (CISN) has collaborated to develop a next-generation earthquake notification system that is nearing its first operations-ready release. The CISN Display actively alerts users of seismic data, and vital earthquake hazards information following a significant event. It will primarily replace the Caltech/USGS Broadcast of Earthquakes (CUBE) and Rapid Earthquake Data Integration (REDI) Display as the principal means of delivering geographical seismic data to emergency operations centers, utility companies and media outlets. A subsequent goal is to provide automated access to the many Web products produced by regional seismic networks after an earthquake. Another aim is to create a highly configurable client, allowing user organizations to overlay infrastructure data critical to their roles as first-responders, or lifeline operators. And the final goal is to integrate these requirements, into a package offering several layers of reliability to ensure delivery of services. Central to the CISN Display's role as a gateway to Web-based earthquake products is its comprehensive XML-messaging schema. The message model uses many of the same attributes in the CUBE format, but extends the old standard by provisioning additional elements for products currently available, and others yet to be considered. The client consumes these XML-messages, sorts them through a resident Quake Data Merge filter, and posts updates that also include hyperlinks associated to specific event IDs on the display map. Earthquake products available for delivery to the CISN Display are ShakeMap, focal mechanisms, waveform data, felt reports, aftershock forecasts and earthquake commentaries. By design the XML-message schema can evolve as products and information needs change, without breaking existing applications that rely on it. The latest version of the CISN Display can also automatically download ShakeMaps and display shaking intensity within the GIS system. This

  13. Item response theory analysis to evaluate reliability and minimal clinically important change of the Roland-Morris Disability Questionnaire in patients with severe disability due to back pain from vertebral compression fractures.

    PubMed

    Lee, Minji K; Yost, Kathleen J; McDonald, Jennifer S; Dougherty, Ryne W; Vine, Roanna L; Kallmes, David F

    2017-06-01

    The majority of validation done on the Roland-Morris Disability Questionnaire (RMDQ) has been in patients with mild or moderate disability. There is paucity of research focusing on the psychometric quality of the RMDQ in patients with severe disability. To evaluate the psychometric quality of the RMDQ in patients with severe disability. Observational clinical study. The sample consisted of 214 patients with painful vertebral compression fractures who underwent vertebroplasty or kyphoplasty. The 23-item version of the RMDQ was completed at two time points: baseline and 30-day postintervention follow-up. With the two-parameter logistic unidimensional item response theory (IRT) analyses, we derived the range of scores that produced reliable measurement and investigated the minimal clinically important difference (MCID). Scores for 214 (100%) patients at baseline and 108 (50%) patients at follow-up did not meet the reliability criterion of 0.90 or higher, with the majority of patients having disability due to back pain that was too severe to be reliably measured by the RMDQ. Depending on methodology, MCID estimates ranged from 2 to 8 points and the proportion of patients classified as having experienced meaningful improvement ranged from 26% to 68%. A greater change in score was needed at the extreme ends of the score scale to be classified as having achieved MCID using IRT methods. Replacing items measuring moderate disability with items measuring severe disability could yield a version of the RMDQ that better targets patients with severe disability due to back pain. Improved precision in measuring disability would be valuable to clinicians who treat patients with greater functional impairments. Caution is needed when choosing criteria for interpreting meaningful change using the RMDQ. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. [Pain assessment in dementia].

    PubMed

    Husebø, Bettina Sandgathe

    2009-10-08

    Patients with dementia are often unable to describe their pain because of memory deficiency and speech problems. This may lead to under-diagnosing and suboptimal pain treatment. The article summarises a thesis on development and testing of a new instrument for pain assessment: Mobilisation-Observation-Behavior-Intensity-Dementia (MOBID-2) pain scale. 284 nursing home patients (with and without pain), who had been diagnosed with dementia of different types in various stages, were included in the study. Behaviour and intensity of pain was assessed during video-uptakes of clinical examinations and during regular morning care. Psychometric property testing included assessments of reliability, validity and clinical usefulness for the nursing home staff. Observation of pain behaviour during standardised and guided movements, by using the MOBID-2 Pain Scale, provides reliable and valid estimation of intensity of pain associated with the musculoskeletal-system. Pain that is not associated with the musculoskeletal-system is frequently observed, but more challenging to assess. Patients who have severe dementia and/or a combination of Alzheimer's disease and vascular dementia, have a higher risk of suffering from severe and untreated pain than patients without dementia. The MOBID-2 pain scale may help to ensure competent pain treatment, and should be available in all Norwegian nursing homes. A multidisciplinary approach is needed for its implementation and use. Physicians in nursing homes should reconsider the staff's observations, perform additional investigations and find the balance between effects and side effects of pain treatment.

  15. Reproducibility and Reliability of Quantitative and Weighted T1 and T2∗ Mapping for Myelin-Based Cortical Parcellation at 7 Tesla

    PubMed Central

    Haast, Roy A. M.; Ivanov, Dimo; Formisano, Elia; Uludaǧ, Kâmil

    2016-01-01

    Different magnetic resonance (MR) parameters, such as R1 (=1/T1) or T2∗, have been used to visualize non-invasively the myelin distribution across the cortical sheet. Myelin contrast is consistently enhanced in the primary sensory and some higher order cortical areas (such as MT or the cingulate cortex), which renders it suitable for subject-specific anatomical cortical parcellation. However, no systematic comparison has been performed between the previously proposed MR parameters, i.e., the longitudinal and transversal relaxation values (or their ratios), for myelin mapping at 7 Tesla. In addition, usually these MR parameters are acquired in a non-quantitative manner (“weighted” parameters). Here, we evaluated the differences in ‘parcellability,’ contrast-to-noise ratio (CNR) and inter- and intra-subject variability and reproducibility, respectively, between high-resolution cortical surface maps based on these weighted MR parameters and their quantitative counterparts in ten healthy subjects. All parameters were obtained in a similar acquisition time and possible transmit- or receive-biases were removed during post-processing. It was found that CNR per unit time and parcellability were lower for the transversal compared to the longitudinal relaxation parameters. Further, quantitative R1 was characterized by the lowest inter- and intra-subject coefficient of variation (5.53 and 1.63%, respectively), making R1 a better parameter to map the myelin distribution compared to the other parameters. Moreover, quantitative MRI approaches offer the advantage of absolute rather than relative characterization of the underlying biochemical composition of the tissue, allowing more reliable comparison within subjects and between healthy subjects and patients. Finally, we explored two parcellation methods (thresholding the MR parameter values vs. surface gradients of these values) to determine areal borders based on the cortical surface pattern. It is shown that both

  16. CISN Display - Reliable Delivery of Real-time Earthquake Information, Including Rapid Notification and ShakeMap to Critical End Users

    NASA Astrophysics Data System (ADS)

    Rico, H.; Hauksson, E.; Thomas, E.; Friberg, P.; Given, D.

    2002-12-01

    earthquake information on the Web. The links are automatically created when product generators deliver CUBE formatted packets to a Quake Data Distribution System (QDDS) hub (new distribution methods may be used later). The "feeder" modules tap into the QDDS hub and convert the packets into XML-messages. These messages are forwarded to message queues, and then distributed to clients where URLs are dynamically created for these products and linked to events on the CISN Display map. The products may be downloaded out-of-band; and with the inclusion of a GIS mapping tool users can plot organizational assets on the CISN Display map and overlay them against key spectral data, such as ground accelerations. This gives Emergency Response Managers information useful in allocating limited personnel and resources after a major event. At the heart of the system's robustness is a well-established and reliable set of communication protocols for best-effort delivery of data. For critical users a Common Object Request Broker Architecture (CORBA) state-full connection is used via a dedicated signaling channel. The system employs several CORBA methods that alert users of changes in the link status. Loss of connectivity triggers a strategy that attempts to reconnect through various physical and logical paths. Thus, by building on past application successes and proven Internet advances the CISN Display targets a specific audience by providing enhancements previously not available from other applications.

  17. Evaluating the reliability and sensitivity of the Kerr electro-optic field mapping measurements with high-voltage pulsed transformer oil

    NASA Astrophysics Data System (ADS)

    Zhang, X.; Nowocin, J. K.; Zahn, M.

    2013-08-01

    Transformer oil is the most widely used dielectric liquid for high voltage insulation. Measurements of the electric field distribution in high voltage pulsed transformer oil are of both practical and theoretical interests. Due to its low Kerr constant, previous electro-optic measurements with transformer oil rely on a technique called ac modulation, which works only for dc steady-state electric field mapping. With the help of a high-sensitivity charge-coupled device, we directly measure the Kerr electro-optic effect between parallel electrodes in transformer oil stressed by high voltage pulses. This work aims at demonstrating the reliability and evaluating the sensitivity of the measurements for three cases with identical electrodes: space-charge free, uniform electric field in the mid-region of the gap; space-charge free, non-uniform fringing electric field; and space charge distorted electric field in the mid-region of the gap. Future directions to improve accuracy by identifying and handling various sources of error and noise are suggested.

  18. Quantitative cerebral blood flow mapping and functional connectivity of postherpetic neuralgia pain: a perfusion fMRI study.

    PubMed

    Liu, Jing; Hao, Ying; Du, Minyi; Wang, Xiaoying; Zhang, Jue; Manor, Brad; Jiang, Xuexiang; Fang, Wenxue; Wang, Dongxin

    2013-01-01

    This article investigates the effects of postherpetic neuralgia (PHN) on resting-state brain activity utilizing arterial spin labeling (ASL) techniques. Features of static and dynamic cerebral blood flow (CBF) were analyzed to reflect the specific brain response to PHN pain. Eleven consecutive patients suffering from PHN and 11 age- and gender-matched control subjects underwent perfusion functional magnetic resonance imaging brain scanning during the resting state. Group comparison was conducted to detect the regions with significant changes of CBF in PHN patients. Then we chose those regions that were highly correlated with the self-reported pain intensity as "seeds" to calculate the functional connectivity of both groups. Absolute CBF values of these regions were also compared across PHN patients and control subjects. Significant increases in CBF of the patient group were observed in left striatum, right thalamus, left primary somatosensory cortex (S1), left insula, left amygdala, left primary somatomotor cortex, and left inferior parietal lobule. Significant decreases in CBF were mainly located in the frontal cortex. Regional CBF in the left caudate, left insula, left S1, and right thalamus was highly correlated with the pain intensity, and further comparison showed that the regional CBF in these regions is significantly higher in PHN groups. Functional connectivity results demonstrated that the reward circuitry involved in striatum, prefrontal cortex, amygdala, and parahippocampal gyrus and the circuitry among striatum, thalamus, and insula were highly correlated with each element in PHN patients. In addition, noninvasive brain perfusion imaging at rest may provide novel insights into the central mechanisms underlying PHN pain.

  19. A validation study of the Brief Scale for Psychiatric problems in Orthopaedic Patients (BS-POP) for patients with chronic low back pain (verification of reliability, validity, and reproducibility).

    PubMed

    Yoshida, Katshuhiro; Sekiguchi, Miho; Otani, Koji; Mashiko, Hirobumi; Shiota, Harumi; Wakita, Takafumi; Niwa, Shin ichi; Kikuchi, Shin-ichi; Konno, Shin-ichi

    2011-01-01

    We developed the Brief Scale for Psychiatric problems in Orthopaedic Patients (BS-POP) (doctor and patient versions). The present study aimed to proactively verify the factorial validity, internal consistency, criterion-related validity and reproducibility of the BS-POP with regard to chronic low back pain patients. Subjects comprised 193 chronic low back pain patients. During the first test, the BS-POP, Minnesota Multiphasic Personality Inventory (MMPI), Profile of Mood States (POMS) and 36-Item Short-Form Health Survey version 2 (SF-36 v2) were conducted. In the second test, patients were asked to complete the BS-POP in order to verify BS-POP reproducibility. Factor analysis demonstrated the factorial validity of the BS-POP, including 1-factor structure. Internal consistency was confirmed by Cronbach's α reliability coefficients of 0.794 (doctor version) and 0.750 (patient version). Criterion-related validity was confirmed through association with the psychosocial factors of the SF-36, the MMPI, and the POMS. The correlation coefficients for the retests were r = 0.654 (doctor version) and r = 0.719 (patient version), showing reproducibility. The present findings indicate that the BS-POP possesses sufficient reliability regarding computational psychology. The BS-POP constitutes a tool enabling orthopaedists themselves to easily identify psychiatric problems in orthopaedic patients. Further study is required regarding responsiveness.

  20. Reliability and Construct Validity of the Psychopathic Personality Inventory-Revised in a Swedish Non-Criminal Sample – A Multimethod Approach including Psychophysiological Correlates of Empathy for Pain

    PubMed Central

    Sörman, Karolina; Nilsonne, Gustav; Howner, Katarina; Tamm, Sandra; Caman, Shilan; Wang, Hui-Xin; Ingvar, Martin; Edens, John F.; Gustavsson, Petter; Lilienfeld, Scott O; Petrovic, Predrag; Fischer, Håkan; Kristiansson, Marianne

    2016-01-01

    Cross-cultural investigation of psychopathy measures is important for clarifying the nomological network surrounding the psychopathy construct. The Psychopathic Personality Inventory-Revised (PPI-R) is one of the most extensively researched self-report measures of psychopathic traits in adults. To date however, it has been examined primarily in North American criminal or student samples. To address this gap in the literature, we examined PPI-R’s reliability, construct validity and factor structure in non-criminal individuals (N = 227) in Sweden, using a multimethod approach including psychophysiological correlates of empathy for pain. PPI-R construct validity was investigated in subgroups of participants by exploring its degree of overlap with (i) the Psychopathy Checklist: Screening Version (PCL:SV), (ii) self-rated empathy and behavioral and physiological responses in an experiment on empathy for pain, and (iii) additional self-report measures of alexithymia and trait anxiety. The PPI-R total score was significantly associated with PCL:SV total and factor scores. The PPI-R Coldheartedness scale demonstrated significant negative associations with all empathy subscales and with rated unpleasantness and skin conductance responses in the empathy experiment. The PPI-R higher order Self-Centered Impulsivity and Fearless Dominance dimensions were associated with trait anxiety in opposite directions (positively and negatively, respectively). Overall, the results demonstrated solid reliability (test-retest and internal consistency) and promising but somewhat mixed construct validity for the Swedish translation of the PPI-R. PMID:27300292

  1. Mapping of pain circuitry in early post-natal development using manganese-enhanced MRI in rats.

    PubMed

    Sperry, M M; Kandel, B M; Wehrli, S; Bass, K N; Das, S R; Dhillon, P S; Gee, J C; Barr, G A

    2017-04-06

    Premature or ill full-term infants are subject to a number of noxious procedures as part of their necessary medical care. Although we know that human infants show neural changes in response to such procedures, we know little of the sensory or affective brain circuitry activated by pain. In rodent models, the focus has been on spinal cord and, more recently, midbrain and medulla. The present study assesses activation of brain circuits using manganese-enhanced magnetic resonance imaging (MEMRI). Uptake of manganese, a paramagnetic contrast agent that is transported across active synapses and along axons, was measured in response to a hindpaw injection of dilute formalin in 12-day-old rat pups, the age at which rats begin to show aversion learning and which is roughly the equivalent of full-term human infants. Formalin induced the well-reported biphasic response at this age and induced a conditioned aversion to cues associated with its injection, thus demonstrating the aversiveness of the stimulation. Morphometric analyses, structural equation modeling and co-expression analysis showed that limbic and sensory paths were activated, the most prominent of which were the prefrontal and anterior cingulate cortices, nucleus accumbens, amygdala, hypothalamus, several brainstem structures, and the cerebellum. Therefore, both sensory and affective circuits, which are activated by pain in the adult, can also be activated by noxious stimulation in 12-day-old rat pups.

  2. Defining the limits and reliability of rigid-body fitting in cryo-EM maps using multi-scale image pyramids.

    PubMed

    van Zundert, G C P; Bonvin, A M J J

    2016-08-01

    Cryo-electron microscopy provides fascinating structural insight into large macromolecular machines at increasing detail. Despite significant advances in the field, the resolution of the resulting three-dimensional images is still typically insufficient for de novo model building. To bridge the resolution gap and give an atomic interpretation to the data, high-resolution models are typically placed into the density as rigid bodies. Unfortunately, this is often done manually using graphics software, a subjective method that can lead to over-interpretation of the data. A more objective approach is to perform an exhaustive cross-correlation-based search to fit subunits into the density. Here we show, using five experimental ribosome maps ranging in resolution from 5.5 to 6.9Å, that cross-correlation-based fitting is capable of successfully fitting subunits correctly in the density for over 90% of the cases. Importantly, we provide indicators for the reliability and ambiguity of a fit, using the Fisher z-transformation and its associated confidence intervals, giving a formal approach to identify over-interpreted regions in the density. In addition, we quantify the resolution requirement for a successful fit as a function of the subunit size. For larger subunits the resolution of the data can be down-filtered to 20Å while still retaining an unambiguous fit. We leverage this information through the use of multi-scale image pyramids to accelerate the search up to 30-fold on CPUs and 40-fold on GPUs at a negligible loss in success rate. We implemented this approach in our rigid-body fitting software PowerFit, which can be freely downloaded from https://github.com/haddocking/powerfit.

  3. Using intervention mapping to develop a theory-driven, group-based complex intervention to support self-management of osteoarthritis and low back pain (SOLAS).

    PubMed

    Hurley, Deirdre A; Murphy, Laura Currie; Hayes, David; Hall, Amanda M; Toomey, Elaine; McDonough, Suzanne M; Lonsdale, Chris; Walsh, Nicola E; Guerin, Suzanne; Matthews, James

    2016-04-26

    The Medical Research Council framework provides a useful general approach to designing and evaluating complex interventions, but does not provide detailed guidance on how to do this and there is little evidence of how this framework is applied in practice. This study describes the use of intervention mapping (IM) in the design of a theory-driven, group-based complex intervention to support self-management (SM) of patients with osteoarthritis (OA) and chronic low back pain (CLBP) in Ireland's primary care health system. The six steps of the IM protocol were systematically applied to develop the self-management of osteoarthritis and low back pain through activity and skills (SOLAS) intervention through adaptation of the Facilitating Activity and Self-management in Arthritis (FASA) intervention. A needs assessment including literature reviews, interviews with patients and physiotherapists and resource evaluation was completed to identify the programme goals, determinants of SM behaviour, consolidated definition of SM and required adaptations to FASA to meet health service and patient needs and the evidence. The resultant SOLAS intervention behavioural outcomes, performance and change objectives were specified and practical application methods selected, followed by organised programme, adoption, implementation and evaluation plans underpinned by behaviour change theory. The SOLAS intervention consists of six weekly sessions of 90-min education and exercise designed to increase participants' physical activity level and use of evidence-based SM strategies (i.e. pain self-management, pain coping, healthy eating for weight management and specific exercise) through targeting of individual determinants of SM behaviour (knowledge, skills, self-efficacy, fear, catastrophizing, motivation, behavioural regulation), delivered by a trained physiotherapist to groups of up to eight individuals using a needs supportive interpersonal style based on self-determination theory

  4. VLSI reliability

    SciTech Connect

    Sabnis, A.G. )

    1990-01-01

    This book presents major topics in IC reliability from basic concepts to packaging issues. Other topics covered include failure analysis techniques, radiation effects, and reliability assurance and qualification. This book offers insight into the practical aspects of VLSI reliability.

  5. Sacroiliac joint pain.

    PubMed

    Dreyfuss, Paul; Dreyer, Susan J; Cole, Andrew; Mayo, Keith

    2004-01-01

    The sacroiliac joint is a source of pain in the lower back and buttocks in approximately 15% of the population. Diagnosing sacroiliac joint-mediated pain is difficult because the presenting complaints are similar to those of other causes of back pain. Patients with sacroiliac joint-mediated pain rarely report pain above L5; most localize their pain to the area around the posterior superior iliac spine. Radiographic and laboratory tests primarily help exclude other sources of low back pain. Magnetic resonance imaging, computed tomography, and bone scans of the sacroiliac joint cannot reliably determine whether the joint is the source of the pain. Controlled analgesic injections of the sacroiliac joint are the most important tool in the diagnosis. Treatment modalities include medications, physical therapy, bracing, manual therapy, injections, radiofrequency denervation, and arthrodesis; however, no published prospective data compare the efficacy of these modalities.

  6. The "neuro-mapping locator" software. A real-time intraoperative objective paraesthesia mapping tool to evaluate paraesthesia coverage of the painful zone in patients undergoing spinal cord stimulation lead implantation.

    PubMed

    Guetarni, F; Rigoard, P

    2015-03-01

    Conventional spinal cord stimulation (SCS) generates paraesthesia, as the efficacy of this technique is based on the relationship between the paraesthesia provided by SCS on the painful zone and an analgesic effect on the stimulated zone. Although this basic postulate is based on clinical evidence, it is clear that this relationship has never been formally demonstrated by scientific studies. There is a need for objective evaluation tools ("transducers") to transpose electrical signals to clinical effects and to guide therapeutic choices. We have developed a software at Poitiers University hospital allowing real-time objective mapping of the paraesthesia generated by SCS lead placement and programming during the implantation procedure itself, on a touch screen interface. The purpose of this article is to describe this intraoperative mapping software, in terms of its concept and technical aspects. The Neuro-Mapping Locator (NML) software is dedicated to patients with failed back surgery syndrome, candidates for SCS lead implantation, to actively participate in the implantation procedure. Real-time geographical localization of the paraesthesia generated by percutaneous or multicolumn surgical SCS lead implanted under awake anaesthesia allows intraoperative lead programming and possibly lead positioning to be modified with the patient's cooperation. Software updates should enable us to refine objectives related to the use of this tool and minimize observational biases. The ultimate goals of NML software should not be limited to optimize one specific device implantation in a patient but also allow to compare instantaneously various stimulation strategies, by characterizing new technical parameters as "coverage efficacy" and "device specificity" on selected subgroups of patients. Another longer-term objective would be to organize these predictive factors into computer science ontologies, which could constitute robust and helpful data for device selection and programming

  7. Measurement of Trigeminal Neuralgia Pain: Penn Facial Pain Scale.

    PubMed

    Lee, John Y K

    2016-07-01

    Pain is a subjective experience that cannot be directly measured. Therefore, patient-reported outcome is one of the currently accepted methods to capture pain intensity and its impact on activities of daily living. This article focuses on five patient-reported outcomes that have been used to measure trigeminal neuralgia pain-Visual Analog Scale, numeric rating scale, Barrow Neurological Institute Pain Intensity Score, McGill Pain Questionnaire, and Penn Facial Pain Scale. Each scale is evaluated for its practicality, applicability, comprehensiveness, reliability, validity, and sensitivity to measuring trigeminal neuralgia pain. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. RIT Stability through the Transition to Common Core-Aligned MAP® Tests. How Using MAP to Measure Student Learning Growth is Reliable Now and in 2014

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2013

    2013-01-01

    While many educators expect the Common Core State Standards (CCSS) to be more rigorous than previous state standards, some wonder if the transition to CCSS and to a Common Core aligned MAP test will have an impact on their students' RIT scores or the NWEA norms. MAP assessments use a proprietary scale known as the RIT (Rasch unit) scale to measure…

  9. Groin pain

    MedlinePlus

    Pain - groin; Lower abdominal pain; Genital pain; Perineal pain ... Common causes of groin pain include: Pulled muscle, tendon, or ligaments in the leg: This problem often occurs in people who play sports such as ...

  10. Reliability of drumlin morphometric data based on manual mapping - assessment of inter-mapper differences using a morphometrically diverse sample of relict drumlins

    NASA Astrophysics Data System (ADS)

    Jorge, Marco G.; Brennand, Tracy A.; Perkins, Andrew J.; Neudorf, Christina; Hillier, John K.; Cripps, Jonathan E.; Spagnolo, Matteo; Dinney, Meaghan; Storrar, Robert D.

    2016-04-01

    Mapper-dependent (subjective) differences in drumlin morphometry have received little attention even though over one-hundred thousand drumlins have been manually mapped and used to characterize drumlin morphometry and infer drumlin genesis, and several obstacles to objectivity in drumlin mapping can be identified. Due to uncertainty in drumlin genesis, drumlins remain putative morphogenetic landforms, yet still lack a complete single morphological definition. Additionally, post-formational degradation of relict subglacial landscapes challenges our ability: 1) to identify all drumlins in the landscape (some [potential] drumlins may be too degraded to be mapped and are thus excluded from the inventory), with implications for the analysis of field properties (e.g., spatial arrangement and autocorrelation); and 2) to accurately map the original footprint (i.e., shape and size). These issues (definitional ambiguity; degradation of original drumlin topography) are a problem for both manual and automated mapping. Automation is touted as the solution to the subjectivity of manual mapping, but the quality of any automated method directly depends on the quality of the operational definition (ruleset) it draws upon; if drumlin definitions are subjective (expert-dependent), so will be the automated algorithms relying on them. Additionally, recognizing highly degraded drumlins is, arguably, more difficult automatedly than manually (visually). Because a single morphologic definition is missing, mapping is expert-dependent. Therefore, quantifying the magnitude of inter-mapper differences is important for fully understanding the morphology of drumlins, constraining the robustness of drumlin morphometric inventories and assisting in the development of stricter operational definitions/mapping guidelines. We present the results of an experiment to quantify inter-mapper differences in mapped drumlin morphometry. All participants mapped 42 morphologically diverse drumlins in the Puget

  11. A novel, objective, quantitative method of evaluation of the back pain component using comparative computerized multi-parametric tactile mapping before/after spinal cord stimulation and database analysis: the "Neuro-Pain't" software.

    PubMed

    Rigoard, P; Nivole, K; Blouin, P; Monlezun, O; Roulaud, M; Lorgeoux, B; Bataille, B; Guetarni, F

    2015-03-01

    One of the major challenges of neurostimulation is actually to address the back pain component in patients suffering from refractory chronic back and leg pain. Facing a tremendous expansion of neurostimulation techniques and available devices, implanters and patients can still remain confused as they need to select the right tool for the right indication. To be able to evaluate and compare objectively patient outcomes, depending on therapeutical strategies, it appears essential to develop a rational and quantitative approach to pain assessment for those who undergo neurostimulation implantation. We developed a touch screen interface, in Poitiers University Hospital and N(3)Lab, called the "Neuro-Pain'T", to detect, record and quantify the painful area surface and intensity changes in an implanted patient within time. The second aim of this software is to analyse the link between a paraesthesia coverage generated by a type of neurostimulation and a potential analgesic effect, measured by pain surface reduction, pain intensity reduction within the painful surface and local change in pain characteristics distribution. The third aim of Neuro-Pain'T is to correlate these clinical parameters to global patient data and functional outcome analysis, via a network database (Neuro-Database), to be able to provide a concise but objective approach of the neurostimulation efficacy, summarized by an index called "RFG Index". This software has been used in more than 190 patients since 2012, leading us to define three clinical parameters grouped as a clinical component of the RFG Index, which might be helpful to assess neurostimulation efficacy and compare implanted devices. The Neuro-Pain'T is an original software designed to objectively and quantitatively characterize reduction of a painful area in a given individual, in terms of intensity, surface and pain typology, in response to a treatment strategy or implantation of an analgesic device. Because pain is a physical sensation

  12. What is the reliability of non-trained investigators in recognising structural MRI lesions of sacroiliac joints in patients with recent inflammatory back pain? Results of the DESIR cohort

    PubMed Central

    Jacquemin, Charlotte; Rubio Vargas, Roxana; van den Berg, Rosaline; Thévenin, Fabrice; Lenczner, Gregory; Reijnierse, Monique; Ferkal, Salah; Le Corvoisier, Philippe; Rahmouni, Alain; Loeuille, Damien; Feydy, Antoine; Dougados, Maxime; van der Heijde, Désirée; Claudepierre, Pascal

    2016-01-01

    Objective The objective of this study was to evaluate the reliability of recognising structural lesions on MRI (erosions, fatty lesions, ankylosis) of the sacroiliac joints (MRI-SIJ) in clinical practice compared to a central reading in patients with a possible recent axial spondyloarthritis (axSpA). Methods Patients aged 18–50 years, with recent (<3 years) and chronic (≥3 months) inflammatory back pain, suggestive of axSpA were included in the DEvenir des Spondyloarthrites Indifférenciées Récentes (DESIR) cohort. MRI-SIJ structural lesions were scored by non-trained local readers, and by two trained central readers. Local readers scored each SIJ as normal, doubtful or definite lesions. Central readers scored separately each type of lesion. The central reading (mean of the two central readers’ scores) was the external standard. Agreement (κ) was calculated first between local (3 definitions of a positive MRI-SIJ) and central readings (9 definitions), and then between the two central readers. Results 664/708 patients with complete available images were included. Agreements between local and central readings were overall ‘fair’, except when considering at least 2 or 3 fatty lesions and at least 3 erosions and/or fatty lesions where agreement was ‘moderate’. Agreement between central readers was similar. MRI-SIJ was positive for 52.6% of patients according to central reading (at least 1 structural lesion) and for 35.4% of patients according to local reading (at least unilateral ‘doubtful‘ or ‘definite’ structural lesions). Conclusions Agreement on a positive structural MRI-SIJ was fair to moderate between local and central readings, as well as between central readers. The reliability improved when fatty lesions were considered. Trial registration number NCTO 164 8907. PMID:27933207

  13. Test-retest reliability and discriminant validity for the Brazilian version of “The Interstitial Cystitis Symptom Index and Problem Index” and “Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale” instruments

    PubMed Central

    D’Ancona, Carlos Arturo Levi; Junqueira, Roberto Gomes; Carlos da Silva, Daniel; Oliveira, Henrique Ceretta; de Moraes Lopes, Maria Helena Baena

    2015-01-01

    Background The purpose is to evaluate the psychometric properties of reliability and discriminant validity of the Brazilian Portuguese versions of two instruments used in the diagnosis of interstitial cystitis (IC): “The Interstitial Cystitis Symptom Index and Problem Index” (The O’Leary-Sant), and “Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale”. Methods Three groups of patients were examined: a study group (subjects with IC), control group 1 (individuals with at least one IC symptom), and control group 2 (subjects without IC symptoms). Test-retest stability was evaluated at intervals of 3 to 7 days in the study group. Discriminant validity was examined in all three groups. Results The intraclass correlation coefficient (ICC) [95% confidence interval (CI)] results were 0.56 (range, 0.21-0.78) for The O’Leary-Sant Symptom Index, 0.48 (range, 0.10-0.73) for The O’Leary-Sant Problem Index, and 0.49 (range, 0.12-0.74) for the PUF. To analyze discriminant validity between groups, we used Fisher’s exact test and odd ratio (OR) to identify differences. We obtained a P value<0.0001, which indicated that the null hypothesis was rejected; in other words, there was evidence that at least two different groups were compared to the proportion of patients with IC. Conclusions The analyzed instruments did not reach appropriate values for reliability. Future studies are needed to analyze the psychometric measures of these instruments on a larger sample of patients with IC. PMID:26813711

  14. Abdominal pain

    MedlinePlus

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is does not always reflect the seriousness ...

  15. Flank pain

    MedlinePlus

    Pain - side; Side pain ... Flank pain can be a sign of a kidney problem. But, since many organs are in this area, other causes are possible. If you have flank pain and fever , chills, blood in the urine, or ...

  16. Heel pain

    MedlinePlus

    Pain - heel ... Heel pain is most often the result of overuse. However, it may be caused by an injury. Your heel ... on the heel Conditions that may cause heel pain include: Swelling and pain in the Achilles tendon ...

  17. Chronic Pain

    MedlinePlus

    ... a problem you need to take care of. Chronic pain is different. The pain signals go on for ... there is no clear cause. Problems that cause chronic pain include Headache Low back strain Cancer Arthritis Pain ...

  18. Reliability and repeatability of quantitative tractography methods for mapping structural white matter connectivity in preterm and term infants at term-equivalent age.

    PubMed

    Kaur, Supreet; Powell, Samuel; He, Lili; Pierson, Christopher R; Parikh, Nehal A

    2014-01-01

    Premature infants exhibit widespread insults and delays in white matter maturation that can be sensitively detected early using diffusion tensor imaging. Diffusion tensor tractography facilitates in vivo visualization of white matter tracts and has the potential to be more sensitive than simpler two-dimensional DTI-based measures. However, the reliability and reproducibility of performing tractography for major white matter tracts in preterm infants is not known. The main objective of our study was to develop highly reliable and repeatable methods for ten white matter tracts in extremely low birth weight infants (birth weight ≤ 1000 g) at term-equivalent age. To demonstrate clinical utility, we also compared fiber microstructural and macrostructural parameters between preterm and healthy term controls. Twenty-nine ELBW infants and a control group of 15 healthy term newborns were studied. A team of researchers experienced in neuroanatomy/neuroimaging established the manual segmentation protocol based on a priori anatomical knowledge and an extensive training period to identify sources of variability. Intra- and inter-rater reliability and repeatability was tested using intra-class correlation coefficient, within-subject standard deviation (SD), repeatability, and Dice similarity index. Our results support our primary goal of developing highly reliable and reproducible comprehensive methods for manual segmentation of 10 white matter tracts in ELBW infants. The within-subject SD was within 1-2% and repeatability within 3-7% of the mean values for all 10 tracts. The intra-rater Dice index was excellent with a range of 0.97 to 0.99, and as expected, the inter-rater Dice index was lower (range: 0.80 to 0.91), but still within a very good reliability range. ELBW infants exhibited fewer fiber numbers and/or abnormal microstructure in a majority of the ten quantified tracts, consistent with injury/delayed development. This protocol could serve as a valuable tool for

  19. Direct Georeferencing on Small Unmanned Aerial Platforms for Improved Reliability and Accuracy of Mapping Without the Need for Ground Control Points

    NASA Astrophysics Data System (ADS)

    Mian, O.; Lutes, J.; Lipa, G.; Hutton, J. J.; Gavelle, E.; Borghini, S.

    2015-08-01

    This paper presents results from a Direct Mapping Solution (DMS) comprised of an Applanix APX-15 UAV GNSS-Inertial system integrated with a Sony a7R camera to produce highly accurate ortho-rectified imagery without Ground Control Points on a Microdrones md4-1000 platform. A 55 millimeter Nikkor f/1.8 lens was mounted on the Sony a7R and the camera was then focused and calibrated terrestrially using the Applanix camera calibration facility, and then integrated with the APX-15 UAV GNSS-Inertial system using a custom mount specifically designed for UAV applications. In July 2015, Applanix and Avyon carried out a test flight of this system. The goal of the test flight was to assess the performance of DMS APX-15 UAV direct georeferencing system on the md4-1000. The area mapped during the test was a 250 x 300 meter block in a rural setting in Ontario, Canada. Several ground control points are distributed within the test area. The test included 8 North-South lines and 1 cross strip flown at 80 meters AGL, resulting in a ~1 centimeter Ground Sample Distance (GSD). Map products were generated from the test flight using Direct Georeferencing, and then compared for accuracy against the known positions of ground control points in the test area. The GNSS-Inertial data collected by the APX-15 UAV was post-processed in Single Base mode, using a base station located in the project area via POSPac UAV. The base-station's position was precisely determined by processing a 12-hour session using the CSRS-PPP Post Processing service. The ground control points were surveyed in using differential GNSS post-processing techniques with respect to the base-station.

  20. Reliability training

    NASA Technical Reports Server (NTRS)

    Lalli, Vincent R. (Editor); Malec, Henry A. (Editor); Dillard, Richard B.; Wong, Kam L.; Barber, Frank J.; Barina, Frank J.

    1992-01-01

    Discussed here is failure physics, the study of how products, hardware, software, and systems fail and what can be done about it. The intent is to impart useful information, to extend the limits of production capability, and to assist in achieving low cost reliable products. A review of reliability for the years 1940 to 2000 is given. Next, a review of mathematics is given as well as a description of what elements contribute to product failures. Basic reliability theory and the disciplines that allow us to control and eliminate failures are elucidated.

  1. Comparison of complementary and alternative medicine with conventional mind–body therapies for chronic back pain: protocol for the Mind–body Approaches to Pain (MAP) randomized controlled trial

    PubMed Central

    2014-01-01

    Background The self-reported health and functional status of persons with back pain in the United States have declined in recent years, despite greatly increased medical expenditures due to this problem. Although patient psychosocial factors such as pain-related beliefs, thoughts and coping behaviors have been demonstrated to affect how well patients respond to treatments for back pain, few patients receive treatments that address these factors. Cognitive-behavioral therapy (CBT), which addresses psychosocial factors, has been found to be effective for back pain, but access to qualified therapists is limited. Another treatment option with potential for addressing psychosocial issues, mindfulness-based stress reduction (MBSR), is increasingly available. MBSR has been found to be helpful for various mental and physical conditions, but it has not been well-studied for application with chronic back pain patients. In this trial, we will seek to determine whether MBSR is an effective and cost-effective treatment option for persons with chronic back pain, compare its effectiveness and cost-effectiveness compared with CBT and explore the psychosocial variables that may mediate the effects of MBSR and CBT on patient outcomes. Methods/Design In this trial, we will randomize 397 adults with nonspecific chronic back pain to CBT, MBSR or usual care arms (99 per group). Both interventions will consist of eight weekly 2-hour group sessions supplemented by home practice. The MBSR protocol also includes an optional 6-hour retreat. Interviewers masked to treatment assignments will assess outcomes 5, 10, 26 and 52 weeks postrandomization. The primary outcomes will be pain-related functional limitations (based on the Roland Disability Questionnaire) and symptom bothersomeness (rated on a 0 to 10 numerical rating scale) at 26 weeks. Discussion If MBSR is found to be an effective and cost-effective treatment option for patients with chronic back pain, it will become a valuable

  2. Mapping of neural activity produced by thermal pain in the healthy human spinal cord and brain stem: a functional magnetic resonance imaging study.

    PubMed

    Cahill, Catherine M; Stroman, Patrick W

    2011-04-01

    Functional magnetic resonance imaging (fMRI) has greatly advanced our current understanding of pain, although most studies to date have focused on imaging of cortical structures. In the present study, we have used fMRI at 3 T to investigate the neural activity evoked by thermal sensation and pain (42 °C and 46 °C) throughout the entire lower neuroaxis from the first synapse in the spinal cord rostral to the thalamus in healthy subjects. The results demonstrate that noxious thermal stimulation (46 °C) produces consistent activity within various structures known to be involved in the pain matrix including the dorsal spinal cord, reticular formation, periaqueductal gray and rostral ventral medulla. However, additional areas of activity were evident that are not considered to be part of the pain matrix, including the olivary nucleus. Thermal stimulation (42 °C) reported as either not painful or mildly painful produced quantitative, but not qualitative, differences in neuronal activity depending on the order of experiments. Activity was greater in the spinal cord and brain stem in earlier experiments, compared with repeated experiments after the more noxious (46 °C) stimulus had been applied. This study provides significant insight into how the lower neuroaxis integrates and responds to pain in humans. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Mapping the association between back pain and type 2 diabetes: A cross-sectional and longitudinal study of adult Spanish twins

    PubMed Central

    Ordoñana, Juan; Ferreira, Paulo

    2017-01-01

    Background Back pain and type 2 diabetes often co-occur, resulting in greater impact on people’s health and complexity in their care. Plausible causal mechanisms for this association have been proposed, yet the nature of the link remains unclear. We therefore explored the direction of the association between type 2 diabetes and chronic back pain in twins, controlling for genetics and early environmental confounding. Methods 2,096 and 1,098 twins were included in the cross-sectional and longitudinal analyses, respectively. Any or severe (≥ 9) low back pain (LBP), neck pain (NP), and spinal pain (concurrent LBP and NP) and type 2 diabetes were investigated. Sequential analyses were performed using logistic regression. Firstly, twins were analysed unpaired (adjusted age and gender): total sample analyses. Then, to control for genetic and shared environmental factors, a co-twin case-control analysis was performed including monozygotic and dizygotic twin pairs discordant for back pain (cross-sectional only). Results In the cross-sectional total sample analyses, type 2 diabetes was associated with chronic spinal pain (OR 1.61; 95%CI 1.12 to 2.31), severe chronic spinal pain (OR 3.33; 95%CI 1.47 to 7.53), chronic NP (OR 1.37; 95%CI 1.01 to 1.85), severe chronic NP (OR 2.28; 95%CI 1.24 to 4.21), and severe chronic LBP (OR 1.63; 95%CI 1.00 to 2.64). After further adjustment for genetic and shared environmental factors, none of the associations remained significant. The longitudinal analyses indicated that the presence of type 2 diabetes did not increase the risk of future back pain, or vice-versa, after two to four years. Conclusions Chronic back pain (spinal pain, NP, or LBP) was associated with the prevalence of type 2 diabetes. Associations are stronger for severe cases of pain. Future research should investigate the temporal relationships between these conditions with longer follow up in twins. PMID:28369107

  4. Athletes' leg pains.

    PubMed Central

    Orava, S.; Puranen, J.

    1979-01-01

    The frequency and nature of exertion pains of the leg in athletes were studied in 2,750 cases of overuse injuries treated at the Sports Clinic of the Deaconess Institute of Oulu, Finland, during the years 1972-1977. 465 cases of exertion pain (18%) were located in the shin. The medial tibial syndrome was the most common overuse injury among these athletes, comprising 9.5% of all exertion injuries and 60% of the leg exertion pains. Together with stress fracture of the tibia, the second most common exertion pain of the leg, it accounted for 75% of the total leg pains. There are certain difficulties in differentiating between the medial tibial syndrome and stress fracture of the tibia. They both occur at the same site with similar symptoms. Radiological examination and isotope scanning are needed. The medial tibial syndrome is an overuse injury at the medial tibial border caused by running exercises. The pain is elicited by exertional ischaemia. The pathogenesis is explained by increased pressure in the fascial compartment of the deep flexor muscles due to prolonged exercise. Similar chronic ischaemic pains from exercise are also found in other fascial compartments of the leg, especially in the anterior compartment. The only treatment needed for stress fractures is rest from training. Fascial compartment pains also usually subside. If chronic fascial syndromes prevent training, fasciotomy is recommended as a reliable method to restore the athlete to normal training without pains. PMID:486888

  5. Person Reliability

    ERIC Educational Resources Information Center

    Lumsden, James

    1977-01-01

    Person changes can be of three kinds: developmental trends, swells, and tremors. Person unreliability in the tremor sense (momentary fluctuations) can be estimated from person characteristic curves. Average person reliability for groups can be compared from item characteristic curves. (Author)

  6. Quantitative Evaluation of Pain with Pain Index Extracted from Electroencephalogram

    PubMed Central

    An, Jian-Xiong; Wang, Yong; Cope, Doris K; Williams, John P

    2017-01-01

    Background: The current pain assessment methods are strongly subjective and easily affected by outside influences, and there is an urgent need to develop a reliable objective and quantitative pain-monitoring indicator. The aim of this study was to evaluate the feasibility of using Pain index (Pi) to assess pain symptoms in pain patients. Methods: Subjects were enrolled from patients seeking treatment at Pain Medicine Center of China Medical University Aviation General Hospital from October 2015 to December 2016, such as postherpetic neuralgia, spinal cord injury, femoral head necrosis, lumbar disc herniation, trigeminal neuralgia, complex regional pain syndrome, perineal pain, phantom limb pain, etc., (pain group, n = 111), as well as healthy volunteers without subjective pain (control group, n = 100). The subjective pain symptoms in pain patients were evaluated by Pi and visual analogue scale/numerical rating scales (VAS/NRS), respectively, and the relationship between them was analyzed using single factor correlation analysis and multiple factor regression analysis. Results: Pi levels in the pain group were significantly higher than those of the control group (t = 6.273, P < 0.001), the correlation analysis of Pi and VAS/NRS score in the pain group showed that the Pearson correlation coefficient was 0.797 (P < 0.001); After adjusted for types of pain, pain sites, medication, gender, and age, Pi was found to be independently correlated to VAS/NRS score (P < 0.001). Conclusions: Pi significantly correlates with VAS/NRS score, might be used to evaluate the subjective pain symptoms in patients and has good research and application value as an objective pain assessment tool. PMID:28776544

  7. Cancer pain

    SciTech Connect

    Swerdlow, M.; Ventafridda, V.

    1987-01-01

    This book contains 13 chapters. Some of the chapter titles are: Importance of the Problem; Neurophysiology and Biochemistry of Pain; Assessment of Pain in Patients with Cancer; Drug Therapy; Chemotherapy and Radiotherapy for Cancer Pain; Sympton Control as it Relates to Pain Control; and Palliative Surgery in Cancer Pain Treatment.

  8. Parametric T2 and T2* mapping techniques to visualize intervertebral disc degeneration in patients with low back pain: initial results on the clinical use of 3.0 Tesla MRI.

    PubMed

    Welsch, Goetz Hannes; Trattnig, Siegfried; Paternostro-Sluga, Tatjana; Bohndorf, Klaus; Goed, Sabine; Stelzeneder, David; Mamisch, Tallal Charles

    2011-05-01

    To assess, compare and correlate quantitative T2 and T2* relaxation time measurements of intervertebral discs (IVDs) in patients suffering from low back pain, with respect to the IVD degeneration as assessed by the morphological Pfirrmann Score. Special focus was on the spatial variation of T2 and T2* between the annulus fibrosus (AF) and the nucleus pulposus (NP). Thirty patients (mean age: 38.1 ± 9.1 years; 20 female, 10 male) suffering from low back pain were included. Morphological (sagittal T1-FSE, sagittal and axial T2-FSE) and biochemical (sagittal T2- and T2* mapping) MRI was performed at 3 Tesla covering IVDs L1-L2 to L5-S1. All IVDs were morphologically classified using the Pfirrmann score. Region-of-interest (ROI) analysis was performed on midsagittal T2 and T2* maps at five ROIs from anterior to posterior to obtain information on spatial variation between the AF and the NP. Statistical analysis-of-variance and Pearson correlation was performed. The spatial variation as an increase in T2 and T2* values from the AF to the NP was highest at Pfirmann grade I and declined at higher Pfirmann grades II-IV (p < 0.05). With increased IVD degeneration, T2 and T2* revealed a clear differences in the NP, whereas T2* was additionally able to depict changes in the posterior AF. Correlation between T2 and T2* showed a medium Pearson's correlation (0.210 to 0.356 [p < 0.001]). The clear differentiation of IVD degeneration and the possible quantification by means of T2 and fast T2* mapping may provide a new tool for follow-up therapy protocols in patients with low back pain.

  9. Psychometric analysis of the audiovisual taxonomy for assessing pain behavior in chronic back-pain patients.

    PubMed

    Kleinke, C L; Spangler, A S

    1988-02-01

    Sixty chronic back-pain patients were administered the audiovisual taxonomy of pain behavior during their first and last weeks in an inpatient multidisciplinary pain clinic. Audiovisual total score provided a useful index of pain behavior with a suitable frequency and reliability, while offering unique variance as a measure of treatment outcome. Patients' pain behaviors upon admission to the pain program were positively correlated with the following background variables: receiving worker's compensation, pounds overweight, and number of back surgeries. Patients' pain behaviors upon completion of the pain program were significantly correlated with their preferences for pain treatment modalities. High levels of pain behavior correlated with a preference for treatments of ice and heat. Low levels of pain behavior correlated with a preference for physical therapy, social work, lectures, and relaxation. It was suggested that treatment outcome in a multidisciplinary pain clinic is more immediately related to patients' coping styles and their choice of pain treatment modalities than to their demographics and personalities.

  10. Foetal pain?

    PubMed

    Derbyshire, Stuart W G

    2010-10-01

    The majority of commentary on foetal pain has looked at the maturation of neural pathways to decide a lower age limit for foetal pain. This approach is sensible because there must be a minimal necessary neural development that makes pain possible. Very broadly, it is generally agreed that the minimal necessary neural pathways for pain are in place by 24 weeks gestation. Arguments remain, however, as to the possibility of foetal pain before or after 24 weeks. Some argue that the foetus can feel pain earlier than 24 weeks because pain can be supported by subcortical structures. Others argue that the foetus cannot feel pain at any stage because it is maintained in a state of sedation in the womb and lacks further neural and conceptual development necessary for pain. Much of this argument rests on the definition of terms such as 'wakefulness' and 'pain'. If a behavioural and neural reaction to a noxious stimulus is considered sufficient for pain, then pain is possible from 24 weeks and probably much earlier. If a conceptual subjectivity is considered necessary for pain, however, then pain is not possible at any gestational age. Regardless of how pain is defined, it is clear that pain for conceptual beings is qualitatively different than pain for non-conceptual beings. It is therefore a mistake to draw an equivalence between foetal pain and pain in the older infant or adult.

  11. Phantom Pain

    MedlinePlus

    ... horizon Newer approaches to relieve phantom pain include virtual reality goggles. The computer program for the goggles mirrors ... Pain Medicine. In press. Accessed Sept. 15, 2014. Virtual reality therapies for phantom limb pain. European Journal of ...

  12. Eye pain

    MedlinePlus

    Ophthalmalgia; Pain - eye ... Pain in the eye can be an important symptom of a health problem. Make sure you tell your health care provider if you have eye pain that does not go away. Tired eyes or ...

  13. Foot pain

    MedlinePlus

    Pain - foot ... Foot pain may be due to: Aging Being on your feet for long periods of time Being overweight A ... sports activity Trauma The following can cause foot pain: Arthritis and gout . Common in the big toe, ...

  14. Elbow pain

    MedlinePlus

    Pain - elbow ... Elbow pain can be caused by many problems. A common cause in adults is tendinitis . This is inflammation and ... a partial dislocation ). Other common causes of elbow pain are: Bursitis -- inflammation of a fluid-filled cushion ...

  15. Hip pain

    MedlinePlus

    ... pain involves any pain in or around the hip joint. You may not feel pain from your hip ... 2012:chap 48. Read More Hip fracture surgery Hip joint replacement Patient Instructions Hip fracture - discharge Hip or ...

  16. Depression, Pain, and Pain Behavior.

    ERIC Educational Resources Information Center

    Keefe, Francis J.; And Others

    1986-01-01

    Examined the degree to which depression predicted pain and pain behavior. The Beck Depression Inventory was administered to 207 low back pain patients. Depression and physical findings were the most important predictors of pain and pain behavior. Depression proved significant even after controlling for important demographic and medical status…

  17. Depression, Pain, and Pain Behavior.

    ERIC Educational Resources Information Center

    Keefe, Francis J.; And Others

    1986-01-01

    Examined the degree to which depression predicted pain and pain behavior. The Beck Depression Inventory was administered to 207 low back pain patients. Depression and physical findings were the most important predictors of pain and pain behavior. Depression proved significant even after controlling for important demographic and medical status…

  18. Associations between pain drawing and psychological characteristics of different body region pains.

    PubMed

    Hayashi, Kazuhiro; Arai, Young-Chang P; Morimoto, Atsuko; Aono, Shuichi; Yoshimoto, Takahiko; Nishihara, Makoto; Osuga, Tomoaki; Inoue, Shinsuke; Ushida, Takahiro

    2015-04-01

    Pain drawings have frequently been used for documentation of pain and a convenient diagnosis tool. Pain drawings were found to be associated with psychological states in chronic patients with low back pain. Few researchers have investigated pain drawings except in low back pain. The aim of this study was to investigate the pain, pain drawings, psychological characteristics, and pain interference in the head, neck-shoulder (NS), and low-back/lower-limb (LB-LL) regions among patients with chronic pain. We included a total of 291 patients with new chronic pain (headache, 62; NS pain, 87; LB-LL pain, 142). The pain drawings and scores of 10-cm Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale (PCS), Short-Form McGill Pain Questionnaire (SF-MPQ), and Pain Disability Assessment Scale (PDAS) were extracted from medical records. A subset of 60 pain drawings was scored by senior and junior evaluators to assess inter-rater agreement. We investigated the correlation between pain drawings and VAS, HADS, PCS, SF-MPQ, and PDAS in each body region group at the initial visit. Moreover, almost all patients received nonsurgical treatment as a follow-up and were investigated using VAS after treatment. The reliability of pain drawings was substantial with an interevaluator reliability in headache, NS, and LB-LL pain. Nonorganic pain drawings were associated with psychological disturbances in NS and LB-LL pain, but not headache. Poor outcomes were associated with nonorganic drawings in LB-LL pain, but not in the case of headache or NS pain. Our results suggest that the characteristics of patients with nonorganic drawings differ according to body regions. © 2014 World Institute of Pain.

  19. Reliability physics

    NASA Technical Reports Server (NTRS)

    Cuddihy, E. F.; Ross, R. G., Jr.

    1984-01-01

    Speakers whose topics relate to the reliability physics of solar arrays are listed and their topics briefly reviewed. Nine reports are reviewed ranging in subjects from studies of photothermal degradation in encapsulants and polymerizable ultraviolet stabilizers to interface bonding stability to electrochemical degradation of photovoltaic modules.

  20. The classification of orofacial pains.

    PubMed

    Okeson, Jeffrey P

    2008-05-01

    This article highlights the process of making the proper orofacial pain diagnosis. A classification is presented based on the clinical characteristics of the pain complaint and the structure by which it emanates. It is meant to serve as a road map for the clinician, which will help him or her establish the correct diagnosis, thereby allowing the selection of the proper treatment.

  1. Conclusions: chronic pain studies of lidocaine patch 5% using the Neuropathic Pain Scale.

    PubMed

    Argoff, Charles E

    2004-01-01

    Many chronic pain patients have multiple etiologies for their pain, and accurate characterization of pain qualities and pain relief is essential for managing their pain. The ability to utilize a validated tool for assessing pain qualities and for identifying unique analgesic therapy effects on different pain qualities may assist clinicians in devising an appropriate treatment regimen. The Neuropathic Pain Scale (NPS) is a novel pain metric for characterizing pain in 10 dimensions. The ability to differentiate among pain qualities for each patient may result in a more refined and effective choice of therapy. The three research articles in this Supplement demonstrate the utility of the NPS in chronic pain patients treated with the lidocaine patch 5%, a peripherally acting medication that is not associated with systemic accumulation of the active drug. Significant reduction in the intensity of commonly reported pain qualities in patients with neuropathic and non-neuropathic chronic pain due to low-back pain, osteoarthritis, post-herpetic neuralgia, and painful diabetic neuropathy were achieved. The NPS offers clinicians a reliable means to accurately identify pain qualities associated with each individual patient and to target and assess the efficacy of various therapeutic options on those pain components. Utilizing the NPS, the lidocaine patch 5% was effective in treating chronic pain of both neuropathic and non-neuropathic origins suggesting that a given treatment's effect on various pain qualities may be consistent across pain types.

  2. A randomized, placebo-controlled trial of the analgesic efficacy and safety of the p38 MAP kinase inhibitor, losmapimod, in patients with neuropathic pain from lumbosacral radiculopathy.

    PubMed

    Ostenfeld, Thor; Krishen, Alok; Lai, Robert Y; Bullman, Jonathan; Green, Joanne; Anand, Praveen; Scholz, Joachim; Kelly, Madeline

    2015-04-01

    Preclinical studies have demonstrated involvement of p38 mitogen-activated protein kinase signaling pathways in the development of persistent pain after peripheral nerve injury. A double-blind, randomized, placebo-controlled study was undertaken to evaluate the analgesic efficacy of losmapimod (GW856553), a novel p38α/β inhibitor, in patients with chronic neuropathic pain due to lumbosacral radiculopathy. A total of 144 patients with at least moderate baseline pain intensity (average daily score of ≥4 on an 11-point pain intensity numeric rating scale) were randomized to receive losmapimod, 7.5 mg bid orally or placebo. All patients underwent a blinded placebo run-in period for 7 days before receiving losmapimod/placebo for 28 days. Efficacy and safety evaluations were undertaken weekly. The adjusted mean treatment difference for the change from baseline to week 4 in numeric rating scale was -0.36 U (95% confidence interval, -0.84, 0.13; P=0.149) in favor of losmapimod over placebo; this was not considered clinically meaningful. Statistically significant differences in favor of losmapimod were observed, however, for several secondary endpoints of emotional, physical, and social functioning: Oswestry Disability Index; Profile of Mood States total score; Short-Form 36 Health Survey physical functioning, bodily pain, general health, role emotional, social functioning, and vitality domains; and Short-Form 36 physical, and mental components. There were no unexpected findings related to safety or tolerability following treatment with losmapimod. Losmapimod could not be differentiated from placebo in terms of analgesia. The lack of response could reflect insufficient losmapimod levels in the spinal cord or differences between lumbosacral radiculopathy and animal models of neuropathic pain.

  3. Effective pain management in patients with dementia: benefits beyond pain?

    PubMed

    Flo, Elisabeth; Gulla, Christine; Husebo, Bettina S

    2014-12-01

    This current opinion aims to provide a literature overview of the associations between pain and neuropsychiatric symptoms and the efficacy of pain management for both pain and neuropsychiatric symptoms in patients with dementia. In addition, international guidelines and recommendations for pain management have been collated, and important developing research areas are highlighted. Pain is, in general, under-recognized and undertreated in people with dementia and may therefore trigger or exacerbate neuropsychiatric symptoms. While there is an abundance of pain assessment instruments intended for people with dementia, few have been adequately tested for their feasibility, reliability and validity. In patients with dementia, vocalizations, facial expressions and body movements may be the only valid expressions of pain. Further, pain has been related to the neuropsychiatric symptoms of agitation, aggression, mood syndrome and sleep problems. Unfortunately, health personnel may misinterpret these symptoms as neuropsychiatric symptoms of dementia. A differential assessment of dementia, its presenting neuropsychiatric symptoms and the potential presence of pain is crucial to provide the correct treatment. To achieve this, use of pain assessment tools that are responsive to change and are validated for use in patients with dementia is a prerequisite. To date, there have been few studies, with inconsistent findings on the association between pain and neuropsychiatric symptoms. To ensure a better differential assessment of pain and neuropsychiatric symptoms, and consequently more accurate treatment for patients with dementia, studies with adequate statistical power and high-quality study designs, including randomized controlled trials, are needed.

  4. Pelvic Pain

    MedlinePlus

    Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

  5. Optimizing and Interpreting Insular Functional Connectivity Maps Obtained During Acute Experimental Pain: The Effects of Global Signal and Task Paradigm Regression.

    PubMed

    Ibinson, James W; Vogt, Keith M; Taylor, Kevin B; Dua, Shiv B; Becker, Christopher J; Loggia, Marco; Wasan, Ajay D

    2015-12-01

    The insula is uniquely located between the temporal and parietal cortices, making it anatomically well-positioned to act as an integrating center between the sensory and affective domains for the processing of painful stimulation. This can be studied through resting-state functional connectivity (fcMRI) imaging; however, the lack of a clear methodology for the analysis of fcMRI complicates the interpretation of these data during acute pain. Detected connectivity changes may reflect actual alterations in low-frequency synchronous neuronal activity related to pain, may be due to changes in global cerebral blood flow or the superimposed task-induced neuronal activity. The primary goal of this study was to investigate the effects of global signal regression (GSR) and task paradigm regression (TPR) on the changes in functional connectivity of the left (contralateral) insula in healthy subjects at rest and during acute painful electric nerve stimulation of the right hand. The use of GSR reduced the size and statistical significance of connectivity clusters and created negative correlation coefficients for some connectivity clusters. TPR with cyclic stimulation gave task versus rest connectivity differences similar to those with a constant task, suggesting that analysis which includes TPR is more accurately reflective of low-frequency neuronal activity. Both GSR and TPR have been inconsistently applied to fcMRI analysis. Based on these results, investigators need to consider the impact GSR and TPR have on connectivity during task performance when attempting to synthesize the literature.

  6. Network reliability

    NASA Technical Reports Server (NTRS)

    Johnson, Marjory J.

    1985-01-01

    Network control (or network management) functions are essential for efficient and reliable operation of a network. Some control functions are currently included as part of the Open System Interconnection model. For local area networks, it is widely recognized that there is a need for additional control functions, including fault isolation functions, monitoring functions, and configuration functions. These functions can be implemented in either a central or distributed manner. The Fiber Distributed Data Interface Medium Access Control and Station Management protocols provide an example of distributed implementation. Relative information is presented here in outline form.

  7. Reliability Prediction

    NASA Technical Reports Server (NTRS)

    1993-01-01

    RELAV, a NASA-developed computer program, enables Systems Control Technology, Inc. (SCT) to predict performance of aircraft subsystems. RELAV provides a system level evaluation of a technology. Systems, the mechanism of a landing gear for example, are first described as a set of components performing a specific function. RELAV analyzes the total system and the individual subsystem probabilities to predict success probability, and reliability. This information is then translated into operational support and maintenance requirements. SCT provides research and development services in support of government contracts.

  8. Sexual pain.

    PubMed

    Boardman, Lori A; Stockdale, Colleen K

    2009-12-01

    Sexual pain is an underrecognized and poorly treated constellation of disorders that significantly impact affected women and their partners. Recognized as a form of chronic pain, sexual pain disorders are heterogeneous and include dyspareunia (superficial and deep), vaginismus, vulvodynia, vestibulitis, and noncoital sexual pain disorder. Women too often tolerate pain in the belief that this will meet their partners' needs. This article provides a review of the terminology and definition of the condition, theories on the pathophysiology, diagnostic considerations, and recommendations on the management of female sexual pain.

  9. Back Pain

    MedlinePlus

    ... Oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, ... 10 people at some point during their lives. Back pain can range from a dull, constant ache to ...

  10. Orofacial Pain

    MedlinePlus

    ... Neck, shoulder or back pain Dizziness ?xml:namespace> Sleep disorders ; If you have gone through treatment and still experience orofacial pain, you may have a sleep disorder, such as bruxism, or a sleep-related breathing ...

  11. Period Pain

    MedlinePlus

    ... You may also have other symptoms, such as lower back pain, nausea, diarrhea, and headaches. Period pain is not ... Taking a hot bath Doing relaxation techniques, including yoga and meditation You might also try taking over- ...

  12. Ribcage pain

    MedlinePlus

    ... not cause the pain in someone who has pleurisy (swelling of the lining of the lungs) or ... Inflammation of cartilage near the breastbone ( costochondritis ) Osteoporosis Pleurisy (the pain is worse when breathing deeply)

  13. Testicle Pain

    MedlinePlus

    ... is more common in adolescents. Seek immediate medical attention if you have: Sudden, severe testicle pain Testicle pain accompanied by nausea, fever, chills or blood in your urine Schedule a doctor's visit if you have: Mild ...

  14. Face pain

    MedlinePlus

    ... face may be caused by a nerve problem, injury, or infection. Face pain may also begin in other places in ... zoster (shingles) or herpes simplex (cold sores) infection Injury to the face Migraine Myofascial pain syndrome Sinusitis or sinus infection ( ...

  15. Breast Pain

    MedlinePlus

    ... before your period and sometimes continuing through your menstrual cycle. The pain may be moderate or severe, and ... breasts. Throughout the month, not related to your menstrual cycle. Postmenopausal women sometimes have breast pain, but breast ...

  16. Pain Assessment

    MedlinePlus

    ... acupuncture, chiropractic care, massage or other manual therapies, yoga, herbal and nutritional therapies, or others. This information helps the health care provider understand the nature of the pain or the potential benefits of treatment. The goals of the comprehensive pain ...

  17. Neck Pain

    MedlinePlus

    ... problems, most commonly with the structures of the cervical spine (neck). Only in rare instances is neck pain ... the neck. Pain can be localized to the cervical spine or may travel down an arm (radiculopathy). All ...

  18. Hip Pain

    MedlinePlus

    ... clues about the underlying cause. Problems within the hip joint itself tend to result in pain on the ... tendons and other soft tissues that surround your hip joint. Hip pain can sometimes be caused by diseases ...

  19. Patellofemoral Pain.

    PubMed

    Dutton, Rebecca A; Khadavi, Michael J; Fredericson, Michael

    2016-02-01

    Patellofemoral pain is characterized by insidious onset anterior knee pain that is exaggerated under conditions of increased patellofemoral joint stress. A variety of risk factors may contribute to the development of patellofemoral pain. It is critical that the history and physical examination elucidate those risk factors specific to an individual in order to prescribe an appropriate and customized treatment plan. This article aims to review the epidemiology, risk factors, diagnosis, and management of patellofemoral pain.

  20. Feeling pain

    MedlinePlus Videos and Cool Tools

    ... it to potential or actual damage to the body's tissues. In the example of a bee sting, the pain receptors in the skin detect tissue damage from the bee sting. Then, the peripheral nerves send a pain signal to the brain. The brain analyzes the pain signal. In turn, ...

  1. Gynecological Management of Neuropathic Pain

    PubMed Central

    TU, Frank F.; HELLMAN, Kevin; BACKONJA, Miroslav

    2011-01-01

    Obstetrician/gynecologists often are the initial management clinicians for pelvic neuropathic pain. While treatment may require comprehensive team management and consultation with other specialists, there a few critical and basic steps that can be performed on an office visit that offer the opportunity to significantly improve quality of life in this patient population. A key first step is a thorough clinical examination to physically map the pain site and identify potentially involved nerves. Only limited evidence exists on how best to manage neuropathic pain, but generally a combination of surgical, manipulative or pharmacological methods should be considered. Experimental methods for more precisely characterizing the nature of the nerve dysfunction exist to diagnose and treat neuropathic pain, but additional scientific evidence is needed to unanimously recommend these options. In the meantime, an approach adopted from guidelines of the International Association for Study of Pain tailored for gynecological pain is suggested. PMID:21777899

  2. Temporomandibular pain

    PubMed Central

    Prasad, S Raghavendra; Kumar, N Ravi; Shruthi, HR; Kalavathi, SD

    2016-01-01

    Temporomandibular joint pain has various medical and dental etiological factors. The etiology of the temporomandibular joint pain is enigmatic, no single etiological factor is regarded as the cause. Its distribution is also not confined to a single area. This article presents the basic etiologic factors, its epidemiology, distribution of pain, classification of patients and the psychosocial behavior of patients suffering with temporomandibular pain. As overwhelming majority of medical and dental conditions/issues related to etiology of temporomandibular pain in patients have traditionally been presented and interpreted from the clinician's point of view. PMID:27601822

  3. Parent perceptions of adolescent pain expression: The adolescent pain behavior questionnaire

    PubMed Central

    Lynch-Jordan, Anne M.; Kashikar-Zuck, Susmita; Goldschneider, Kenneth R.

    2013-01-01

    Pain behaviors provide meaningful information about adolescents in chronic pain, enhancing their verbal report of pain intensity with information about the global pain experience. Caregivers likely consider these expressions when making judgments about their adolescents’ medical or emotional needs. Current validated measures of pain behavior target acute or procedural pain and young or non-verbal children, while observation systems may be too cumbersome for clinical practice. The objective of this research was to design and evaluate the Adolescent Pain Behavior Questionnaire (APBQ), a parent-report measure of adolescent (11–19 years) pain expressions. This paper provides preliminary results on reliability and validity of the APBQ. Parent-adolescent dyads (N = 138) seen in a multidisciplinary pain management clinic completed the APBQ and questionnaires assessing pain characteristics, quality of life, functional disability, depressive symptoms, and pain catastrophizing. Principal components analysis of the APBQ supported a single component structure. The final APBQ scale contained 23 items with high internal consistency (α= 0.93). No relationship was found between parent-reported pain behaviors and adolescentreported pain intensity. However, significant correlations were found between parent-reported pain behaviors and parent- and adolescent-reported functional disability, pain catastrophizing, depressive symptoms, and poorer quality of life. The assessment of pain behaviors provides qualitatively different information than solely recording pain intensity and disability. It has clinical utility for use in behavioral treatments seeking to reduce disability, poor coping, and distress. PMID:20961688

  4. Reliability of a measurement of neck flexor muscle endurance.

    PubMed

    Harris, Kevin D; Heer, Darren M; Roy, Tanja C; Santos, Diane M; Whitman, Julie M; Wainner, Robert S

    2005-12-01

    Neck flexor muscle endurance has been negatively correlated with cervical pain and dysfunction. The purposes of this study were to determine rater reliability in subjects both with and without neck pain and to determine whether there was a difference in neck flexor muscle endurance between the 2 groups. Forty-one subjects with and without neck pain were enrolled in this repeated-measures reliability study. Two raters used an isometric neck retraction test to assess neck flexor muscle endurance for all subjects during an initial session, and subjects without neck pain returned for testing 1 week later. For the group without neck pain, intrarater reliability was good to excellent (intraclass correlation coefficient [ICC(3,1)]=.82-.91), and interrater reliability was moderate to good (ICC[2,1]=.67-.78). The associated standard error of measurement (SEM) ranged from 8.0 to 11.0 seconds and from 12.6 to 15.3 seconds, respectively. For the group with neck pain, interrater reliability was moderate (ICC[2,1]=.67, SEM=11.5). Neck flexor muscle endurance test results for the group without neck pain (mean=38.95 seconds, SD=26.4) and the group with neck pain (mean=24.1 seconds, SD=12.8) were significantly different. Reliability coefficients differed between the 2 groups and ranged from moderate to excellent and improved after the first test session. The interrater reliability of data obtained with the neck flexor muscle endurance test in people with neck pain must be improved in order for clinicians to distinguish a clinically meaningful change from measurement error. Neck flexor muscle endurance was both statistically and clinically greater for subjects without neck pain than for those with neck pain.

  5. Facial pain.

    PubMed

    Graff-Radford, Steven B

    2009-07-01

    Facial pain is a debilitating disorder if left untreated. Too often, patients are labeled as having psychopathology when face pain etiology is unclear. These patients are categorized as "atypical," "idiopathic," or "psychogenic." Cases of facial pain involving neuropathic, neurovascular, musculoskeletal, as well as intracranial and extracranial systems will be reviewed. Peripheral and central mechanisms associated with these disorders are used to provide an update of these frequently seen clinical issues.

  6. Chronic pain and the thoracic spine

    PubMed Central

    Louw, Adriaan; Schmidt, Stephen G.

    2015-01-01

    In recent years there has been an increased interest in pain neuroscience in physical therapy.1,2 Emerging pain neuroscience research has challenged prevailing models used to understand and treat pain, including the Cartesian model of pain and the pain gate.2–4 Focus has shifted to the brain's processing of a pain experience, the pain neuromatrix and more recently, cortical reorganisation of body maps.2,3,5,6 In turn, these emerging theories have catapulted new treatments, such as therapeutic neuroscience education (TNE)7–10 and graded motor imagery (GMI),11,12 to the forefront of treating people suffering from persistent spinal pain. In line with their increased use, both of these approaches have exponentially gathered increasing evidence to support their use.4,10 For example, various randomised controlled trials and systematic reviews have shown that teaching patients more about the biology and physiology of their pain experience leads to positive changes in pain, pain catastrophization, function, physical movement and healthcare utilisation.7–10 Graded motor imagery, in turn, has shown increasing evidence to help pain and disability in complex pain states such as complex regional pain syndrome (CRPS).11,12 Most research using TNE and GMI has focussed on chronic low back pain (CLBP) and CRPS and none of these advanced pain treatments have been trialled on the thoracic spine. This lack of research and writings in regards to the thoracic spine is not unique to pain science, but also in manual therapy. There are, however, very unique pain neuroscience issues that skilled manual therapists may find clinically meaningful when treating a patient struggling with persistent thoracic pain. Utilising the latest understanding of pain neuroscience, three key clinical chronic thoracic issues will be discussed – hypersensitisation of intercostal nerves, posterior primary rami nerves mimicking Cloward areas and mechanical and sensitisation issues of the spinal dura in

  7. Chronic pain and the thoracic spine.

    PubMed

    Louw, Adriaan; Schmidt, Stephen G

    2015-07-01

    In recent years there has been an increased interest in pain neuroscience in physical therapy.1,2 Emerging pain neuroscience research has challenged prevailing models used to understand and treat pain, including the Cartesian model of pain and the pain gate.2-4 Focus has shifted to the brain's processing of a pain experience, the pain neuromatrix and more recently, cortical reorganisation of body maps.2,3,5,6 In turn, these emerging theories have catapulted new treatments, such as therapeutic neuroscience education (TNE)7-10 and graded motor imagery (GMI),11,12 to the forefront of treating people suffering from persistent spinal pain. In line with their increased use, both of these approaches have exponentially gathered increasing evidence to support their use.4,10 For example, various randomised controlled trials and systematic reviews have shown that teaching patients more about the biology and physiology of their pain experience leads to positive changes in pain, pain catastrophization, function, physical movement and healthcare utilisation.7-10 Graded motor imagery, in turn, has shown increasing evidence to help pain and disability in complex pain states such as complex regional pain syndrome (CRPS).11,12 Most research using TNE and GMI has focussed on chronic low back pain (CLBP) and CRPS and none of these advanced pain treatments have been trialled on the thoracic spine. This lack of research and writings in regards to the thoracic spine is not unique to pain science, but also in manual therapy. There are, however, very unique pain neuroscience issues that skilled manual therapists may find clinically meaningful when treating a patient struggling with persistent thoracic pain. Utilising the latest understanding of pain neuroscience, three key clinical chronic thoracic issues will be discussed - hypersensitisation of intercostal nerves, posterior primary rami nerves mimicking Cloward areas and mechanical and sensitisation issues of the spinal dura in the

  8. How to investigate: Chronic pain.

    PubMed

    Hague, Matthew; Shenker, Nicholas

    2014-12-01

    Chronic pain is defined as an unpleasant sensory and emotional experience persisting longer than the normal process of healing, usually longer than 3 months. About a fifth of the world's population is believed to suffer from chronic pain. In Europe, chronic pain accounts for nearly 500 m lost working days, and it costs the European economy >€34 billion (£28 billion) every year. Establishing a reliable diagnosis is the primary challenge in evaluating a patient with chronic pain. Common diagnoses not to miss include seronegative spondyloarthritides, endocrine abnormalities including severe vitamin D deficiency and polymyalgia rheumatica. Once important or treatable diagnoses have been ruled out, the history can be used as a tool to establish a therapeutic plan for shared decision-making using the biopsychosocial model. Onward referral to pain clinics can be helpful for more involved patient management, but often good outcomes are achieved with the support of primary care.

  9. Neuropathic pain.

    PubMed

    Colloca, Luana; Ludman, Taylor; Bouhassira, Didier; Baron, Ralf; Dickenson, Anthony H; Yarnitsky, David; Freeman, Roy; Truini, Andrea; Attal, Nadine; Finnerup, Nanna B; Eccleston, Christopher; Kalso, Eija; Bennett, David L; Dworkin, Robert H; Raja, Srinivasa N

    2017-02-16

    Neuropathic pain is caused by a lesion or disease of the somatosensory system, including peripheral fibres (Aβ, Aδ and C fibres) and central neurons, and affects 7-10% of the general population. Multiple causes of neuropathic pain have been described and its incidence is likely to increase owing to the ageing global population, increased incidence of diabetes mellitus and improved survival from cancer after chemotherapy. Indeed, imbalances between excitatory and inhibitory somatosensory signalling, alterations in ion channels and variability in the way that pain messages are modulated in the central nervous system all have been implicated in neuropathic pain. The burden of chronic neuropathic pain seems to be related to the complexity of neuropathic symptoms, poor outcomes and difficult treatment decisions. Importantly, quality of life is impaired in patients with neuropathic pain owing to increased drug prescriptions and visits to health care providers, as well as the morbidity from the pain itself and the inciting disease. Despite challenges, progress in the understanding of the pathophysiology of neuropathic pain is spurring the development of new diagnostic procedures and personalized interventions, which emphasize the need for a multidisciplinary approach to the management of neuropathic pain.

  10. Neuropathic pain

    PubMed Central

    Colloca, Luana; Ludman, Taylor; Bouhassira, Didier; Baron, Ralf; Dickenson, Anthony H.; Yarnitsky, David; Freeman, Roy; Truini, Andrea; Attal, Nadine; Finnerup, Nanna B.; Eccleston, Christopher; Kalso, Eija; Bennett, David L.; Dworkin, Robert H.; Raja, Srinivasa N.

    2017-01-01

    Neuropathic pain is caused by a lesion or disease of the somatosensory system, including peripheral fibres (Aβ, Aδ and C fibres) and central neurons, and affects 7–10% of the general population. Multiple causes of neuropathic pain have been described and its incidence is likely to increase owing to the ageing global population, increased incidence of diabetes mellitus and improved survival from cancer after chemotherapy. Indeed, imbalances between excitatory and inhibitory somatosensory signalling, alterations in ion channels and variability in the way that pain messages are modulated in the central nervous system all have been implicated in neuropathic pain. The burden of chronic neuropathic pain seems to be related to the complexity of neuropathic symptoms, poor outcomes and difficult treatment decisions. Importantly, quality of life is impaired in patients with neuropathic pain owing to increased drug prescriptions and visits to health care providers, as well as the morbidity from the pain itself and the inciting disease. Despite challenges, progress in the understanding of the pathophysiology of neuropathic pain is spurring the development of new diagnostic procedures and personalized interventions, which emphasize the need for a multidisciplinary approach to the management of neuropathic pain. PMID:28205574

  11. Central pain.

    PubMed

    Singh, Supreet

    2014-12-01

    Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. The topic addressed in this issue is central pain, a neuropathic pain syndrome caused by a lesion in the brain or spinal cord that sensitizes one's perception of pain. It is a debilitating condition caused by various diseases such as multiple sclerosis, strokes, spinal cord injuries, or brain tumors. Varied symptoms and the use of pharmacological medicines and nonpharmacological therapies will be addressed.

  12. Do glial cells control pain?

    PubMed Central

    Suter, Marc R; Wen, Yeong-Ray; Decosterd, Isabelle; Ji, Ru-Rong

    2008-01-01

    Management of chronic pain is a real challenge, and current treatments focusing on blocking neurotransmission in the pain pathway have only resulted in limited success. Activation of glia cells has been widely implicated in neuroinflammation in the central nervous system, leading to neruodegeneration in many disease conditions such as Alzheimer’s and multiple sclerosis. The inflammatory mediators released by activated glial cells, such as tumor necrosis factor-α and interleukin-1β can not only cause neurodegeneration in these disease conditions, but also cause abnormal pain by acting on spinal cord dorsal horn neurons in injury conditions. Pain can also be potentiated by growth factors such as BDNF and bFGF that are produced by glia to protect neurons. Thus, glia cells can powerfully control pain when they are activated to produce various pain mediators. We will review accumulating evidence supporting an important role of microglia cells in the spinal cord for pain control under injury conditions (e.g. nerve injury). We will also discuss possible signaling mechanisms in particular MAP kinase pathways that are critical for glia control of pain. Investigating signaling mechanisms in microglia may lead to more effective management of devastating chronic pain. PMID:18504511

  13. Reliable aerial thermography for energy conservation

    NASA Technical Reports Server (NTRS)

    Jack, J. R.; Bowman, R. L.

    1981-01-01

    A method for energy conservation, the aerial thermography survey, is discussed. It locates sources of energy losses and wasteful energy management practices. An operational map is presented for clear sky conditions. The map outlines the key environmental conditions conductive to obtaining reliable aerial thermography. The map is developed from defined visual and heat loss discrimination criteria which are quantized based on flat roof heat transfer calculations.

  14. Dimensions of "unidimensional" ratings of pain and emotions in patients with chronic musculoskeletal pain.

    PubMed

    Huber, Alexa; Suman, Anna Lisa; Rendo, Carmela Anna; Biasi, Giovanni; Marcolongo, Roberto; Carli, Giancarlo

    2007-08-01

    The use of unidimensional scales to measure pain intensity has been criticised because of the multidimensional nature of pain. We conducted multiple linear regression analyses to determine which dimensions of pain--sensory versus affective--predicted scores on unidimensional scales measuring pain intensity and emotions in 109 Italian women suffering from chronic, non-malignant musculoskeletal pain. We then compared the results with earlier findings in two groups of cancer patients suffering from acute post-operative pain and chronic cancer-related pain, respectively. Age, physical capacity and scores on the multidimensional affect and pain survey (MAPS) were used to predict patients' ratings on one visual analogue scale (VAS) and three numerical rating scales (NRS) measuring pain intensity, anxiety and depressed mood. Unidimensional pain intensity ratings were predicted better from sensory than from affective pain predictors, and the affective predictors made no unique contribution (NRS), or only a very small one (VAS). Both sensory and emotional pain aspects were unique predictors of NRS anxiety and depression. Therefore, in contrast to earlier findings in two different types of cancer patients, in subjects affected by chronic non-malignant musculoskeletal pain, the scores on unidimensional pain intensity scales mainly reflect sensory pain dimensions, supporting the discriminant validity of the NRS and VAS used. However, the patients had some difficulty in distinguishing between sensory and emotional information. For this reason, several unidimensional scales to rate pain intensity and emotions separately should be used to obtain a complete picture of the status and needs of any given patient.

  15. Chest pain

    MedlinePlus

    ... have a fever or a cough that produces yellow-green phlegm. You have chest pain that is severe and does not go away. You are having problems swallowing. Chest pain lasts longer than 3 to 5 days. What to Expect at Your Office Visit ...

  16. [Chest pain].

    PubMed

    Horn, Benedikt

    2015-01-01

    Chest pain in ambulatory setting is predominantly not heart-associated. Most patients suffer from muskuloskeletal or functional (psychogenic) chest pain. Differential diagnosis covers aortic dissection, rib-fracture, shingles, GERD, Tietze-Syndrome, pulmonary embolism, pleuritis, pneumothorax, pleurodynia and metastatic disease. In most cases history, symptoms and signs allow a clinical diagnosis of high pretest-probability.

  17. [Heel pain].

    PubMed

    Cizmár, I; Svizenská, I; Pilný, J; Repko, M; Ira, D

    2005-01-01

    Heel pain is quite frequent clinical symptom in our population. Successful therapy derives from the problem aetiology. The most frequent source of pain is the mechanical basis, both on dorsal and plantar side of calcaneum. Therapy includes a variety of procedures, from routine measures to surgical intervention.

  18. Mapping health assessment questionnaire disability index (HAQ-DI) score, pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) onto the EuroQol-5D (EQ-5D) utility score with the KORean Observational study Network for Arthritis (KORONA) registry data.

    PubMed

    Kim, Hye-Lin; Kim, Dam; Jang, Eun Jin; Lee, Min-Young; Song, Hyun Jin; Park, Sun-Young; Cho, Soo-Kyung; Sung, Yoon-Kyoung; Choi, Chan-Bum; Won, Soyoung; Bang, So-Young; Cha, Hoon-Suk; Choe, Jung-Yoon; Chung, Won Tae; Hong, Seung-Jae; Jun, Jae-Bum; Kim, Jinseok; Kim, Seong-Kyu; Kim, Tae-Hwan; Kim, Tae-Jong; Koh, Eunmi; Lee, Hwajeong; Lee, Hye-Soon; Lee, Jisoo; Lee, Shin-Seok; Lee, Sung Won; Park, Sung-Hoon; Shim, Seung-Cheol; Yoo, Dae-Hyun; Yoon, Bo Young; Bae, Sang-Cheol; Lee, Eui-Kyung

    2016-04-01

    The aim of this study was to estimate the mapping model for EuroQol-5D (EQ-5D) utility values using the health assessment questionnaire disability index (HAQ-DI), pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) in a large, nationwide cohort of rheumatoid arthritis (RA) patients in Korea. The KORean Observational study Network for Arthritis (KORONA) registry data on 3557 patients with RA were used. Data were randomly divided into a modeling set (80 % of the data) and a validation set (20 % of the data). The ordinary least squares (OLS), Tobit, and two-part model methods were employed to construct a model to map to the EQ-5D index. Using a combination of HAQ-DI, pain VAS, and DAS28, four model versions were examined. To evaluate the predictive accuracy of the models, the root-mean-square error (RMSE) and mean absolute error (MAE) were calculated using the validation dataset. A model that included HAQ-DI, pain VAS, and DAS28 produced the highest adjusted R (2) as well as the lowest Akaike information criterion, RMSE, and MAE, regardless of the statistical methods used in modeling set. The mapping equation of the OLS method is given as EQ-5D = 0.95-0.21 × HAQ-DI-0.24 × pain VAS/100-0.01 × DAS28 (adjusted R (2) = 57.6 %, RMSE = 0.1654 and MAE = 0.1222). Also in the validation set, the RMSE and MAE were shown to be the smallest. The model with HAQ-DI, pain VAS, and DAS28 showed the best performance, and this mapping model enabled the estimation of an EQ-5D value for RA patients in whom utility values have not been measured.

  19. Comparison of pain scale preferences and pain intensity according to pain scales among Turkish Patients: a descriptive study.

    PubMed

    Yazici Sayin, Yazile; Akyolcu, Neriman

    2014-03-01

    Pain scale preferences may vary among patients. Providing a choice of which pain scale to use might be helpful for patients. The aim of this study was to determine patient pain scale preferences and compare the level of agreement among pain scales commonly used during postoperative pain assessment. A total of 621 patients during the early postoperative period were enrolled in this descriptive study. A questionnaire form, the faces pain scale (FPS), visual analog scale (VAS), numeric rating scale (NRS), verbal descriptor scale (VDS), thermometer pain scale (TPS), McGill Pain Questionnaire (MPQ), Short-form McGill Pain Questionnaire (SFMPQ), and Brief Pain Inventory (BPI) were used to collect data. Most patients reported that their pain was not measured with any of the pain scales. Patient preference for pain scales were as follows: 97.4% FPS, 88.6% NRS, 84.1% VDS, 78.1% TPS, 60.1% SFMPQ, 37.0% BPI, 11.4% VAS, and 10.5% MPQ. Education was an important factor in the preferences for all scales (p < .000). The level of pain determined by the VAS did not correlate with the level of pain identified by the NRS, TPS, FPS, and VDS (p < .05). There was no difference among the levels of pain for the NRS, TPS, FPS and VDS (p > .05), but there was for the VAS (p < .05). The pain scales chosen should be reliable, valid, and able to evaluate the effects of treatment. The results suggest that the NRS, TPS, FPS, and VDS were appropriate pain rating scales for the participants in this study, and that the VAS should be used in combination with one of these scales.

  20. Orofacial Pain and Mastication in Dementia.

    PubMed

    Lobbezoo, Frank; Delwel, Suzanne; Weijenberg, Roxane A F; Scherder, Erik J A

    2017-01-01

    Orofacial pain is a common condition in the general population. It is likely that this is also the case in older persons with a dementia. However, the assessment of (orofacial) pain in non-verbal individuals is hampered by the subjective nature of pain, and their limited communicative abilities. To overcome this drawback, several tools have been developed for the assessment of pain based on observations of pain-specific facial activities, body movements, and vocalizations. Unfortunately, none of the so far developed observational tools have been designed specifically for the assessment of orofacial pain. While the recent psychometric testing of the Orofacial MOBID Pain Scale did not yield reliable outcomes, the subsequently developed Orofacial Pain Scale for Non-Verbal Individuals (OPS-NVI) is currently being evaluated and shows good promise to be reliable and valid. Besides the assessment of orofacial pain, an important application of this instrument will be the investigation of the probable causal association between impaired chewing and cognitive decline, in which orofacial pain plays a mediating role by its negative influence on chewing ability. The identification of this negative influence will urge opinion leaders and policy makers to improve the oral health status in older persons with a dementia. Ultimately, pain-free oral functioning may lead to a higher quality of life and might help stabilizing or improving cognition in this frail and vulnerable patient population. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  1. Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits

    PubMed Central

    Hashmi, Javeria A.; Baliki, Marwan N.; Huang, Lejian; Baria, Alex T.; Torbey, Souraya; Hermann, Kristina M.; Schnitzer, Thomas J.; Apkarian, A. Vania

    2013-01-01

    Chronic pain conditions are associated with abnormalities in brain structure and function. Moreover, some studies indicate that brain activity related to the subjective perception of chronic pain may be distinct from activity for acute pain. However, the latter are based on observations from cross-sectional studies. How brain activity reorganizes with transition from acute to chronic pain has remained unexplored. Here we study this transition by examining brain activity for rating fluctuations of back pain magnitude. First we compared back pain-related brain activity between subjects who have had the condition for ∼2 months with no prior history of back pain for 1 year (early, acute/subacute back pain group, n = 94), to subjects who have lived with back pain for >10 years (chronic back pain group, n = 59). In a subset of subacute back pain patients, we followed brain activity for back pain longitudinally over a 1-year period, and compared brain activity between those who recover (recovered acute/sub-acute back pain group, n = 19) and those in which the back pain persists (persistent acute/sub-acute back pain group, n = 20; based on a 20% decrease in intensity of back pain in 1 year). We report results in relation to meta-analytic probabilistic maps related to the terms pain, emotion, and reward (each map is based on >200 brain imaging studies, derived from neurosynth.org). We observed that brain activity for back pain in the early, acute/subacute back pain group is limited to regions involved in acute pain, whereas in the chronic back pain group, activity is confined to emotion-related circuitry. Reward circuitry was equally represented in both groups. In the recovered acute/subacute back pain group, brain activity diminished in time, whereas in the persistent acute/subacute back pain group, activity diminished in acute pain regions, increased in emotion-related circuitry, and remained unchanged in reward circuitry. The results demonstrate that brain

  2. Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits.

    PubMed

    Hashmi, Javeria A; Baliki, Marwan N; Huang, Lejian; Baria, Alex T; Torbey, Souraya; Hermann, Kristina M; Schnitzer, Thomas J; Apkarian, A Vania

    2013-09-01

    Chronic pain conditions are associated with abnormalities in brain structure and function. Moreover, some studies indicate that brain activity related to the subjective perception of chronic pain may be distinct from activity for acute pain. However, the latter are based on observations from cross-sectional studies. How brain activity reorganizes with transition from acute to chronic pain has remained unexplored. Here we study this transition by examining brain activity for rating fluctuations of back pain magnitude. First we compared back pain-related brain activity between subjects who have had the condition for ∼2 months with no prior history of back pain for 1 year (early, acute/subacute back pain group, n = 94), to subjects who have lived with back pain for >10 years (chronic back pain group, n = 59). In a subset of subacute back pain patients, we followed brain activity for back pain longitudinally over a 1-year period, and compared brain activity between those who recover (recovered acute/sub-acute back pain group, n = 19) and those in which the back pain persists (persistent acute/sub-acute back pain group, n = 20; based on a 20% decrease in intensity of back pain in 1 year). We report results in relation to meta-analytic probabilistic maps related to the terms pain, emotion, and reward (each map is based on >200 brain imaging studies, derived from neurosynth.org). We observed that brain activity for back pain in the early, acute/subacute back pain group is limited to regions involved in acute pain, whereas in the chronic back pain group, activity is confined to emotion-related circuitry. Reward circuitry was equally represented in both groups. In the recovered acute/subacute back pain group, brain activity diminished in time, whereas in the persistent acute/subacute back pain group, activity diminished in acute pain regions, increased in emotion-related circuitry, and remained unchanged in reward circuitry. The results demonstrate that brain

  3. Mother-child concordance for pain location in a pediatric chronic pain sample

    PubMed Central

    Schwartz, Lindsay F.; Seidman, Laura C.; Zeltzer, Lonnie K.; Tsao, Jennie C. I.

    2013-01-01

    Body maps have long been used to assess pain location in adult and pediatric chronic pain patients. Assessing agreement between parent and child reports of pain location using such maps may help establish a unified picture of children’s pain experience. However, few studies have examined the extent of agreement between mothers and children on the location of the child’s pain. Using kappa coefficients and other determinants of the magnitude of kappa we assessed mother-child concordance in pain location using body maps with 21 standardized areas in 41 children with chronic pain (65.9% female, mean age = 14.60) and their mothers. The highest level of agreement was found for the abdominal region; agreement for the head region was moderate and not superior to the other body areas. Approximately half of the body map areas yielded poor to fair mother-child agreement, while the other half yielded moderate or better agreement. There was more agreement between mothers and sons than between mothers and daughters on the total number of body areas considered painful, but there were no effects of pubertal status, race, and ethnicity on agreement. Our results are consistent with previous studies indicating that parent assessments of children’s pain do not necessarily mimic their child’s report. Future research should test additional psychosocial factors that may contribute to parent-child discordance regarding the location of the child’s pain. PMID:26413192

  4. Reliability computation from reliability block diagrams

    NASA Technical Reports Server (NTRS)

    Chelson, P. O.; Eckstein, E. Y.

    1975-01-01

    Computer program computes system reliability for very general class of reliability block diagrams. Four factors are considered in calculating probability of system success: active block redundancy, standby block redundancy, partial redundancy, and presence of equivalent blocks in the diagram.

  5. A comprehensive Fabry-related pain questionnaire for adult patients.

    PubMed

    Üçeyler, Nurcan; Magg, Barbara; Thomas, Phillip; Wiedmann, Silke; Heuschmann, Peter; Sommer, Claudia

    2014-11-01

    Pain may be the earliest symptom in Fabry disease and presents with a distinct phenotype including triggerable pain attacks, evoked pain, pain crises, and chronic pain. Current pain questionnaires do not reflect the special phenotype of Fabry disease-associated pain, which hampers its systematic evaluation as the basis of correct diagnosis and effective treatment. A questionnaire specifically designed to assess Fabry disease-associated pain is thus urgently needed. At the Würzburg Fabry Center for Interdisciplinary Therapy (FAZIT), Germany, we developed and validated the first face-to-face Fabry Pain Questionnaire (FPQ) for adult patients. The initial version of the FPQ was tested in a pilot study with 20 consecutive Fabry disease patients. The performance of the revised FPQ was assessed in a first (n=56) and second (n=20) validation phase in consecutive Fabry disease patients. For this, patients were interviewed at baseline and 2 weeks later. We determined the test-retest reliability and validity of the FPQ in comparison to data obtained with the Neuropathic Pain Symptom Inventory. The FPQ contains 15 questions on the 4 pain phenotypes of Fabry disease (pain attacks, pain crises, evoked pain, chronic pain) in childhood and adulthood, on pain development during life with and without enzyme replacement therapy, and on everyday life impairment due to pain. This first disease-specific questionnaire is a valuable tool for baseline and follow-up assessment of pain in Fabry disease patients and may guide treatment in this distinct pain phenotype.

  6. [Musculoskeletal pain].

    PubMed

    Casser, H-R; Schaible, H-G

    2015-10-01

    Among the clinically relevant pain conditions, pain in the musculoskeletal system is most frequent. This article reports extensive epidemiological data on musculoskeletal system pain in Germany and worldwide. Since back pain is most frequent, the diagnostics and therapeutic algorithms of acute, recurring, and chronic lower back pain in Germany will be particularly addressed. The importance of the physiologic-organic, the cognitive-emotional, the behavioral, and the social level to diagnostics and treatment will be discussed. We will also focus on osteoarthritic pain and address its epidemiology, clinical importance, and significance for the health care system. This article will list some reasons why the musculoskeletal system in particular is frequently the site of chronic pain. The authors believe that these reasons are to be sought in the complex structures of the musculoskeletal system; in the particular sensitivity of the deep somatic nociceptive system for long-term sensitization processes, as well as the ensuing nervous system reactions; and in the interactions between the nervous and immune systems. The article will give some insights into the research carried out on this topic in Germany.

  7. Fetal pain?

    PubMed

    Vanhatalo, S; van Nieuwenhuizen, O

    2000-05-01

    During the last few years a vivid debate, both scientifically and emotionally, has risen in the medical literature as to whether a fetus is able to feel pain during abortion or intrauterine surgery. This debate has mainly been inspired by the demonstration of various hormonal or motor reactions to noxious stimuli at very early stages of fetal development. The aims of this paper are to review the literature on development of the pain system in the fetus, and to speculate about the relationship between "sensing" as opposed to "feeling" pain and the number of reactions associated with painful stimuli. While a cortical processing of pain theoretically becomes possible after development of the thalamo-cortical connections in the 26th week of gestation, noxious stimuli may trigger complex reflex reactions much earlier. However, more important than possible painfulness is the fact that the noxious stimuli, by triggering stress responses, most likely affect the development of an individual at very early stages. Hence, it is not reasonable to speculate on the possible emotional experiences of pain in fetuses or premature babies. A clinically relevant aim is rather to avoid and/or treat any possibly noxious stimuli, and thereby prevent their potential adverse effects on the subsequent development.

  8. Treatment of Neck Pain

    PubMed Central

    Hurwitz, Eric L.; Cheng, Ivan; Carroll, Linda J.; Nordin, Margareta; Guzman, Jaime; Peloso, Paul; Holm, Lena W.; Côthé, Pierre; Hogg-Johnson, Sheilah; van der Velde, Gabrielle; Cassidy, J. David; Haldeman, Scott

    2008-01-01

    Study Design Best evidence synthesis. Objective To identify, critically appraise, and synthesize literature from 1980 through 2006 on surgical interventions for neck pain alone or with radicular pain in the absence of serious pathologic disease. Summary of Background Data There have been no comprehensive systematic literature or evidence-based reviews published on this topic. Methods We systematically searched Medline for literature published from 1980 to 2006 on percutaneous and open surgical interventions for neck pain. Publications on the topic were also solicited from experts in the field. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our Best Evidence Synthesis. Results Of the 31,878 articles screened, 1203 studies were relevant to the Neck Pain Task Force mandate and of these, 31 regarding treatment by surgery or injections were accepted as scientifically admissible. Radiofrequency neurotomy, cervical facet injections, cervical fusion and cervical arthroplasty for neck pain without radiculopathy are not supported by current evidence. We found there is support for short-term symptomatic improvement of radicular symptoms with epidural corticosteroids. It is not clear from the evidence that long-term out comes are improved with the surgical treatment of cervical radiculopathy compared to non operative measures. However, relatively rapid and substantial symptomatic relief after surgical treatment seems to be reliably achieved. It is not evident that one open surgical technique is clearly superior to others for radiculopathy. Cervical foramenal or epidural injections are associated with relatively frequent minor adverse events (5%–20%); however, serious adverse events are very uncommon (<1%). After open surgical procedures on the cervical spine, potentially serious acute complications are seen in approximately 4% of patients. Conclusion Surgical treatment and limited

  9. Painful neuropathies.

    PubMed

    Koltzenburg, M

    1998-10-01

    Pain following peripheral nerve lesion appears to be a paradox because damage of primary afferent nerve fibres carrying nociceptive information should result in hypoalgesia. The very existence of neuropathic pain therefore implies fundamental changes of nociceptive processing and there have been considerable advances in the understanding of factors that precipitate neuropathic pain. This knowledge has already been harnessed for the development of novel analgesic therapies to supplement traditional treatment with anticonvulsant and antidepressants drugs which has shown clear effectiveness in systematic reviews of randomised controlled trials.

  10. Parental pain expectancy as a mediator between child expected and experienced procedure-related pain intensity during painful medical procedures.

    PubMed

    Liossi, Christina; White, Paul; Franck, Linda; Hatira, Popi

    2007-06-01

    The aim of this prospective investigation was to evaluate child and parental expectancies as a predictor of pain perception in pediatric oncology patients undergoing painful medical procedures. Forty-five children with leukemia or non-Hodgkin lymphoma and their parents rated expected and experienced pain during lumbar punctures at baseline, during intervention (ie, cognitive-behavior therapy) administered by a therapist and when children were using cognitive-behavior therapy skills independently. Parental and child expectancies were significantly correlated. Parents consistently expected their children to experience more pain than children were expecting themselves. Parental expectancy was found to mediate the relationship between child expected and experienced pain during every phase of the study. It is concluded that parental expectancies are reliable predictors of pediatric procedure-related pain and possible useful targets for psychologic interventions to manage such pain.

  11. What a Pain! Kids and Growing Pains

    MedlinePlus

    ... dientes Video: Getting an X-ray What a Pain! Kids and Growing Pains KidsHealth > For Kids > What a Pain! Kids and ... something doctors call growing pains . What Are Growing Pains? Growing pains aren't a disease. You probably ...

  12. What a Pain! Kids and Growing Pains

    MedlinePlus

    ... What Happens in the Operating Room? What a Pain! Kids and Growing Pains KidsHealth > For Kids > What a Pain! Kids and ... something doctors call growing pains . What Are Growing Pains? Growing pains aren't a disease. You probably ...

  13. Pain in elderly people with severe dementia: A systematic review of behavioural pain assessment tools

    PubMed Central

    Zwakhalen, Sandra MG; Hamers, Jan PH; Abu-Saad, Huda Huijer; Berger, Martijn PF

    2006-01-01

    Background Pain is a common and major problem among nursing home residents. The prevalence of pain in elderly nursing home people is 40–80%, showing that they are at great risk of experiencing pain. Since assessment of pain is an important step towards the treatment of pain, there is a need for manageable, valid and reliable tools to assess pain in elderly people with dementia. Methods This systematic review identifies pain assessment scales for elderly people with severe dementia and evaluates the psychometric properties and clinical utility of these instruments. Relevant publications in English, German, French or Dutch, from 1988 to 2005, were identified by means of an extensive search strategy in Medline, Psychinfo and CINAHL, supplemented by screening citations and references. Quality judgement criteria were formulated and used to evaluate the psychometric aspects of the scales. Results Twenty-nine publications reporting on behavioural pain assessment instruments were selected for this review. Twelve observational pain assessment scales (DOLOPLUS2; ECPA; ECS; Observational Pain Behavior Tool; CNPI; PACSLAC; PAINAD; PADE; RaPID; Abbey Pain Scale; NOPPAIN; Pain assessment scale for use with cognitively impaired adults) were identified. Findings indicate that most observational scales are under development and show moderate psychometric qualities. Conclusion Based on the psychometric qualities and criteria regarding sensitivity and clinical utility, we conclude that PACSLAC and DOLOPLUS2 are the most appropriate scales currently available. Further research should focus on improving these scales by further testing their validity, reliability and clinical utility. PMID:16441889

  14. Development of the KnowPain-12 pain management knowledge survey.

    PubMed

    Gordon, Debra B; Loeser, John D; Tauben, David; Rue, Tessa; Stogicza, Agnes; Doorenbos, Ardith

    2014-06-01

    The purpose of this study was to develop a brief knowledge survey about chronic noncancer pain that could be used as a reliable and valid measure of a provider's pain management knowledge. This study used a cross-sectional study design. A group of pain experts used a systematic consensus approach to reduce the previously validated KnowPain-50 to 12 questions (2 items per original 6 domains). A purposive sampling of pain specialists and health professionals generated from public lists and pain societies was invited to complete the KnowPain-12 online survey. Between April 4 and September 16, 2012, 846 respondents completed the survey. Respondents included registered nurses (34%), physicians (23%), advanced practice registered nurses (14%), and other allied health professionals and students. Twenty-six percent of the total sample self-identified as "pain specialist." Pain specialists selected the most correct response to the knowledge assessment items more often than did those who did not identify as pain specialists, with the exception of 1 item. KnowPain-12 demonstrated adequate internal consistency reliability (α=0.67). Total scores across all 12 items were significantly higher (P<0.0001) among pain specialists compared with respondents who did not self-identify as pain specialists. The psychometric properties of the KnowPain-12 support its potential as an instrument for measuring provider pain management knowledge. The ability to assess pain management knowledge with a brief measure will be useful for developing future research studies and specific pain management knowledge intervention approaches for health care providers.

  15. The lumbar multifidus muscle and patterns of pain.

    PubMed

    Cornwall, Jon; John Harris, A; Mercer, Susan R

    2006-02-01

    This paper describes the patterns of pain induced by injecting hypertonic saline into the lumbar multifidus muscle opposite the L5 spinous process in 15 healthy adult volunteers. All subjects experienced local pain while referred pain was reported by 13 subjects in one of two regions of the thigh; anterior (n=5) or posterior (n=8). These results confirm that the multifidus muscle may be a source of local and referred pain. Comparison of these maps with pain maps following stimulation of the L4 medial dorsal rami and L4-5 interspinous ligaments shows that pain arising from the band of multifidus innervated by the L4 dorsal ramus has a segmental distribution. In addition patterns of pain arising from multifidus clearly overlap those reported for other lumbar structures. These findings highlight the difficulty of using pain distribution to accurately identify specific lumbar structures as the source of pain.

  16. Chronic pain - resources

    MedlinePlus

    Pain - resources; Resources - chronic pain ... The following organizations are good resources for information on chronic pain: American Chronic Pain Association -- theacpa.org National Fibromyalgia and Chronic Pain Association -- www.fmcpaware.org National ...

  17. Abdominal Pain

    MedlinePlus

    ... and your health care provider may not feel pain medication is the safest option. In this case, distraction techniques such as guided imagery may help your child cope. You could also try progressive ...

  18. [Abdominal pain].

    PubMed

    Gschossmann, J M; Holtmann, G; Netzer, P; Essig, M; Balsiger, B M; Scheurer, U

    2005-10-01

    Abdominal pain can result from a variety of different intra- and extra-abdominal disorders. Given the wide variety of etiological triggers for this pain, the primary task during the first stage of the diagnostic work-up is to determine as soon as possible the underlying cause and the degree of emergency. The aim of this evaluation is to adapt the therapeutic measures which are necessary for a causal treatment to the individual situation. Contrary to somatic causes of abdominal pain, the availability of such a causal therapy for functional bowel disorders is still very limited. Given this dilemma, the therapeutic focus of abdominal pain associated with these functional syndromes has to be placed on symptom-oriented treatment.

  19. Pain Control

    MedlinePlus

    ... reduce pain: ■■ Radiation therapy. Different forms of radiation energy are used to shrink the tumor and reduce ... acupressure.) The goal is to change the body’s energy flow so it can heal itself. When receiving ...

  20. Shoulder Pain

    MedlinePlus

    ... familydoctor.org editorial staff Categories: Exercise and Fitness, Injury Rehabilitation, Prevention and WellnessTags: Exercise Prescription, pain relievers, Shoulder Problems, sports medicine Exercise and Fitness, Injury Rehabilitation, Prevention and ...

  1. Back Pain

    MedlinePlus

    ... lasts less than a few months. Education There's no commonly accepted program to teach people with back pain how to manage the condition effectively. So education might involve a class, a talk with your doctor, written material or ...

  2. Pain Management

    MedlinePlus

    ... analgesia, identify new targets for analgesic drugs, and test the efficacy and adverse reactions of newly developed or currently used drugs to treat pain. Researchers are currently using these technologies to discover the mechanisms by which drugs such ...

  3. Chest Pain

    MedlinePlus

    ... causes Chest pain can also be caused by: Panic attack. If you have periods of intense fear accompanied ... fear of dying, you may be experiencing a panic attack. Shingles. Caused by a reactivation of the chickenpox ...

  4. Chronic Pain

    MedlinePlus

    ... Strategy Current Research Research Funded by NINDS Basic Neuroscience Clinical Research Translational Research Research at NINDS Focus ... pain has done. Scientists believe that advances in neuroscience will lead to more and better treatments for ...

  5. Joint pain

    MedlinePlus

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: Gout (especially ...

  6. Pain (PDQ)

    MedlinePlus

    ... the PDQ summary on Acupuncture for more information. Hypnosis Hypnosis may help you relax and may be combined with other thinking and behavior methods. Hypnosis to relieve pain works best in people who ...

  7. Testicle pain

    MedlinePlus

    ... be caused by a hernia or kidney stone. Testicular cancer is almost always painless. But any testicle lump ... Read More Abdominal pain Scrotum Testes Testicle lump Testicular cancer Testicular torsion Review Date 8/31/2015 Updated ...

  8. Heel Pain

    MedlinePlus

    ... Heel pain is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress ... inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar surface) of the ...

  9. Breast pain

    MedlinePlus

    ... chocolate in your diet helps reduce breast pain. Vitamin E, thiamine, magnesium, and evening primrose oil are not harmful, but most studies have not shown any benefit. Talk to your health care provider before starting ...

  10. Fetal pain.

    PubMed

    Rokyta, Richard

    2008-12-01

    The fetus reacts to nociceptive stimulations through different motor, autonomic, vegetative, hormonal, and metabolic changes relatively early in the gestation period. With respect to the fact that the modulatory system does not yet exist, the first reactions are purely reflexive and without connection to the type of stimulus. While the fetal nervous system is able to react through protective reflexes to potentially harmful stimuli, there is no accurate evidence concerning pain sensations in this early period. Cortical processes occur only after thalamocortical connections and pathways have been completed at the 26th gestational week. Harmful (painful) stimuli, especially in fetuses have an adverse effect on the development of humans regardless of the processes in brain. Moreover, pain activates a number of subcortical mechanisms and a wide spectrum of stress responses influence the maturation of thalamocortical pathways and other cortical activation which are very important in pain processing.

  11. Neonatal pain

    PubMed Central

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

  12. Neonatal pain.

    PubMed

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback.

  13. How diagnostic tests help to disentangle the mechanisms underlying neuropathic pain symptoms in painful neuropathies.

    PubMed

    Truini, Andrea; Cruccu, Giorgio

    2016-02-01

    Neuropathic pain, ie, pain arising directly from a lesion or disease affecting the somatosensory afferent pathway, manifests with various symptoms, the commonest being ongoing burning pain, electrical shock-like sensations, and dynamic mechanical allodynia. Reliable insights into the mechanisms underlying neuropathic pain symptoms come from diagnostic tests documenting and quantifying somatosensory afferent pathway damage in patients with painful neuropathies. Neurophysiological investigation and skin biopsy studies suggest that ongoing burning pain primarily reflects spontaneous activity in nociceptive-fiber pathways. Electrical shock-like sensations presumably arise from high-frequency ectopic bursts generated in demyelinated, nonnociceptive, Aβ fibers. Although the mechanisms underlying dynamic mechanical allodynia remain debatable, normally innocuous stimuli might cause pain by activating spared and sensitized nociceptive afferents. Extending the mechanistic approach to neuropathic pain symptoms might advance targeted therapy for the individual patient and improve testing for new drugs.

  14. Measurement Properties of the Non-Communicating Adult Pain Checklist (NCAPC): A Pain Scale for Adults with Intellectual and Developmental Disabilities, Scored in a Clinical Setting

    ERIC Educational Resources Information Center

    Lotan, M.; Moe-Nilssen, R.; Ljunggren, A. E.; Strand, L. I.

    2010-01-01

    The 18 items' Non-Communicating Adult Pain Checklist (NCAPC) has been developed from the 27 items Non-Communicating Children Pain Checklist to better capture pain behavior of adults with Intellectual and Developmental Disabilities (IDD). As part of the NCAPC's measurement properties, internal consistency, reliability and sensitivity to pain have…

  15. Measurement Properties of the Non-Communicating Adult Pain Checklist (NCAPC): A Pain Scale for Adults with Intellectual and Developmental Disabilities, Scored in a Clinical Setting

    ERIC Educational Resources Information Center

    Lotan, M.; Moe-Nilssen, R.; Ljunggren, A. E.; Strand, L. I.

    2010-01-01

    The 18 items' Non-Communicating Adult Pain Checklist (NCAPC) has been developed from the 27 items Non-Communicating Children Pain Checklist to better capture pain behavior of adults with Intellectual and Developmental Disabilities (IDD). As part of the NCAPC's measurement properties, internal consistency, reliability and sensitivity to pain have…

  16. Reliability model generator

    NASA Technical Reports Server (NTRS)

    McMann, Catherine M. (Inventor); Cohen, Gerald C. (Inventor)

    1991-01-01

    An improved method and system for automatically generating reliability models for use with a reliability evaluation tool is described. The reliability model generator of the present invention includes means for storing a plurality of low level reliability models which represent the reliability characteristics for low level system components. In addition, the present invention includes means for defining the interconnection of the low level reliability models via a system architecture description. In accordance with the principles of the present invention, a reliability model for the entire system is automatically generated by aggregating the low level reliability models based on the system architecture description.

  17. Glenohumeral Joint Pain Referral Patterns: A Descriptive Study.

    PubMed

    Kennedy, David J; Mattie, Ryan; Nguyen, Quang; Hamilton, Scott; Conrad, Bryan

    2015-08-01

    Pain diagrams are a useful tool to help physicians understand the varying presentation patterns of specific pain generators. This study is the first to describe the potential pain patterns of the glenohumeral joint (GHJ) based on responses to diagnostic image-guided GHJ injections. To determine potential GHJ pain referral patterns. 162 consecutive patients undergoing 168 GHJ injections recorded their preprocedure pain scores and drew accurate pain diagrams prior to undergoing fluoroscopically guided GHJ injections with local anesthetic. Postprocedure pain scores were recorded and those with complete relief were considered responders. Pain diagrams were overlaid via computer software to facilitate analysis and a composite pain map. A responder composite was also compared with a nonresponder composite. The GHJ was shown to cause pain in traditionally localized areas of the anterior and/or posterior shoulder and upper arm regions in 100% of patients who experienced complete pain relief after injection. Among 100% responders, 18% had neck pain and 6% had scapular pain. Pain was shown to radiate distally, with anterior forearm pain in 9%, posterior forearm pain in 8%, and hand pain in 9%. No patients with pain both in the medial neck and below the elbow were found to be 100% responders. Similarly, no patients were 100% responders if they had pain in the medial scapula and below the elbow, or medial scapula and medial neck. Anterior or posterior shoulder and upper arm pain, or a combination of the two, is the most common pain referral area from a symptomatic shoulder joint. Referral to the lateral neck, in combination with shoulder pain, was occasionally seen. Pain referral to the forearm and hand was less common. Rarely did a symptomatic shoulder joint refer pain to the scapula or to the medial neck. Wiley Periodicals, Inc.

  18. [Visceral pain].

    PubMed

    Elsenbruch, S; Häuser, W; Jänig, W

    2015-10-01

    Chronic visceral pain is an unresolved neurobiological, medical and socioeconomic challenge. Up to 20% of the adult population suffer from chronic visceral pain and abdominal complaints constitute a prevalent symptom also in children and adolescents. Existing treatment approaches are often unsuccessful and patients typically suffer from multiple somatic and psychological symptoms. This complex situation requires integrative treatment approaches. This review summarizes current basic and clinical research on acute and chronic visceral pain with a focus on research groups in Germany. Despite significant clinical and scientific advances, a number of questions remain open calling for more funding to support research to elucidate the complex pathophysiology of chronic visceral pain and to develop and test new treatment approaches. Research support should focus on interdisciplinary concepts and methodology using expertise from multiple disciplines. The field would also benefit from a broader integration of visceral pain into teaching curricula in medicine and psychology and should aim to motivate young clinicians and scientists to strive for a career within this important and highly fascinating area.

  19. The Cuernos del Paine mountains in Torres del Paine National Park, Chile, during NASA's AirSAR 2004 campaign

    NASA Image and Video Library

    2004-03-11

    The Cuernos del Paine mountains in Torres del Paine National Park, Chile, during NASA's AirSAR 2004 campaign. AirSAR 2004 is a three-week expedition in Central and South America by an international team of scientists that is using an all-weather imaging tool, called the Airborne Synthetic Aperture Radar (AirSAR), located onboard NASA's DC-8 airborne laboratory. Scientists from many parts of the world are combining ground research with NASA's AirSAR technology to improve and expand on the quality of research they are able to conduct. Founded in 1959, Torres del Paine National Park encompasses 450,000 acres in the Patagonia region of Chile. This region is being studied by NASA using a DC-8 equipped with an Airborne Synthetic Aperture Radar (AirSAR) developed by scientists from NASA’s Jet Propulsion Laboratory. This is a very sensitive region that is important to scientists because the temperature has been consistently rising causing a subsequent melting of the region’s glaciers. AirSAR will provide a baseline model and unprecedented mapping of the region. This data will make it possible to determine whether the warming trend is slowing, continuing or accelerating. AirSAR will also provide reliable information on ice shelf thickness to measure the contribution of the glaciers to sea level.

  20. Reliability Generalization: "Lapsus Linguae"

    ERIC Educational Resources Information Center

    Smith, Julie M.

    2011-01-01

    This study examines the proposed Reliability Generalization (RG) method for studying reliability. RG employs the application of meta-analytic techniques similar to those used in validity generalization studies to examine reliability coefficients. This study explains why RG does not provide a proper research method for the study of reliability,…

  1. Reliability Generalization: "Lapsus Linguae"

    ERIC Educational Resources Information Center

    Smith, Julie M.

    2011-01-01

    This study examines the proposed Reliability Generalization (RG) method for studying reliability. RG employs the application of meta-analytic techniques similar to those used in validity generalization studies to examine reliability coefficients. This study explains why RG does not provide a proper research method for the study of reliability,…

  2. Reliability. ERIC Digest.

    ERIC Educational Resources Information Center

    Rudner, Lawrence M.; Schafer, William D.

    This digest discusses sources of error in testing, several approaches to estimating reliability, and several ways to increase test reliability. Reliability has been defined in different ways by different authors, but the best way to look at reliability may be the extent to which measurements resulting from a test are characteristics of those being…

  3. AAPT Diagnostic Criteria for Chronic Sickle Cell Disease Pain.

    PubMed

    Dampier, Carlton; Palermo, Tonya M; Darbari, Deepika S; Hassell, Kathryn; Smith, Wally; Zempsky, William

    2017-01-05

    Pain in sickle cell disease (SCD) is associated with increased morbidity, mortality, and high health care costs. Although episodic acute pain is the hallmark of this disorder, there is an increasing awareness that chronic pain is part of the pain experience of many older adolescents and adults. A common set of criteria for classifying chronic pain associated with SCD would enhance SCD pain research efforts in epidemiology, pain mechanisms, and clinical trials of pain management interventions, and ultimately improve clinical assessment and management. As part of the collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks public-private partnership with the U.S. Food and Drug Administration and the American Pain Society, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy initiative developed the outline of an optimal diagnostic system for chronic pain conditions. Subsequently, a working group of experts in SCD pain was convened to generate core diagnostic criteria for chronic pain associated with SCD. The working group synthesized available literature to provide evidence for the dimensions of this disease-specific pain taxonomy. A single pain condition labeled chronic SCD pain was derived with 3 modifiers reflecting different clinical features. Future systematic research is needed to evaluate the feasibility, validity, and reliability of these criteria.

  4. Quantitative Sensory Testing in Chronic Musculoskeletal Pain.

    PubMed

    Uddin, Zakir; MacDermid, Joy C

    2016-09-01

    In recent years, several published articles have demonstrated that quantitative sensory testing (QST) is useful in the analysis of musculoskeletal pain disorders. Based on the evidence from these studies, it is assumed that QST might be a useful tool in the analysis of the pathogenesis, classification, differential diagnosis, and prognosis of chronic musculoskeletal pain. The objective of this paper is to discuss measurement properties of QST and potentials research and clinical applications in musculoskeletal pain. This is a review of the current knowledge base on QST as it relates to musculoskeletal pain disorders. We based our summary on articles retrieved from Ovid MEDLINE (1946 to present) including EMBASE, AMED, and PsycINFO databases to search for all published literature focused on QST and musculoskeletal pain. QST has been shown to be related to neural sensitivity in musculoskeletal pain. QST measurement properties have been evaluated for multiple sensory evaluation modalities and protocols with no clear superior instrument or test protocol. The research evidence is incomplete, but suggests potential clinical benefits for predicting outcomes and subtyping pain. Threshold detection testing is commonly used to quantify sensory loss or gain, in current practice and has shown moderate reliability. Intensity/magnitude rating can be assessed on a wide range of rating scales and may be more useful for pain rating in a clinical context. Threshold detection-based testing and intensity/magnitude rating-based testing can be combined to determine pain threshold in clinical evaluation. Musculoskeletal pain management may benefit from treatment algorithms that consider mechanism, pain quality, or neurophysiological correlates. Non-invasive QST may be helpful to find sensory array of altered nociceptive process. Due to the diverse etiopathogenetic basis of musculoskeletal pain disorders, a broad range of reliable and valid QST tests may be needed to analyze the various

  5. Parent perceptions of adolescent pain expression: the adolescent pain behavior questionnaire.

    PubMed

    Lynch-Jordan, Anne M; Kashikar-Zuck, Susmita; Goldschneider, Kenneth R

    2010-12-01

    Pain behaviors provide meaningful information about adolescents in chronic pain, enhancing their verbal report of pain intensity with information about the global pain experience. Caregivers likely consider these expressions when making judgments about their adolescents' medical or emotional needs. Current validated measures of pain behavior target acute or procedural pain and young or non-verbal children, while observation systems may be too cumbersome for clinical practice. The objective of this research was to design and evaluate the Adolescent Pain Behavior Questionnaire (APBQ), a parent-report measure of adolescent (11-19 years) pain expressions. This paper provides preliminary results on reliability and validity of the APBQ. Parent-adolescent dyads (N=138) seen in a multidisciplinary pain management clinic completed the APBQ and questionnaires assessing pain characteristics, quality of life, functional disability, depressive symptoms, and pain catastrophizing. Principal components analysis of the APBQ supported a single component structure. The final APBQ scale contained 23 items with high internal consistency (α=0.93). No relationship was found between parent-reported pain behaviors and adolescent-reported pain intensity. However, significant correlations were found between parent-reported pain behaviors and parent- and adolescent-reported functional disability, pain catastrophizing, depressive symptoms, and poorer quality of life. The assessment of pain behaviors provides qualitatively different information than solely recording pain intensity and disability. It has clinical utility for use in behavioral treatments seeking to reduce disability, poor coping, and distress. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  6. Characterization of Whole Body Pain in Urologic Chronic Pelvic Pain Syndrome at Baseline – A MAPP Research Network Study

    PubMed Central

    Lai, H. Henry; Jemielita, Thomas; Sutcliffe, Siobhan; Bradley, Catherine S.; Naliboff, Bruce; Williams, David A.; Gereau, Robert W.; Kreder, Karl; Clemens, J. Quentin; Rodriguez, Larissa V.; Krieger, John N.; Farrar, John T.; Robinson, Nancy; Landis, J. Richard

    2017-01-01

    Purpose We characterized the location and spatial distribution of whole body pain among patients with urologic chronic pelvic pain syndrome (UCPPS) using a body map; and compared the severity of urinary symptoms, pelvic pain, non-pelvic pain, and psychosocial health among patients with different pain patterns. Methods 233 women and 191 men with UCPPS enrolled in a multi-center, one-year observational study completed a battery of baseline measures, including a body map describing the location of pain during the past week. Participants were categorized as having “pelvic pain only” if they reported pain in the abdomen and pelvis only. Participants who reported pain beyond the pelvis were further divided into two sub-groups based on the number of broader body regions affected by pain: an “intermediate” group (1–2 additional regions outside the pelvis) and a “widespread pain” group (3–7 additional regions). Results Of the 424 enrolled patients 25% reported pelvic pain only, and 75% reported pain beyond the pelvis of which 38% reported widespread pain. Participants with greater number of pain locations had greater non-pelvic pain severity (p<0.0001), sleep disturbance (p=0.035), depression (p=0.005), anxiety (p=0.011), psychological stress (p=0.005), negative affect scores (p=0.0004), and worse quality of life (p≤0.021). No difference in pelvic pain and urinary symptom severity were observed by increasing pain distribution. Conclusions Three-quarters of men and women with UCPPS reported pain outside the pelvis. Widespread pain was associated with greater severity of non-pelvic pain symptoms, poorer psychosocial health and worse quality of life, but not worse pelvic pain or urinary symptoms. PMID:28373134

  7. Pain-related and negative semantic priming enhances perceived pain intensity

    PubMed Central

    Richter, Maria; Schroeter, Christoph; Puensch, Theresa; Straube, Thomas; Hecht, Holger; Ritter, Alexander; Miltner, Wolfgang HR; Weiss, Thomas

    2014-01-01

    BACKGROUND: Negative affective and pain-related cues, such as pictures or words, have been shown to act as primes and enhance the perceived intensity of subsequent painful events. For pain-related semantic primes, it remains unclear whether this effect depends on negative valence itself or, specifically, on the pain-relatedness of the words. OBJECTIVES: To investigate the effect of pain-related, negative affective (pain-unrelated) and neutral semantic primes on the perception of subsequent noxious target stimuli. METHODS: Pain ratings in response to noxious electrical stimulation of light and moderate intensity were examined in 39 healthy subjects after subjects were exposed to semantic primes of different meaning and valence (pain-related, negative, positive and neutral adjectives) presented with different interstimulus intervals (0 ms, 500 ms and 1500 ms). RESULTS: Increased pain ratings of noxious stimuli were observed following pain-related and negative compared with neutral primes. DISCUSSION: The results support the motivational priming theory for semantic stimuli, indicating that affectively negative semantic primes increase subjective pain intensity. However, a specific pain-related priming effect was not reliably demonstrated. Additionally, it is shown that experimental parameters (ie, stimulus intensity and interstimulus interval) modify the extent of negative and pain-related semantic priming. CONCLUSIONS: Verbal priming plays a role for the perception of noxious stimuli in a time-dependent manner. PMID:24716197

  8. Affective, sensory and empathic sharing of another's pain: The Empathy for Pain Scale.

    PubMed

    Giummarra, M J; Fitzgibbon, B M; Georgiou-Karistianis, N; Beukelman, M; Verdejo-Garcia, A; Blumberg, Z; Chou, M; Gibson, S J

    2015-07-01

    Through two studies, we introduce and validate the Empathy for Pain Scale (EPS), which characterizes the phenomenology of empathy for pain, including the vicarious experience of pain when seeing others in pain. In study 1, 406 individuals completed the EPS and Interpersonal Reactivity Index (IRI). In the EPS, four painful scenarios (witnessing surgery, patient recovering from surgery, assault and accidental injury) were rated for 12 emotional, empathic and sensory responses. In study 2, 59 participants completed the same questionnaires and then watched and rated videos of sporting injuries. In study 1, we identified three factors of the EPS with principal component analysis, which were validated with confirmatory factor analysis: affective distress; vicarious pain; and empathic concern. The EPS demonstrated good psychometric properties, re-test reliability (n = 105) and concurrent validity. In study 2, we validated the EPS against empathic reactions to the pain of others as displayed in video clips depicting sporting injuries and showed that the scale has unique utility to characterize empathic reactions to pain above general trait empathy measures. Both studies showed that the affective distress and empathic concern subscales of the EPS correlated with measures of cognitive and affective empathy from the IRI, whereas the vicarious pain subscale was only correlated with the personal distress IRI subscale. The EPS is a psychometrically sound new scale that characterizes empathy for pain and vicarious pain. The EPS offers valuable insight to the phenomenological profile of the affective, empathic and sensory dimensions of empathy for pain. © 2014 European Pain Federation - EFIC®

  9. Determining pain scale preference in a veteran population experiencing chronic pain.

    PubMed

    Douglas, Mary E; Randleman, Mary L; DeLane, Alice M; Palmer, Glen A

    2014-09-01

    The purpose of this study was to determine veteran pain scale preference of four common pain scales: the Faces Scale, the Visual Analog Scale, the Numeric Rating Scale, and the Mankoski Pain Scale. The study also examined the reliability and validity of the Mankoski Pain Scale with the other three scales. A sample of veterans (N = 200) with chronic pain receiving treatment in a residential rehabilitation treatment program (RRTP) and a surgical and specialty care (SSC) outpatient clinic at a Department of Veterans Affairs (VA) medical center participated in the study. There was a significant difference between scales in regard to preference, χ2(3) = 64.59, p < .001. A large percentage of the sample preferred the Mankoski Pain Scale (46%). Test-retest of the reliability was comparable for all the scales. Validity of the Mankoski scale was excellent, as it correlated very well with the Numeric (r = .84, p < .001), Analog (r = .83, p < .001), and Faces (r = .78, p < .001) scales. The findings indicate that the Mankoski Pain Scale is a valid and reliable tool for pain with veterans, and it was the preferred scale by veterans for use when describing pain. Published by Elsevier Inc.

  10. Abdominal Pain (Stomach Pain), Short-Term

    MedlinePlus

    ... in Children and TeensRead MoreBMI Calculator Abdominal Pain (Stomach Pain), Short-termJust about everyone has had a " ... time or another. But sudden severe abdominal pain (stomach pain), also called acute pain, shouldn't be ...

  11. Jordanian patients' satisfaction with pain management.

    PubMed

    Darawad, Muhammad W; Al-Hussami, Mahmoud; Saleh, Ali M; Al-Sutari, Manal

    2014-03-01

    Pain is still undertreated among hospitalized patients. Recently, patient satisfaction with pain management has received significant attention. This field has not yet been explored among Jordanian patients. The purpose of this study was to determine the knowledge regarding pain characteristics, beliefs, and satisfaction that can be included in planning pain management strategies and protocols within Jordanian hospitals. Using descriptive cross-sectional methodology, the American Pain Society Patient Outcome Questionnaire (APS-POQ) was used to survey 375 inpatients from Jordanian hospitals. Participants reported relatively severe pain and pain interferences while being hospitalized and seemed to be well informed regarding pain and pain management. Participants reported high levels of pain management satisfaction. Also, the Arabic version of the APS-POQ was found to be reliable among the Jordanian population. Findings of this study are similar to those reported by earlier studies in other countries and support the need for applying the caring attitude in managing patients' reports of having pain. This study is the first in Jordan, opening the door for future studies to be conducted in this important field.

  12. The language of pain: A short study.

    PubMed

    Rathnam, Arun; Madan, Nidhi; Madan, Neeti

    2010-07-01

    Pain perception is a very controversial topic in child patients. It is affected by various factors such as fear, anxiety, previous experiences, parental factors, and pain threshold. The communication of such pain by the child to the parent is also very confusing with children having rudimentary and developing communication skills. A study to evaluate the pain perception of children and the parental understanding of the children's pain would be helpful in this scenario. The effect on behavior due to pain is also attempted in this particular study. A cross-sectional study of 100 children aged between 5-13 years accompanied by either parent was performed. Data collection was done with the help of questionnaires, which assessed the parental understanding of the child's pain. Pain perception recording was done with the Visual Analog Scale of Faces (VASOF). The behavior of the child was noted using the Frankl's behavior rating scale. Data was collated and statistical analysis was performed using the SPSS (version 10) software. The results show that parental factors such as education, work culture, influence parental understanding of pain. VASOF proves to be a reliable tool for pain perception in children. Behavior of the child shows a positive correlation to pain perception.

  13. Can There Be Reliability without "Reliability?"

    ERIC Educational Resources Information Center

    Mislevy, Robert J.

    2004-01-01

    An "Educational Researcher" article by Pamela Moss (1994) asks the title question, "Can there be validity without reliability?" Yes, she answers, if by reliability one means "consistency among independent observations intended as interchangeable" (Moss, 1994, p. 7), quantified by internal consistency indices such as…

  14. Pain assessment in context: a state of the science review of the McGill pain questionnaire 40 years on.

    PubMed

    Main, Chris J

    2016-07-01

    The McGill pain questionnaire (MPQ) and its later derivative the short form-MPQ have been used widely both in experimental and clinical pain studies. They have been of considerable importance in stimulating research into the perception of pain and now, with the publication of its latest variant, the short form-MPQ-2, it is appropriate to appraise their utility in the light of subsequent research into the nature of pain and the purpose of pain assessment. Following a description of the content and development of the questionnaires, issues of validity, reliability, and utility are addressed, not only in terms of the individual pain descriptors and the scales, but also in terms of methods of quantification. In addition, other methods of pain depiction are considered. In the second part of the review, advances in pain measurement and methodology, in the elucidation of pain mechanisms and pathways, in the psychology of pain, and in the nature of pain behavior are presented and their implications for pain assessment in general and the MPQ family of measures in particular will be addressed. It is suggested that pain assessment needs to be cast in its social context. We need to understand the influences on pain expression using a socio-communication model of pain that recognizes the function of pain and the importance of both innate pain responses and the effects of social learning. The review concludes with recommendations for future use of the MPQ and identifies a number of research challenges which lie ahead.

  15. Can there be reliability without reliability?

    NASA Astrophysics Data System (ADS)

    Mislevy, Robert J.

    1994-10-01

    A recent article by Pamela Moss asks the title question, 'Can there be validity without reliability?' If by reliability we mean only KR-2O coefficients or inter-rater correlations, the answer is yes. Sometimes these particular indices for evaluating evidence suit the problem we encounter; sometimes they don't. If by reliability we mean credibility of evidence, where credibility is defined as 'appropriate to the intended inference, the answer is no, we cannot have validity without reliability. Because 'validity' encompasses the process of reasoning as well as the data, uncritically accepting observations as strong evidence, when they may be incorrect, misleading, unrepresentative, or fraudulent, may lead coincidentally to correct conclusions but not to valid ones. This paper discusses and illustrates a broader conception of 'reliability' in educational assessment, to ground a deeper understanding of the issues raised by Professor Moss's question.

  16. Back pain in athletes.

    PubMed

    Lawrence, James P; Greene, Hunter S; Grauer, Jonathan N

    2006-12-01

    The athlete with back pain presents a clinical challenge. Self-limited symptoms must be distinguished from persistent or recurrent symptoms associated with identifiable pathology. Athletes involved in impact sports appear to have risk factors for specific spinal pathologies that correlate with the loading and repetition demands of specific activities. For example, elite athletes who participate in longer and more intense training have higher incidence rates of degenerative disk disease and spondylolysis than athletes who do not. However, data suggest that the recreational athlete may be protected from lumbar injury with physical conditioning. Treatment of athletes with acute or chronic back pain usually is nonsurgical, and symptoms generally are self-limited. However, a systematic approach to the athlete with back pain, involving a thorough history and physical examination, pertinent imaging, and treatment algorithms designed for specific diagnoses, can facilitate symptomatic improvement and return to play. There are no reliable studies examining the long-term consequences of athletic activity on the lumbar spine.

  17. [Elbow pain].

    PubMed

    Viikari-Juntura, Eira; Miintyselkii, Pekka; Havulinna, Jouni

    2010-01-01

    Pain and disability in the elbow are not as common as in the neck, shoulder or wrist, for example. The elbow may, however, present disorders that may in a prolonged state be difficult and cause significant loss of working capacity. These include epicondylitis, osteoarthritis and entrapment of the ulnar nerve.

  18. Achilles Pain.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Five ailments which can cause pain in the achilles tendon area are: (1) muscular strain, involving the stretching or tearing of muscle or tendon fibers; (2) a contusion, inflammation or infection called tenosynovitis; (3) tendonitis, the inflammation of the tendon; (4) calcaneal bursitis, the inflammation of the bursa between the achilles tendon…

  19. Achilles Pain.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Five ailments which can cause pain in the achilles tendon area are: (1) muscular strain, involving the stretching or tearing of muscle or tendon fibers; (2) a contusion, inflammation or infection called tenosynovitis; (3) tendonitis, the inflammation of the tendon; (4) calcaneal bursitis, the inflammation of the bursa between the achilles tendon…

  20. Medical conditions and body pain in patients presenting orofacial pain.

    PubMed

    Franco, Ana Lúcia; Runho, Gabriel Henrique Farto; Siqueira, José Tadeu Tesseroli de; Camparis, Cinara Maria

    2012-05-01

    To verify the frequency of self-reported medical conditions and pain areas in orofacial pain patients, comparing them with patients from the routine dental care. Data were collected from archives of the Orofacial Pain Clinic (Group A, n=319) and of the routine dental care clinics (Group B, n=84) at Faculdade de Odontologia de Araraquara, São Paulo, in Brazil. All individuals answered a standardized clinical questionnaire and completed a body map indicating their pain areas. The Mann-Whitney's test demonstrated that Group A presented a higher mean number of medical reports than Group B (p=0.004). In both groups, Pearson's correlation test showed that the highest frequencies of medical conditions were positively correlated to highest frequencies of painful areas (0.478, p=0.001 and 0.246, p=0.000, respectively). Group A tended to report more medical conditions and there was a positive correlation between the number of medical conditions and the one of pain areas for both groups.

  1. Disorders characterised by pain: a methodological review of population surveys.

    PubMed Central

    Raspe, H; Kohlmann, T

    1994-01-01

    OBJECTIVE--To review a series of conceptual and methodological problems encountered in surveys primarily devoted to pain disorders. CRITERIA FOR INCLUSION AND EXCLUSION OF ARTICLES--Published reports were systematically collected by electronic database searches (Medline), citations in existing publications, and through personal contacts. Relevant articles from clinical and epidemiological research on pain were included and special attention was given to epidemiological research on back pain. CONCLUSIONS--Surveys of pain disorders should be based on a multidimensional pain model that includes nociceptive input, pain perception, suffering, and pain behaviour as major components. Because of the limited applicability of diagnostic procedures or genuine "non-specificity" of pain states, or both, epidemiological surveys may result in a considerable proportion of cases without an identifiable pathophysiological basis. Staging and grading procedures for pain disorders (as distinguished from classification) may comprise various aspects of pain perception: regional distribution, pain intensity, temporal characteristics, sensory qualities, and dimensions of cognitive-emotional appraisal. Description of temporal development and chronification (staging) should refer to different components of the multidimensional pain model. Explicit a posteriori procedures for grading are preferable to implicit grading based on question wording. Evidence from several sources suggests that localistic concepts of pain may be misleading. Identification of complex pain syndromes should be one primary target for epidemiological pain surveys. Of the many factors that may impair the reliability and validity of data collected in pain surveys, recall biases seem to deserve special attention. PMID:7830005

  2. Assuring reliability program effectiveness.

    NASA Technical Reports Server (NTRS)

    Ball, L. W.

    1973-01-01

    An attempt is made to provide simple identification and description of techniques that have proved to be most useful either in developing a new product or in improving reliability of an established product. The first reliability task is obtaining and organizing parts failure rate data. Other tasks are parts screening, tabulation of general failure rates, preventive maintenance, prediction of new product reliability, and statistical demonstration of achieved reliability. Five principal tasks for improving reliability involve the physics of failure research, derating of internal stresses, control of external stresses, functional redundancy, and failure effects control. A final task is the training and motivation of reliability specialist engineers.

  3. Assuring reliability program effectiveness.

    NASA Technical Reports Server (NTRS)

    Ball, L. W.

    1973-01-01

    An attempt is made to provide simple identification and description of techniques that have proved to be most useful either in developing a new product or in improving reliability of an established product. The first reliability task is obtaining and organizing parts failure rate data. Other tasks are parts screening, tabulation of general failure rates, preventive maintenance, prediction of new product reliability, and statistical demonstration of achieved reliability. Five principal tasks for improving reliability involve the physics of failure research, derating of internal stresses, control of external stresses, functional redundancy, and failure effects control. A final task is the training and motivation of reliability specialist engineers.

  4. When Sex Is Painful

    MedlinePlus

    ... AQ FREQUENTLY ASKED QUESTIONS GYNECOLOGIC PROBLEMS FAQ020 When Sex Is Painful • How common is painful sex? • What causes pain during sex? • Where is pain during sex felt? • When should ...

  5. American Pain Society

    MedlinePlus

    ... Management Award Recipients Strong Evidence Still Lacking on Medical Marijuana for Pain Fibromyalgia Has Central Nervous System Origins ... Mayday Fund American Pain Society Offers Guidance on Medical Marijuana for Pain Study Shows Pain Often Improves in ...

  6. Complex Regional Pain Syndrome

    MedlinePlus

    Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. ... in skin temperature, color, or texture Intense burning pain Extreme skin sensitivity Swelling and stiffness in affected ...

  7. When Sex Is Painful

    MedlinePlus

    ... AQ FREQUENTLY ASKED QUESTIONS GYNECOLOGIC PROBLEMS FAQ020 When Sex Is Painful • How common is painful sex? • What causes pain during sex? • Where is pain during sex felt? • When should ...

  8. Back Pain During Pregnancy

    MedlinePlus

    ... Advocacy For Patients About ACOG Back Pain During Pregnancy Home For Patients Search FAQs Back Pain During ... FAQ115, January 2016 PDF Format Back Pain During Pregnancy Pregnancy What causes back pain during pregnancy? How ...

  9. Smartphone applications for pain management.

    PubMed

    Rosser, Benjamin A; Eccleston, Christopher

    2011-01-01

    Smartphone applications (or apps) are becoming increasingly popular. The lack of regulation or guidance for health-related apps means that the validity and reliability of their content is unknown. We have conducted a review of available apps relating to the generic condition of pain. The official application stores for five major smartphone platforms were searched: iPhone, Android, Blackberry, Nokia/Symbian and Windows Mobile. Apps were included if they reported a focus on pain education, management or relief, and were not solely aimed at health-care professionals (HCPs). A total of 111 apps met the inclusion criteria. The majority of apps reviewed claimed some information provision or electronic manual component. Diary tracking of pain variables was also a common feature. There was a low level of stated HCP involvement in app development and content. Despite an increasing number of apps being released, the frequency of HCP involvement is not increasing. Pain apps appear to be able to promise pain relief without any concern for the effectiveness of the product, or for possible adverse effects of product use. In a population often desperate for a solution to distressing and debilitating pain conditions, there is considerable risk of individuals being misled.

  10. Assessment and treatment of pain in children and adolescents.

    PubMed

    Lalloo, Chitra; Stinson, Jennifer N

    2014-04-01

    Pain is one of the most common and distressing symptoms experienced by children and adolescents with juvenile idiopathic arthritis. Pain is known to negatively affect all aspects of health-related quality of life, including physical, emotional, social, and role functioning. The valid and reliable assessment of pain is the first critical step to developing an effective plan for pain management. This chapter will address the following key questions: (1) What is the prevalence and impact of pain in children and adolescents with arthritis? (2) Why is it important for clinicians to assess the multidimensional nature of pain and what are the practical issues that should be considered? (3) What tools are available to help clinicians to assess pain? (4) How can Internet and mobile technologies be used to improve the assessment of pain? (5) What are the recommended strategies for clinically managing pain, including pharmacological, physical, and psychological approaches?

  11. Pain when love is near

    NASA Astrophysics Data System (ADS)

    Tamam, S.; Ahmad, A. H.; Aziz, M. E.; Kamil, W. A.

    2017-05-01

    The aim of the study is to investigate brain responses to acute laser pain when a loved one is nearby. Laser pain stimuli at individual pain threshold were delivered using Th:YAG laser to 17 female participants. The participants were categorised into two groups, Love Hurts or Love Heals, according to their responses to pain stimulation during the presence of their loved ones. fMRI brain activation was obtained using 3 T Philips Achieva MRI scanner utilising blocked design paradigm comprising 15 blocks of stimulation phase and 15 blocks of no stimulation. fMRI images were analysed using statistical parametric mapping (SPM) focusing on random effects (RFX) analysis. We found that both groups activated pain-related areas such as the thalamus, secondary somatosensory cortex, insula and cingulate cortex. However, Love Hurts showed more activity in thalamus, parahippocampal gyrus and hippocampus; while Love Heals showed more activity in the entire part of cingulate cortex during the presence of their loved ones. In conclusion, there may be specific brain regions responsible for modulation of pain due to the presence of a loved one thus manifesting as Love Hurts or Love Heals.

  12. Mechanistic experimental pain assessment in computer users with and without chronic musculoskeletal pain.

    PubMed

    Ge, Hong-You; Vangsgaard, Steffen; Omland, Øyvind; Madeleine, Pascal; Arendt-Nielsen, Lars

    2014-12-06

    Musculoskeletal pain from the upper extremity and shoulder region is commonly reported by computer users. However, the functional status of central pain mechanisms, i.e., central sensitization and conditioned pain modulation (CPM), has not been investigated in this population. The aim was to evaluate sensitization and CPM in computer users with and without chronic musculoskeletal pain. Pressure pain threshold (PPT) mapping in the neck-shoulder (15 points) and the elbow (12 points) was assessed together with PPT measurement at mid-point in the tibialis anterior (TA) muscle among 47 computer users with chronic pain in the upper extremity and/or neck-shoulder pain (pain group) and 17 pain-free computer users (control group). Induced pain intensities and profiles over time were recorded using a 0-10 cm electronic visual analogue scale (VAS) in response to different levels of pressure stimuli on the forearm with a new technique of dynamic pressure algometry. The efficiency of CPM was assessed using cuff-induced pain as conditioning pain stimulus and PPT at TA as test stimulus. The demographics, job seniority and number of working hours/week using a computer were similar between groups. The PPTs measured at all 15 points in the neck-shoulder region were not significantly different between groups. There were no significant differences between groups neither in PPTs nor pain intensity induced by dynamic pressure algometry. No significant difference in PPT was observed in TA between groups. During CPM, a significant increase in PPT at TA was observed in both groups (P < 0.05) without significant differences between groups. For the chronic pain group, higher clinical pain intensity, lower PPT values from the neck-shoulder and higher pain intensity evoked by the roller were all correlated with less efficient descending pain modulation (P < 0.05). This suggests that the excitability of the central pain system is normal in a large group of computer users with low pain intensity

  13. Reliability computation from reliability block diagrams

    NASA Technical Reports Server (NTRS)

    Chelson, P. O.; Eckstein, R. E.

    1971-01-01

    A method and a computer program are presented to calculate probability of system success from an arbitrary reliability block diagram. The class of reliability block diagrams that can be handled include any active/standby combination of redundancy, and the computations include the effects of dormancy and switching in any standby redundancy. The mechanics of the program are based on an extension of the probability tree method of computing system probabilities.

  14. Human Reliability Program Overview

    SciTech Connect

    Bodin, Michael

    2012-09-25

    This presentation covers the high points of the Human Reliability Program, including certification/decertification, critical positions, due process, organizational structure, program components, personnel security, an overview of the US DOE reliability program, retirees and academia, and security program integration.

  15. Power electronics reliability analysis.

    SciTech Connect

    Smith, Mark A.; Atcitty, Stanley

    2009-12-01

    This report provides the DOE and industry with a general process for analyzing power electronics reliability. The analysis can help with understanding the main causes of failures, downtime, and cost and how to reduce them. One approach is to collect field maintenance data and use it directly to calculate reliability metrics related to each cause. Another approach is to model the functional structure of the equipment using a fault tree to derive system reliability from component reliability. Analysis of a fictitious device demonstrates the latter process. Optimization can use the resulting baseline model to decide how to improve reliability and/or lower costs. It is recommended that both electric utilities and equipment manufacturers make provisions to collect and share data in order to lay the groundwork for improving reliability into the future. Reliability analysis helps guide reliability improvements in hardware and software technology including condition monitoring and prognostics and health management.

  16. Geologic map of Mars

    USGS Publications Warehouse

    Tanaka, Kenneth L.; Skinner, James A.; Dohm, James M.; Irwin, Rossman P.; Kolb, Eric J.; Fortezzo, Corey M.; Platz, Thomas; Michael, Gregory G.; Hare, Trent M.

    2014-01-01

    This global geologic map of Mars, which records the distribution of geologic units and landforms on the planet's surface through time, is based on unprecedented variety, quality, and quantity of remotely sensed data acquired since the Viking Orbiters. These data have provided morphologic, topographic, spectral, thermophysical, radar sounding, and other observations for integration, analysis, and interpretation in support of geologic mapping. In particular, the precise topographic mapping now available has enabled consistent morphologic portrayal of the surface for global mapping (whereas previously used visual-range image bases were less effective, because they combined morphologic and albedo information and, locally, atmospheric haze). Also, thermal infrared image bases used for this map tended to be less affected by atmospheric haze and thus are reliable for analysis of surface morphology and texture at even higher resolution than the topographic products.

  17. Mapping functional connectivity

    Treesearch

    Peter Vogt; Joseph R. Ferrari; Todd R. Lookingbill; Robert H. Gardner; Kurt H. Riitters; Katarzyna Ostapowicz

    2009-01-01

    An objective and reliable assessment of wildlife movement is important in theoretical and applied ecology. The identification and mapping of landscape elements that may enhance functional connectivity is usually a subjective process based on visual interpretations of species movement patterns. New methods based on mathematical morphology provide a generic, flexible,...

  18. Central poststroke pain: A systematic review.

    PubMed

    Singer, Jonathan; Conigliaro, Alyssa; Spina, Elizabeth; Law, Susan W; Levine, Steven R

    2017-06-01

    Background Physical, psychological, and/or social impairment can result after a stroke and can be exacerbated by pain. One type of pain after stroke, central poststroke pain, is believed to be due to primary central nervous system mechanisms. Estimated prevalence of central poststroke pain ranges widely from 8% to 55% of stroke patients, suggesting a difficulty in reliably, accurately, and consistently identifying central poststroke pain. This may be due to the absence of a generally accepted definition. Aim We aimed to clarify the role of thalamic strokes and damage to the spinothalamic pathway in central poststroke pain patients. Also, we aimed to gain a current understanding of anatomic substrates, brain imaging, and treatment of central poststroke pain. Summary of review Two independent reviewers identified 10,144 publications. Based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we extracted data from 23 papers and categorized the articles' aims into four sections: somatosensory deficits, pathway stimulation, clinical trials, and brain imaging. Conclusions Our systematic review suggests that damage to the spinothalamic pathway is associated with central poststroke pain and this link could provide insights into mechanisms and treatment. Moreover, historical connection of strokes in the thalamic region of the brain and central poststroke pain should be reevaluated as many studies noted that strokes in other regions of the brain have high occurrence of central poststroke pain as well.

  19. Pain complaint and the weather: weather sensitivity and symptom complaints in chronic pain patients.

    PubMed

    Shutty, M S; Cundiff, G; DeGood, D E

    1992-05-01

    Chronic pain patients frequently report that weather conditions affect their pain; however, no standardized measures of weather sensitivity have been developed. We describe the development and use of the Weather and Pain Questionnaire (WPQ) which assess patient sensitivity to meteorologic variables defined by the National Weather Service (e.g., temperature, precipitation). Seventy chronic pain patients (59% females) with an average age of 43 years completed the WPQ. The instrument was revised using factor analysis to produce a Weather Sensitivity Index (WSI) (48% of variance) with high internal consistency (0.93) and test-retest reliability (r = 0.89). Reporting patterns suggested that patients could reliably identify which meteorologic variables influenced their pain but could not reliably determine which physical symptoms were consistently affected. The most frequently reported meteorologic variables which affect pain complaint were temperature (87%) and humidity (77%). The most frequently reported physical complaints associated with the weather were joint and muscle aches (82% and 79%, respectively). Patients labeled as being 'weather sensitive', defined by greater than median scores on the WPQ, reported significantly greater pain intensity, greater chronicity of pain problems, and more difficulties sleeping than patients with low scores on the WPQ. No differences in gender, education level, disability status, or global psychological distress were found. Results are discussed with respect to physiological and psychological mediating variables.

  20. Pain extent is associated with pain intensity but not with widespread pressure or thermal pain sensitivity in women with fibromyalgia syndrome.

    PubMed

    Barbero, Marco; Fernández-de-Las-Peñas, César; Palacios-Ceña, María; Cescon, Corrado; Falla, Deborah

    2017-06-01

    Widespread pain is considered a sign of central sensitization in people with chronic pain. Our aim was to examine whether pain extent, assessed from the pain drawing, relates to measures from quantitative sensory testing in fibromyalgia syndrome (FMS). Thirty women with FMS and no other co-morbid conditions completed pain drawings (dorsal and ventral views) and clinical and related disability questionnaires. Pain extent and pain frequency maps were obtained from the pain drawings using a novel customized software. Pressure pain thresholds were assessed over the 18 tender points considered by the 1990 American College of Rheumatology criteria for FMS diagnosis and over two additional standardized points. Heat and cold pain thresholds were also assessed on the dorsal aspect of the neck, the dorsal aspect of the wrist, and the tibialis anterior. Spearman's correlation coefficients were used to assess the relationship between pain extent and quantitative sensory testing outcomes as well as clinical symptoms. Larger extent of pain was associated with a higher pain intensity (dorsal area: r s = 0.461, P = 0.010; total area: r s = 0.593, P = 0.001), younger age (ventral area: r s = -0.544, P = 0.002; total area: r s = -0.409, P = 0.025), shorter history of pain (ventral area: r s = -0.367, P = 0.046), and higher cold pain thresholds over the tibialis anterior muscle (r s = -0.406, P = 0.001). No significant association was observed between pain extent and the remaining outcomes. Pain drawings constitute an easy and accurate approach to quantify widespread pain. Larger pain extent is associated with pain intensity but not with signs of central sensitization in women with FMS.

  1. Reliable Design Versus Trust

    NASA Technical Reports Server (NTRS)

    Berg, Melanie; LaBel, Kenneth A.

    2016-01-01

    This presentation focuses on reliability and trust for the users portion of the FPGA design flow. It is assumed that the manufacturer prior to hand-off to the user tests FPGA internal components. The objective is to present the challenges of creating reliable and trusted designs. The following will be addressed: What makes a design vulnerable to functional flaws (reliability) or attackers (trust)? What are the challenges for verifying a reliable design versus a trusted design?

  2. Integrated avionics reliability

    NASA Technical Reports Server (NTRS)

    Alikiotis, Dimitri

    1988-01-01

    The integrated avionics reliability task is an effort to build credible reliability and/or performability models for multisensor integrated navigation and flight control. The research was initiated by the reliability analysis of a multisensor navigation system consisting of the Global Positioning System (GPS), the Long Range Navigation system (Loran C), and an inertial measurement unit (IMU). Markov reliability models were developed based on system failure rates and mission time.

  3. Socioeconomic value of intervention for chronic pain.

    PubMed

    Takura, Tomoyuki; Shibata, Masahiko; Inoue, Shinsuke; Matsuda, Yoichi; Uematsu, Hironobu; Yamada, Keiko; Ushida, Takahiro

    2016-08-01

    The purpose of this study was to examine the cost-effectiveness of pain treatments in two pain centers in Japan. The study population comprised 91 patients receiving various treatments for chronic pain, which were divided into three categories: (1) medication, (2) medication + nerve block, and (3) other modalities (exercise and/or pain education). Pain was assessed using the Pain Disability Assessment Scale (PDAS) score, Hospital Anxiety and Depression Scale (HADS) score, Pain Catastrophizing Scale (PCS) score, and EQ-5D score. First, the reliability of the EQ-5D score first assessed by evaluating the correlation this score with those of the other pain-related evaluation instruments, and then the cost effectiveness of the pain treatments was evaluated. Evaluation of medical costs was based on data provided from the Management Services of the hospital, which in turn were based on national health scheme medical treatment fees. The quality-adjusted life year (QALY) value was calculated from the EQ-5D score, converted to 12 months, and then used for cost-benefit analysis along with medical treatment fees. According to the recent IASP classification, more patients had chronic neuropathic pain (41) than chronic primary pain (37 patients) or chronic musculoskeletal pain (27 patients). There was a significant correlation between the EQ-5D score and the PDAS, HADS, and PCS scores, which demonstrated the reliability of the EQ-5D score. Significant improvement in the HADS, PCS, and EQ-5D scores was noted after 3 months of pain treatment. Calculation of the cost-effectiveness based on the estimated annual medical treatment cost and QALY revealed a mean value of US $45,879 ± 103,155 per QALY (median US $16,903), indicating adequate socioeconomic utility. Based on our results, the EQ-5D is reliable for evaluating chronic pain in patients. The medico-economic balance was appropriate for all treatments provided in two comprehensive pain centers in Japan.

  4. Neuropathic pain.

    PubMed

    Koltzenburg, M; Scadding, J

    2001-10-01

    Damage to peripheral nerves triggers a cascade of events in axotomized sensory neurones that are generally believed to be responsible for the generation of neuropathic pain. Recent data in animal models show that alterations in the properties of undamaged neurones that project into a damaged nerve can also play an important role. These new findings could explain some of the enigmatic clinical signs and symptoms of pain following nerve injury such as the spread of symptoms into areas not affected by the primary lesion. The basis by which uninjured nerves could be affected is a reduced supply of neurotrophic factors, an abnormal interaction in the Remak bundles of partially denervated Schwann cells and unmyelinated axons, or the byproducts of Wallerian degeneration.

  5. Theory of reliable systems

    NASA Technical Reports Server (NTRS)

    Meyer, J. F.

    1975-01-01

    An attempt was made to refine the current notion of system reliability by identifying and investigating attributes of a system which are important to reliability considerations. Techniques which facilitate analysis of system reliability are included. Special attention was given to fault tolerance, diagnosability, and reconfigurability characteristics of systems.

  6. Reliability as Argument

    ERIC Educational Resources Information Center

    Parkes, Jay

    2007-01-01

    Reliability consists of both important social and scientific values and methods for evidencing those values, though in practice methods are often conflated with the values. With the two distinctly understood, a reliability argument can be made that articulates the particular reliability values most relevant to the particular measurement situation…

  7. Viking Lander reliability program

    NASA Technical Reports Server (NTRS)

    Pilny, M. J.

    1978-01-01

    The Viking Lander reliability program is reviewed with attention given to the development of the reliability program requirements, reliability program management, documents evaluation, failure modes evaluation, production variation control, failure reporting and correction, and the parts program. Lander hardware failures which have occurred during the mission are listed.

  8. Reliability model generator specification

    NASA Technical Reports Server (NTRS)

    Cohen, Gerald C.; Mccann, Catherine

    1990-01-01

    The Reliability Model Generator (RMG), a program which produces reliability models from block diagrams for ASSIST, the interface for the reliability evaluation tool SURE is described. An account is given of motivation for RMG and the implemented algorithms are discussed. The appendices contain the algorithms and two detailed traces of examples.

  9. Reliability and structural integrity

    NASA Technical Reports Server (NTRS)

    Davidson, J. R.

    1976-01-01

    An analytic model is developed to calculate the reliability of a structure after it is inspected for cracks. The model accounts for the growth of undiscovered cracks between inspections and their effect upon the reliability after subsequent inspections. The model is based upon a differential form of Bayes' Theorem for reliability, and upon fracture mechanics for crack growth.

  10. Predicting software reliability

    NASA Technical Reports Server (NTRS)

    Littlewood, B.

    1989-01-01

    A detailed look is given to software reliability techniques. A conceptual model of the failure process is examined, and some software reliability growth models are discussed. Problems for which no current solutions exist are addressed, emphasizing the very difficult problem of safety-critical systems for which the reliability requirements can be enormously demanding.

  11. The psychometric properties of an Arabic numeric pain rating scale for measuring osteoarthritis knee pain.

    PubMed

    Alghadir, Ahmad H; Anwer, Shahnawaz; Iqbal, Zaheen Ahmed

    2016-12-01

    The aims of this study were to translate the numeric rating scale (NRS) into Arabic and to evaluate the test-retest reliability and convergent validity of an Arabic Numeric Pain Rating Scale (ANPRS) for measuring pain in osteoarthritis (OA) of the knee. The English version of the NRS was translated into Arabic as per the translation process guidelines for patient-rated outcome scales. One hundred twenty-one consecutive patients with OA of the knee who had experienced pain for more than 6 months were asked to report their pain levels on the ANPRS, visual analogue scale (VAS), and verbal rating scale (VRS). A second assessment was performed 48 h after the first to assess test-retest reliability. The test-retest reliability was calculated using the intraclass correlation coefficient (ICC2,1). The convergent validity was assessed using Spearman rank correlation coefficient. In addition, the minimum detectable change (MDC) and standard error of measurement (SEM) were also assessed. The repeatability of ANPRS was good to excellent (ICC 0.89). The SEM and MDC were 0.71 and 1.96, respectively. Significant correlations were found with the VAS and VRS scores (p <0.01). The Arabic numeric pain rating scale is a valid and reliable scale for measuring pain levels in OA of the knee. Implications for Rehabilitation The Arabic Numeric Pain Rating Scale (ANPRS) is a reliable and valid instrument for measuring pain in osteoarthritis (OA) of the knee, with psychometric properties in agreement with other widely used scales. The ANPRS is well correlated with the VAS and NRS scores in patients with OA of the knee. The ANPRS appears to measure pain intensity similar to the VAS, NRS, and VRS and may provide additional advantages to Arab populations, as Arabic numbers are easily understood by this population.

  12. Neck pain

    PubMed Central

    2008-01-01

    Introduction Non-specific neck pain has a postural or mechanical basis and affects about two thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks, but may become chronic in about 10% of people. Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents. Up to 40% of people continue to report symptoms 15 years after the accident, although this varies between countries. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for people with non-specific neck pain without severe neurological deficit? What are the effects of treatments for acute whiplash injury? What are the effects of treatments for chronic whiplash injury? What are the effects of treatments for neck pain with radiculopathy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 91 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of the evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, biofeedback, drug treatments (analgesics, antidepressants, epidural steroid injections, muscle relaxants, non-steroidal anti-inflammatory drugs [NSAIDs]), early mobilisation, early return to normal activity, exercise, heat or cold, manipulation (alone or plus exercise), mobilisation, multimodal treatment, patient education, percutaneous radiofrequency neurotomy

  13. Electronic pain assessment in clinical practice.

    PubMed

    Marceau, Lisa D; Smith, Lauren D; Jamison, Robert N

    2011-07-01

    SUMMARY The assessment and treatment of chronic pain remains an international challenge for healthcare providers among aging patients and rising healthcare costs. This article provides a brief overview of studies on the use of electronic pain diaries and innovative software programs for pain assessment and monitoring among providers and persons with chronic pain. The advent of software pain monitoring programs on smart phones, personal digital assistants and internet-based tracking allow for the collection of large datasets of momentary data to better assist in the management of chronic pain. Electronic tracking in the home and clinic can improve data quality and reduce the biases of recalled information compared with paper diaries and questionnaires. Furthermore, 3D pain mapping programs can enable patients to represent the location and intensity of their pain with greater accuracy. However, despite the benefits, there are a number of barriers to incorporating electronic pain assessment into daily clinical practice. Additional control trials and clinical investigations are needed to demonstrate the efficacy and benefit of electronic pain assessment over and above standard practices.

  14. RAP Project-an instrument development study to determine common attributes for pain assessment among men and women who represent multiple pain-related diagnoses.

    PubMed

    Richards, Kandyce M

    2008-03-01

    Inadequate pain assessment by nurses is a primary barrier to provision of optimum pain relief and may contribute, in part, to the epidemiologic health problem of unrelieved pain. In this three-phase study, both qualitative and quantitative methods were used to develop, revise, and test a multidimensional pain assessment instrument, theoretically supported for use with all adult patients experiencing pain, for the purpose of contributing to a systematic global approach to comprehensive pain assessment. In phase 1, instrument items were inductively derived from interviews of participants experiencing homogeneous pain. In phase 2, sensitivity of items to heterogeneous pain was established through focus groups and interviews of participants reporting multiple pain problems. In phase 3, psychometric properties were evaluated with subjects representing a variety of pain-related diagnoses. Cronbach's alpha for the global score of the instrument was 0.89. Factor analysis indicated three domains of heterogeneous pain: "learning to live with pain" (nine items), "thinking and feeling pain" (fifteen items), and "perceiving controllability of pain" (six items). Triangulation of phase 3 item clusters with phase 2 data provided a framework for substantive interpretation of factors, identification of heterogeneous pain attributes, and validation of category themes that emerged in phase 1. Preliminary evidence supported initial reliability and validity, indicating sensitivity of the Richards Assessment of Pain (RAP) instrument to heterogeneous pain. Substantive interpretation of RAP factors revealed attributes of heterogeneous pain that may contribute to global pain assessment for all patients with pain.

  15. Calibration of the Dutch-Flemish PROMIS Pain Behavior item bank in patients with chronic pain.

    PubMed

    Crins, M H P; Roorda, L D; Smits, N; de Vet, H C W; Westhovens, R; Cella, D; Cook, K F; Revicki, D; van Leeuwen, J; Boers, M; Dekker, J; Terwee, C B

    2016-02-01

    The aims of the current study were to calibrate the item parameters of the Dutch-Flemish PROMIS Pain Behavior item bank using a sample of Dutch patients with chronic pain and to evaluate cross-cultural validity between the Dutch-Flemish and the US PROMIS Pain Behavior item banks. Furthermore, reliability and construct validity of the Dutch-Flemish PROMIS Pain Behavior item bank were evaluated. The 39 items in the bank were completed by 1042 Dutch patients with chronic pain. To evaluate unidimensionality, a one-factor confirmatory factor analysis (CFA) was performed. A graded response model (GRM) was used to calibrate the items. To evaluate cross-cultural validity, Differential item functioning (DIF) for language (Dutch vs. English) was evaluated. Reliability of the item bank was also examined and construct validity was studied using several legacy instruments, e.g. the Roland Morris Disability Questionnaire. CFA supported the unidimensionality of the Dutch-Flemish PROMIS Pain Behavior item bank (CFI = 0.960, TLI = 0.958), the data also fit the GRM, and demonstrated good coverage across the pain behavior construct (threshold parameters range: -3.42 to 3.54). Analysis showed good cross-cultural validity (only six DIF items), reliability (Cronbach's α = 0.95) and construct validity (all correlations ≥0.53). The Dutch-Flemish PROMIS Pain Behavior item bank was found to have good cross-cultural validity, reliability and construct validity. The development of the Dutch-Flemish PROMIS Pain Behavior item bank will serve as the basis for Dutch-Flemish PROMIS short forms and computer adaptive testing (CAT). © 2015 European Pain Federation - EFIC®

  16. Planetary maps

    USGS Publications Warehouse

    ,

    1992-01-01

    An important goal of the USGS planetary mapping program is to systematically map the geology of the Moon, Mars, Venus, and Mercury, and the satellites of the outer planets. These geologic maps are published in the USGS Miscellaneous Investigations (I) Series. Planetary maps on sale at the USGS include shaded-relief maps, topographic maps, geologic maps, and controlled photomosaics. Controlled photomosaics are assembled from two or more photographs or images using a network of points of known latitude and longitude. The images used for most of these planetary maps are electronic images, obtained from orbiting television cameras, various optical-mechanical systems. Photographic film was only used to map Earth's Moon.

  17. Measurement of pain: the psychometric properties of the Pain-O-Meter, a simple, inexpensive pain assessment tool that could change health care practices.

    PubMed

    Gaston-Johansson, F

    1996-09-01

    A self-administered pain assessment tool called the Pain-O-Meter (POM) was developed for the purposes of improving assessment and management of pain in acute and chronic pain patients. The POM is a hard, white, plastic tool that measures 8-in. long by 2-in. wide and 1-in. thick. Two methods for assessing pain are located on the POM. The first is a 10-cm visual analogue scale (POM-VAS) with a moveable marker that patients use to rate their pain. The second is a list of 15 sensory and 11 affective word descriptors (WDS). Each WDS is assigned an intensity value that can be as low as 1 or as high as 5. A pain intensity score is provided for the sensory and the affective WDSs. This psychometric study, which employed correlational and comparative designs, investigated the test-retest reliability and the concurrent and construct validity of the POM-VAS and the POM-WDS in 279 patients with acute or chronic pain. High correlations were found between initial and repeat pain intensity ratings on the POM-VAS (r = 0.88, P < 0.001) and POM-WDS (r + 0.84, P < 0.001) (test-retest reliability). Correlations between the POM-WDS and the McGill Pain Questionnaire (MPQ) (r = 0.69, P < 0.001) and POM-VAS (r = 0.85, P < 0.001) supported the concurrent validity of the POM-WDS. Construct validity was also supported for the Pain-O-Meter by showing that pain scores decreased significantly for POM-WDS (t + 5.53, P < 0.001), and POM-VAS (t = 6.18, P < 0.001) after the patients were treated with pain medication. The use of a pain tool, such as the POM, could improve patient care by facilitating the documentation of pain and evaluation of pain relief measures.

  18. Independent validation of the Pain Management Plan in a multi-disciplinary pain team setting

    PubMed Central

    Quinlan, Joanna; Hughes, Richard; Laird, David

    2016-01-01

    Context/background: The Pain Management Plan (PP) is a brief cognitive behavioural therapy (CBT) self-management programme for people living with persistent pain that can be individually facilitated or provided in a group setting. Evidence of PP efficacy has been reported previously by the pain centres involved in its development. Objectives: To provide a fully independent evaluation of the PP and compare these with the findings reported by Cole et al. Methods: The PP programme was delivered by the County Durham Pain Team (Co. Durham PT) as outlined in training sessions led by Cole et al. Pre- and post-quantitative/patient experience measures were repeated with reliable and clinical significant change determined and compared to the original evaluation. Results: Of the 69 participants who completed the programme, 33% achieved reliable change and 20% clinical significant change using the Pain Self-Efficacy Questionnaire (PSEQ). Across the Brief Pain Inventory (BPI) interference domains between 11% and 22% of participants achieved clinical significant change. There were high levels of positive patient feedback with 25% of participants scoring 100% satisfaction. The mean participant satisfaction across the population was 88%. Conclusion: The results from this evaluation validate those reported by Cole et al. It demonstrates clinically significant improvement in pain and health functioning and high patient appreciation results. Both evaluations emphasise the potential of this programme as an early intervention delivered within a stratified care pain pathway. This approach could optimise the use of finite resources and improve wider access to pain management. PMID:27867506

  19. Confirmatory factor analysis of the pain care quality surveys (PainCQ©).

    PubMed

    Pett, Marjorie A; Beck, Susan L; Guo, Jia-Wen; Towsley, Gail L; Brant, Jeannine M; Lavoie Smith, Ellen M; Berry, Patricia H; Donaldson, Gary W

    2013-06-01

    To examine the reliability and validity and to decrease the battery of items in the Pain Care Quality (PainCQ(©) ) Surveys. Patient-reported data were collected prospectively from 337 hospitalized adult patients with pain on medical/surgical oncology units in four hospitals in three states. This methodological study used a cross-sectional survey design. Each consenting patient completed two PainCQ(©) Surveys, the Brief Pain Inventory-Short Form, and demographic questions. Clinical data were extracted from the medical record. All data were double entered into a Microsoft Access database, cleaned, and then extracted into SPSS, AMOS, and Mplus for analysis. Confirmatory factor analysis using Structural Equation Modeling supported the initial factor structure. Modification indices guided decisions that resulted in a superior, parsimonious model for the PainCQ-Interdisciplinary Care Survey (six items, two subscales) and the PainCQ-Nursing Care Survey (14 items, three subscales). Cronbach's alpha coefficients all exceeded .80. Cumulative evidence supports the reliability and validity of the companion PainCQ(©) Surveys in hospitalized patients with pain in the oncology setting. The tools may be relevant in both clinical research and quality improvement. Future research is recommended in other populations, settings, and with more diverse groups. © Health Research and Educational Trust.

  20. Facial Pain

    MedlinePlus

    ... yourself? About Stephen J. Schueler, M.D News Advertising How It Works FAQ for Consumers FAQ for Physicians Testimonials Site Map Terms of Use Contact Us FreeMD is provided for information purposes only and should not be used as a ...

  1. Chest Pain

    MedlinePlus

    ... yourself? About Stephen J. Schueler, M.D News Advertising How It Works FAQ for Consumers FAQ for Physicians Testimonials Site Map Terms of Use Contact Us FreeMD is provided for information purposes only and should not be used as a ...

  2. Coccygeal Pain

    MedlinePlus

    ... yourself? About Stephen J. Schueler, M.D News Advertising How It Works FAQ for Consumers FAQ for Physicians Testimonials Site Map Terms of Use Contact Us FreeMD is provided for information purposes only and should not be used as a ...

  3. Dental Pain

    MedlinePlus

    ... yourself? About Stephen J. Schueler, M.D News Advertising How It Works FAQ for Consumers FAQ for Physicians Testimonials Site Map Terms of Use Contact Us FreeMD is provided for information purposes only and should not be used as a ...

  4. [Postoperative pain.].

    PubMed

    Bergmann, H

    1987-07-01

    A short survey about the different methods available for producing postoperative analgesia is given, the goal being to make it clear to the clinician that there are quite a number of techniques to be used although the everyday clinical practice often sticks to simple and not too effective methods of pain treatment following surgery. Initially presenting short informations about the neurophysiology of pain and the pathogenesis and causes of postoperative pain two main groups of producing analgesia are then discussed.Thefirst group deals with the systemic use of analgesics be it nonnarcotic analgesic antipyretics or narcotic analgesics (opioids). As for the first subgroup the peripheral action of these drugs (metamizol, acetylsalicylic acid, paracetamol) is brought about by blocking the synthesis of prostaglandins. These substances can only be used for very moderate postoperative pain f.i. following head and neck surgery. The strong acting opioids belong to the second subgroup. Recent informations on receptor sites in the brain and cord and the subgrouping of the receptors throws new light on the understanding of the different effects of these drugs and on the pathomechanisms of agonistic, antagonistic and mixed activities. The clinically used opioids then are mentioned (morphine, fentanyl, methadon, pethidin, piritramide, tilidin, buprenorphin and pentazocine) and dosage, duration of action, antagonisms and untoward side effects are presented. Stress is laid on the recent development of patient-controlled analgesia with all its advantages. Thesecond main group of methods for postoperative analgesia consists of regional anesthesia techniques as there are brachial plexus block, intercostal block and the continuous epidural analgesia using both local anesthetics and spinal opioids. The brachial plexus block in continuous form is absolutely able to prevent pain after operations in the shoulder-arm-region and can be prolonged even for weeks using catheter techniques. The

  5. The story of the Texas Pain Society: formation and function of a regional pain society.

    PubMed

    Raj, P Prithvi; Hill, C Stratton; Racz, Gabor; Heavner, James; Grabois, Martin; Neill, Lynn; Willis, William; Schade, C M; Rashbaum, Ralph; Calodney, Aaron; Burton, Allen W; Somerville, Judson

    2012-01-01

    The idea of forming a Texas Pain Society came to the Founders in 1987 due to disparity and deficiencies in the practice of pain management in the United States and, in particular, the State of Texas. The Founders considered very carefully the implication of forming such a society. They diligently mapped out the mission and goals of the Texas Pain Society in those early formative years. This report is the history of Texas Pain Society as the activities unfolded from 1989 to 2011. The reader may question why there is a need to tell such a story. We believe strongly that, with disparities of standards of practice in pain medicine and poor recognition of advances in pain management, this scenario is quite common in many states and countries. The practitioners of pain management in these regions certainly must have considered getting together and forming a consensus on the standards of practice in their communities. This historical report of the Texas Pain Society provides the relevant information necessary and the efforts to be made for a society's mission to achieve its goals and have an ongoing impact in its own region. We hope that we have shed some light on a process for the formation of a regional pain society such as ours.  © 2011 The Authors. Pain Practice © 2011 World Institute of Pain.

  6. Inherited Pain

    PubMed Central

    Eberhardt, Mirjam; Nakajima, Julika; Klinger, Alexandra B.; Neacsu, Cristian; Hühne, Kathrin; O'Reilly, Andrias O.; Kist, Andreas M.; Lampe, Anne K.; Fischer, Kerstin; Gibson, Jane; Nau, Carla; Winterpacht, Andreas; Lampert, Angelika

    2014-01-01

    Inherited erythromelalgia (IEM) causes debilitating episodic neuropathic pain characterized by burning in the extremities. Inherited “paroxysmal extreme pain disorder” (PEPD) differs in its clinical picture and affects proximal body areas like the rectal, ocular, or jaw regions. Both pain syndromes have been linked to mutations in the voltage-gated sodium channel Nav1.7. Electrophysiological characterization shows that IEM-causing mutations generally enhance activation, whereas mutations leading to PEPD alter fast inactivation. Previously, an A1632E mutation of a patient with overlapping symptoms of IEM and PEPD was reported (Estacion, M., Dib-Hajj, S. D., Benke, P. J., Te Morsche, R. H., Eastman, E. M., Macala, L. J., Drenth, J. P., and Waxman, S. G. (2008) NaV1.7 Gain-of-function mutations as a continuum. A1632E displays physiological changes associated with erythromelalgia and paroxysmal extreme pain disorder mutations and produces symptoms of both disorders. J. Neurosci. 28, 11079–11088), displaying a shift of both activation and fast inactivation. Here, we characterize a new mutation of Nav1.7, A1632T, found in a patient suffering from IEM. Although transfection of A1632T in sensory neurons resulted in hyperexcitability and spontaneous firing of dorsal root ganglia (DRG) neurons, whole-cell patch clamp of transfected HEK cells revealed that Nav1.7 activation was unaltered by the A1632T mutation but that steady-state fast inactivation was shifted to more depolarized potentials. This is a characteristic normally attributed to PEPD-causing mutations. In contrast to the IEM/PEPD crossover mutation A1632E, A1632T failed to slow current decay (i.e. open-state inactivation) and did not increase resurgent currents, which have been suggested to contribute to high-frequency firing in physiological and pathological conditions. Reduced fast inactivation without increased resurgent currents induces symptoms of IEM, not PEPD, in the new Nav1.7 mutation, A1632T

  7. Central hypersensitivity in chronic musculoskeletal pain.

    PubMed

    Curatolo, Michele; Arendt-Nielsen, Lars

    2015-05-01

    Clinical research has consistently detected alteration in central pain processing leading to hypersensitivity. Most methods used in humans are reliable and have face validity to detect widespread central hypersensitivity. However, construct validity is difficult to investigate due to lack of gold standards. Reference values in the pain-free population have been generated, but need replication. Research on pain biomarkers that reflect specific central hypersensitivity processes is warranted. Few studies have analyzed the prognostic value of central hypersensitivity. Most medications acting at central level and some non-pharmacological approaches, including psychological interventions, are likely to attenuate central hypersensitivity.

  8. Pain sensitivity can be assessed by self-rating: Development and validation of the Pain Sensitivity Questionnaire.

    PubMed

    Ruscheweyh, Ruth; Marziniak, Martin; Stumpenhorst, Frederike; Reinholz, Julia; Knecht, Stefan

    2009-11-01

    Experimental determination of pain sensitivity has received increasing attention because of emerging clinical applications (including prediction of postoperative pain and treatment response) and scientific implications (e.g. it has been proposed that above-average pain sensitivity is a risk factor for the development of chronic pain disorders). However, the use of experimental pain sensitivity assessment on a broad scale is hampered by its requirements on time, equipment and human resources and the fact that it is painful for the tested subject. Alternatives to experimental pain testing are currently lacking. Here we developed a self-rating instrument for the assessment of pain sensitivity, the Pain Sensitivity Questionnaire (PSQ) that is based on pain intensity ratings of daily life situations and takes 5-10min to complete. Adequate reliability of the PSQ was confirmed in 354 subjects. In a validation study comprising 47 healthy subjects, the results of comprehensive experimental pain testing, including different modalities (heat, cold, pressure, and pinprick) and different measures (pain thresholds, pain intensity ratings), were compared to the results of the PSQ. PSQ scores were significantly correlated to experimental pain intensity ratings (r = 0.56, p < 0.001) but not to pain thresholds (r = 0.03). Prediction of experimental pain intensity ratings by the PSQ was better than by pain-associated psychological factors (pain catastrophizing, depression, anxiety). This shows that the PSQ may be a simple alternative to experimental pain intensity rating procedures in healthy subjects and makes the PSQ a highly promising tool for clinical and experimental pain research.

  9. Peripheral nerve stimulation for the treatment of neuropathic craniofacial pain.

    PubMed

    Slavin, K V

    2007-01-01

    Treatment of neuropathic pain in the region of head and face presents a challenging problem for pain specialists. In particular, those patients who do not respond to conventional treatment modalities usually continue to suffer from pain due to lack of reliable medical and surgical approaches. Peripheral nerve stimulation (PNS) has been used for treatment of neuropathic pain for many decades, but only recently it has been systematically applied to the craniofacial region. Here we summarize published experience with PNS in treatment of craniofacial pain and discuss some technical details of the craniofacial PNS procedure.

  10. Extensive validation of the pain disability index in 3 groups of patients with musculoskeletal pain.

    PubMed

    Soer, Remko; Köke, Albère J A; Vroomen, Patrick C A J; Stegeman, Patrick; Smeets, Rob J E M; Coppes, Maarten H; Reneman, Michiel F

    2013-04-20

    A cross-sectional study design was performed. To validate the pain disability index (PDI) extensively in 3 groups of patients with musculoskeletal pain. The PDI is a widely used and studied instrument for disability related to various pain syndromes, although there is conflicting evidence concerning factor structure, test-retest reliability, and missing items. Additionally, an official translation of the Dutch language version has never been performed. For reliability, internal consistency, factor structure, test-retest reliability and measurement error were calculated. Validity was tested with hypothesized correlations with pain intensity, kinesiophobia, Rand-36 subscales, Depression, Roland-Morris Disability Questionnaire, Quality of Life, and Work Status. Structural validity was tested with independent backward translation and approval from the original authors. One hundred seventy-eight patients with acute back pain, 425 patients with chronic low back pain and 365 with widespread pain were included. Internal consistency of the PDI was good. One factor was identified with factor analyses. Test-retest reliability was good for the PDI (intraclass correlation coefficient, 0.76). Standard error of measurement was 6.5 points and smallest detectable change was 17.9 points. Little correlations between the PDI were observed with kinesiophobia and depression, fair correlations with pain intensity, work status, and vitality and moderate correlations with the Rand-36 subscales and the Roland-Morris Disability Questionnaire. The PDI-Dutch language version is internally consistent as a 1-factor structure, and test-retest reliable. Missing items seem high in sexual and professional items. Using the PDI as a 2-factor questionnaire has no additional value and is unreliable.

  11. Pain referral and regional deep tissue hyperalgesia in experimental human hip pain models.

    PubMed

    Izumi, Masashi; Petersen, Kristian Kjær; Arendt-Nielsen, Lars; Graven-Nielsen, Thomas

    2014-04-01

    Hip disorder patients typically present with extensive pain referral and hyperalgesia. To better understand underlying mechanisms, an experimental hip pain model was established in which pain referrals and hyperalgesia could be studied under standardized conditions. In 16 healthy subjects, pain was induced by hypertonic saline injection into the gluteus medius tendon (GMT), adductor longus tendon (ALT), or gluteus medius muscle (GMM). Isotonic saline was injected contralaterally as control. Pain intensity was assessed on a visual analogue scale (VAS), and subjects mapped the pain distribution. Before, during, and after injections, passive hip joint pain provocation tests were completed, together with quantitative sensory testing as follows: pressure pain thresholds (PPTs), cuff algometry pain thresholds (cuff PPTs), cutaneous pin-prick sensitivity, and thermal pain thresholds. Hypertonic saline injected into the GMT resulted in higher VAS scores than hypertonic injections into the ALT and GMM (P<.05). Referred pain areas spread to larger parts of the leg after GMT and GMM injections compared with more regionalized pain pattern after ALT injections (P<.05). PPTs at the injection site were decreased after hypertonic saline injections into GMT and GMM compared with baseline, ALT injections, and isotonic saline. Cuff PPTs from the thigh were decreased after hypertonic saline injections into the ALT compared with baseline, GMT injections, and isotonic saline (P<.05). More subjects had positive joint pain provocation tests after hypertonic compared with isotonic saline injections (P<.05), indicating that this provocation test also assessed hyperalgesia in extra-articular soft tissues. The experimental models may open for better understanding of pain mechanisms associated with painful hip disorders.

  12. Musculoskeletal pain in obese adolescents.

    PubMed

    Jannini, Suely Nóbrega; Dória-Filho, Ulysses; Damiani, Durval; Silva, Clovis Artur Almeida

    2011-01-01

    To determine the prevalence of pain, musculoskeletal syndromes, orthopedic disorders and using computers and playing videogames among obese adolescents. This was a cross-sectional study that investigated 100 consecutive obese adolescents and 100 healthy-weight controls using a confidential, self-report questionnaire covering demographic data, sports participation, painful musculoskeletal system symptoms and using computers and playing videogames. The questionnaire's test-retest reliability was tested. Physical examination covered six musculoskeletal syndromes and seven orthopedic disorders. The kappa index for test-retest was 0.724. Pain and musculoskeletal syndromes were equally prevalent in both groups (44 vs. 56%, p = 0.09; 12 vs. 16%, p = 0.541; respectively). Notwithstanding, orthopedic disorders (98 vs. 76%, p = 0.0001), tight quadriceps (89 vs. 44%, p = 0.0001) and genu valgum (87 vs. 24%, p = 0.0001) were significantly more prevalent in obese adolescents than in controls. Median time spent using a computer the day before, on Saturdays and on Sundays were all lower among the obese subjects (30 vs. 60 minutes, p = 0.0001; 1 vs. 60 minutes, p = 0.001; and 0 vs. 30 minutes, p = 0.02; respectively). Obese adolescents were less likely to play handheld videogames (2 vs. 11%, p = 0.003) and there was no difference in the two groups' use of full-sized videogames (p > 0.05). Comparing obese adolescents with pain to those free from pain revealed that pain was more frequent among females (59 vs. 39%, p = 0.048) and was associated with greater median time spent playing on Sundays [0 (0-720) vs. 0 (0-240) minutes, p = 0.028]. Obesity can cause osteoarticular system damage at the start of adolescence, particularly to the lower limbs. Programs developed specifically for obese female adolescents with musculoskeletal pain are needed.

  13. Central Neuropathic Pain Syndromes.

    PubMed

    Watson, James C; Sandroni, Paola

    2016-03-01

    Chronic pain is common in patients with neurologic complications of a central nervous system insult such as stroke. The pain is most commonly musculoskeletal or related to obligatory overuse of neurologically unaffected limbs. However, neuropathic pain can result directly from the central nervous system injury. Impaired sensory discrimination can make it challenging to differentiate central neuropathic pain from other pain types or spasticity. Central neuropathic pain may also begin months to years after the injury, further obscuring recognition of its association with a past neurologic injury. This review focuses on unique clinical features that help distinguish central neuropathic pain. The most common clinical central pain syndromes-central poststroke pain, multiple sclerosis-related pain, and spinal cord injury-related pain-are reviewed in detail. Recent progress in understanding of the pathogenesis of central neuropathic pain is reviewed, and pharmacological, surgical, and neuromodulatory treatments of this notoriously difficult to treat pain syndrome are discussed.

  14. Spatial sensory organization and body representation in pain perception.

    PubMed

    Haggard, Patrick; Iannetti, Gian Domenico; Longo, Matthew R

    2013-02-18

    Pain is a subjective experience that protects the body. This function implies a special relation between the brain mechanisms underlying pain perception and representation of the body. All sensory systems involve the body for the trivial reason that sensory receptors are located in the body. The nociceptive system of detecting noxious stimuli comprises two classes of peripheral afferents, Aδ and C nociceptors, that cover almost the entire body surface. We review evidence from experimental studies of pain in humans and other animals suggesting that Aδ skin nociceptors project to a spatially-organised, somatotopic map in the primary somatosensory cortex. While the relation between pain perception and homeostatic regulation of bodily systems is widely acknowledged, the organization of nociceptive information into spatial maps of the body has received little attention. Importantly, the somatotopic neural organization of pain systems can shed light on pain-related plasticity and pain modulation. Finally, we show that the neural coding of noxious stimuli, and consequent experience of pain, are both strongly influenced when cognitive representations of the body are activated by viewing the body, as opposed to viewing another object - an effect we term 'visual analgesia'. We argue that pain perception involves some of the representational properties of exteroceptive senses, such as vision and touch. Pain, however, has the unique feature that the content of representation is the body itself, rather than any external object of perception. We end with some suggestions regarding how linking pain to body representation could shed light on clinical conditions, notably chronic pain.

  15. Neuropathic Pain and Spinal Cord Injury: Phenotypes and Pharmacological Management.

    PubMed

    Widerström-Noga, Eva

    2017-06-01

    Chronic neuropathic pain is a complicated condition after a spinal cord injury (SCI) that often has a lifelong and significant negative impact on life after the injury; therefore, improved pain management is considered a significant and unmet need. Neuropathic pain mechanisms are heterogeneous and the difficulty in determining their individual contribution to specific pain types may contribute to poor treatment outcomes in this population. Thus, identifying human neuropathic pain phenotypes based on pain symptoms, somatosensory changes, or cognitive and psychosocial factors that reflect specific spinal cord or brain mechanisms of neuropathic pain is an important goal. Once a pain phenotype can be reliably replicated, its relationship with biomarkers and clinical treatment outcomes can be analyzed, and thereby facilitate translational research and further the mechanistic understanding of individual differences in the pain experience and in clinical trial outcomes. The present article will discuss clinical aspects of SCI-related neuropathic pain, neuropathic pain phenotypes, pain mechanisms, potential biomarkers and pharmacological interventions, and progress regarding how defining neuropathic pain phenotypes may lead to more targeted treatments for these difficult pain conditions.

  16. Chronic pain assessment: A seven-factor model

    PubMed Central

    Davidson, Megan A; Tripp, Dean A; Fabrigar, Leandre R; Davidson, Paul R

    2008-01-01

    BACKGROUND: There are many measures assessing related dimensions of the chronic pain experience (eg, pain severity, pain coping, depression, activity level), but the relationships among them have not been systematically established. OBJECTIVE: The present study set out to determine the core dimensions requiring assessment in individuals with chronic pain. METHODS: Individuals with chronic pain (n=126) completed the Beck Anxiety Inventory, Beck Depression Inventory, Beck Hopelessness Scale, Chronic Pain Coping Index, Multidimensional Pain Inventory, Pain Catastrophizing Scale, McGill Pain Questionnaire – Short Form, Pain Disability Index and the Tampa Scale of Kinesiophobia. RESULTS: Before an exploratory factor analysis (EFA) of the nine chronic pain measures, EFAs were conducted on each of the individual measures, and the derived factors (subscales) from each measure were submitted together for a single EFA. A seven-factor model best fit the data, representing the core factors of pain and disability, pain description, affective distress, support, positive coping strategies, negative coping strategies and activity. CONCLUSIONS: Seven meaningful dimensions of the pain experience were reliably and systematically extracted. Implications and future directions for this work are discussed. PMID:18719712

  17. [Pain measurement in cognitively impaired patients with the Doloshort scale].

    PubMed

    Likar, R; Pipam, W; Neuwersch, S; Köstenberger, M; Pinter, G; Gatternig, C; Marksteiner, J

    2015-08-01

    Until recently the measurement of pain in cognitively impaired patients represented a neglected field in the diagnostics and treatment of pain. Investigations indicate a prevalence of pain in nursing home residents of between 45 % and 80 %. This study investigated the reliability of the German translation of the Doloshort scale and compared it with the visual analog scale (VS). The aim of this study was to determine the practical applicability of this scale in the clinical routine and to calculate the intrarater reliability (retest) and interrater reliability. The interrater and intrarater reliability of the Doloshort scale was between 0.949 and 0.970. There was a highly significant correlation between the values of the Doloshort scale and the VAS. The Doloshort scale is a well suited measurement instrument for the evaluation of pain in cognitively impaired patients. Because of the short form only simple instructions are necessary and it has a high acceptance with users.

  18. Neuropathic Pain After Breast Surgery

    ClinicalTrials.gov

    2017-07-31

    Chronic Neuropathic Pain, Postoperative; Chronic Pain, Postoperative; Chronic Chemotherapy-induced Neuropathic Pain; Chronic Chemotherapy-induced Pain; Chronic Chemotherapy-induced Peripheral Neuropathy

  19. Neuropathic Pain After Lung Surgery

    ClinicalTrials.gov

    2017-05-30

    Chronic Neuropathic Pain, Postoperative; Chronic Pain, Postoperative; Chronic Chemotherapy-induced Neuropathic Pain; Chronic Chemotherapy-induced Pain; Chronic Chemotherapy-induced Peripheral Neuropathy

  20. Recalibrating software reliability models

    NASA Technical Reports Server (NTRS)

    Brocklehurst, Sarah; Chan, P. Y.; Littlewood, Bev; Snell, John

    1990-01-01

    In spite of much research effort, there is no universally applicable software reliability growth model which can be trusted to give accurate predictions of reliability in all circumstances. Further, it is not even possible to decide a priori which of the many models is most suitable in a particular context. In an attempt to resolve this problem, techniques were developed whereby, for each program, the accuracy of various models can be analyzed. A user is thus enabled to select that model which is giving the most accurate reliability predicitons for the particular program under examination. One of these ways of analyzing predictive accuracy, called the u-plot, in fact allows a user to estimate the relationship between the predicted reliability and the true reliability. It is shown how this can be used to improve reliability predictions in a completely general way by a process of recalibration. Simulation results show that the technique gives improved reliability predictions in a large proportion of cases. However, a user does not need to trust the efficacy of recalibration, since the new reliability estimates prodcued by the technique are truly predictive and so their accuracy in a particular application can be judged using the earlier methods. The generality of this approach would therefore suggest that it be applied as a matter of course whenever a software reliability model is used.

  1. Recalibrating software reliability models

    NASA Technical Reports Server (NTRS)

    Brocklehurst, Sarah; Chan, P. Y.; Littlewood, Bev; Snell, John

    1989-01-01

    In spite of much research effort, there is no universally applicable software reliability growth model which can be trusted to give accurate predictions of reliability in all circumstances. Further, it is not even possible to decide a priori which of the many models is most suitable in a particular context. In an attempt to resolve this problem, techniques were developed whereby, for each program, the accuracy of various models can be analyzed. A user is thus enabled to select that model which is giving the most accurate reliability predictions for the particular program under examination. One of these ways of analyzing predictive accuracy, called the u-plot, in fact allows a user to estimate the relationship between the predicted reliability and the true reliability. It is shown how this can be used to improve reliability predictions in a completely general way by a process of recalibration. Simulation results show that the technique gives improved reliability predictions in a large proportion of cases. However, a user does not need to trust the efficacy of recalibration, since the new reliability estimates produced by the technique are truly predictive and so their accuracy in a particular application can be judged using the earlier methods. The generality of this approach would therefore suggest that it be applied as a matter of course whenever a software reliability model is used.

  2. Software Reliability 2002

    NASA Technical Reports Server (NTRS)

    Wallace, Dolores R.

    2003-01-01

    In FY01 we learned that hardware reliability models need substantial changes to account for differences in software, thus making software reliability measurements more effective, accurate, and easier to apply. These reliability models are generally based on familiar distributions or parametric methods. An obvious question is 'What new statistical and probability models can be developed using non-parametric and distribution-free methods instead of the traditional parametric method?" Two approaches to software reliability engineering appear somewhat promising. The first study, begin in FY01, is based in hardware reliability, a very well established science that has many aspects that can be applied to software. This research effort has investigated mathematical aspects of hardware reliability and has identified those applicable to software. Currently the research effort is applying and testing these approaches to software reliability measurement, These parametric models require much project data that may be difficult to apply and interpret. Projects at GSFC are often complex in both technology and schedules. Assessing and estimating reliability of the final system is extremely difficult when various subsystems are tested and completed long before others. Parametric and distribution free techniques may offer a new and accurate way of modeling failure time and other project data to provide earlier and more accurate estimates of system reliability.

  3. Recalibrating software reliability models

    NASA Technical Reports Server (NTRS)

    Brocklehurst, Sarah; Chan, P. Y.; Littlewood, Bev; Snell, John

    1990-01-01

    In spite of much research effort, there is no universally applicable software reliability growth model which can be trusted to give accurate predictions of reliability in all circumstances. Further, it is not even possible to decide a priori which of the many models is most suitable in a particular context. In an attempt to resolve this problem, techniques were developed whereby, for each program, the accuracy of various models can be analyzed. A user is thus enabled to select that model which is giving the most accurate reliability predicitons for the particular program under examination. One of these ways of analyzing predictive accuracy, called the u-plot, in fact allows a user to estimate the relationship between the predicted reliability and the true reliability. It is shown how this can be used to improve reliability predictions in a completely general way by a process of recalibration. Simulation results show that the technique gives improved reliability predictions in a large proportion of cases. However, a user does not need to trust the efficacy of recalibration, since the new reliability estimates prodcued by the technique are truly predictive and so their accuracy in a particular application can be judged using the earlier methods. The generality of this approach would therefore suggest that it be applied as a matter of course whenever a software reliability model is used.

  4. Pain and pain management in haemophilia

    PubMed Central

    Auerswald, Günter; Dolan, Gerry; Duffy, Anne; Hermans, Cedric; Jiménez-Yuste, Victor; Ljung, Rolf; Morfini, Massimo; Lambert, Thierry; Šalek, Silva Zupančić

    2016-01-01

    Joint pain is common in haemophilia and may be acute or chronic. Effective pain management in haemophilia is essential to reduce the burden that pain imposes on patients. However, the choice of appropriate pain-relieving measures is challenging, as there is a complex interplay of factors affecting pain perception. This can manifest as differences in patients’ experiences and response to pain, which require an individualized approach to pain management. Prophylaxis with factor replacement reduces the likelihood of bleeds and bleed-related pain, whereas on-demand therapy ensures rapid bleed resolution and pain relief. Although use of replacement or bypassing therapy is often the first intervention for pain, additional pain relief strategies may be required. There is an array of analgesic options, but consideration should be paid to the adverse effects of each class. Nevertheless, a combination of medications that act at different points in the pain pathway may be beneficial. Nonpharmacological measures may also help patients and include active coping strategies; rest, ice, compression, and elevation; complementary therapies; and physiotherapy. Joint aspiration may also reduce acute joint pain, and joint steroid injections may alleviate chronic pain. In the longer term, increasing use of prophylaxis or performing surgery may be necessary to reduce the burden of pain caused by the degenerative effects of repeated bleeds. Whichever treatment option is chosen, it is important to monitor pain and adjust patient management accordingly. Beyond specific pain management approaches, ongoing collaboration between multidisciplinary teams, which should include physiotherapists and pain specialists, may improve outcomes for patients. PMID:27439216

  5. Pain-related fear is associated with avoidance of spinal motion during recovery from low back pain.

    PubMed

    Thomas, James S; France, Christopher R

    2007-07-15

    A longitudinal assessment of the association between pain-related fear and joint motions in 36 participants with subacute low back pain. To determine how the psychologic construct of pain-related fear maps to motor behavior in standardized reaching tasks. Pain-related fear is a significant predictor of avoidance behavior and occupational disability in individuals with low back pain. However, it is not currently known how pain-related fear maps to motor behavior. Participants with an episode of subacute LBP were tested at 3, 6, and 12 weeks following pain onset. Participants performed reaching tasks at comfortable and fast-paced movement speeds to 3 targets (high, middle, low) located in a midsagittal plane. Three-dimensional joint motions of the thoracic spine, lumbar spine, and hip were recorded using an electromagnetic tracking device. Group differences in joint excursions were assessed using 2 groups (high pain-related fear, low pain-related fear) x 3 times (3, 6, 12 weeks) x 2 movement speeds (comfortable, fast paced) x 3 target heights (high, middle, low) MANOVAs. Individuals with high pain-related fear had smaller excursions of the lumbar spine for reaches to all targets at 3 and 6 weeks, but not at 12 weeks following pain onset. Individuals with high pain-related fear adopt alternative movement strategies and avoid motion of the lumbar spine when performing a common reaching movement. Identifying how pain-related fear maps to actual motor behavior (i.e., alternative movement strategies) is a crucial first step in determining how pain-related fear and motor behavior interact to promote or delay recovery from acute low back pain.

  6. The Reliability and Validity of a Pediatric Back Outcome Measure.

    PubMed

    MacDonald, James P; dʼHemecourt, Pierre A; Micheli, Lyle J

    2016-11-01

    Young athletes not uncommonly complain of back pain. Many patient-reported outcome measures are used to evaluate back pain, but none have been designed specifically to assess young, athletic patients. The Micheli Functional Scale (MFS) was developed to measure impairment due to back pain in this population. This study examined the reliability, validity, and responsiveness of the MFS used in routine clinical assessments. Retrospective Cohort Study. Pediatric sports medicine specialty clinic. Patients presenting with a chief concern of back pain over 1 year (n = 93) were enrolled in the study. Study subjects were administered the MFS and the revised Oswestry Disability Index (ODI) at each visit as part of routine clinical care. Reliability of the MFS was assessed by calculating Cronbach alpha (α). Concurrent validity was determined by measuring Spearman coefficient (rs) for the correlations between the MFS and ODI. Ninety-three patients (50 female, 43 male), mean age 14.1 ± 2.3 years were enrolled and 242 clinic encounters (71 initial/171 follow-up visits) analyzed. The MFS had acceptable item reliability (α = 0.786) and concurrent validity: the MFS and ODI were strongly and positively correlated [rs = 0.824 (P < 0.001)]. The MFS was comparatively more reliable and valid when used in follow-up versus initial visits. The MFS is a reliable and valid instrument in assessing young athletes with back pain, although the instrument has different performance characteristics on initial versus follow-up assessments. Further work is needed to refine the MFS to enhance the instrument's reliability, validity, and responsiveness. This study provides further insight into an outcome measure of clinical use in evaluating young athletes with back pain.

  7. Assessing clinical signs of temporomandibular disorders: reliability of clinical examiners.

    PubMed

    Dworkin, S F; LeResche, L; DeRouen, T; Von Korff, M

    1990-05-01

    Data on interrater reliability in assessing a number of clinical signs commonly evaluated in the diagnosis and treatment of temporomandibular disorders (TMD) is presented in this article. Four experienced dental hygienists who were field examiners for a large epidemiologic study of TMD and three experienced clinical TMD specialists (dentists) who are coinvestigators in the same study followed carefully detailed specifications and criteria for examination of TMD patients and pain-free controls. Excellent reliability was found for vertical range of motion measures and for summary indices measuring the overall presence of a clinical sign that could arise from several sources (for example, summary indices of muscle palpation pain). However, many clinical signs important in the differential diagnosis of subtypes of TMD were not measured with high reliability. In particular, assessment of pain in response to muscle palpation and identification of specific temporomandibular joint sounds seemed to be possible only with modest, sometimes marginal, reliability. These modest reliabilities could arise from examiner error because the clinical signs are themselves unreliable, changing spontaneously over time and making it difficult to find the same sign on successive examinations. The finding that, without calibration, experienced clinicians showed low reliability with other clinicians suggests the importance of establishing reliable clinical standards for the examination and diagnostic classification of TMD.

  8. [Assessment and measurement of pain in infants and children].

    PubMed

    Trapanotto, M; Benini, F; Agosto, C; Pardi, C; Lazzarin, P; Zacchello, F

    2001-04-01

    The assessment of global pain in infants and children involves the analysis of subjective, behavioural and physiological components, beyond the psychological, familiar and environmental factors that influence and modulate the manifestation of painful symptom. Therefore, researchers and clinicians need valid and reliable instruments to obtain a correct measure of pain. Although subjective indices carry out a fundamental role in the assessment of pain (instruments adjusted to the age of the child), behavioural and physiological indices should be used when intelligence deficit or serious physical handicaps exclude such possibility. Behavioural aspects, associated and correlated to physiological changes, allow to obtain a reliable enough measure of pain. In this paper, the main instruments for measuring pain in infants and children will be described, and their advantages and disadvantages underlined.

  9. Motor imagery in people with a history of back pain, current back pain, both, or neither.

    PubMed

    Bowering, K Jane; Butler, David S; Fulton, Ian J; Moseley, G Lorimer

    2014-12-01

    There is mounting evidence that cortical maps are disrupted in chronic limb pain and that these disruptions may contribute to the problem and be a viable target for treatment. Little is known as to whether this is also the case for the most common and costly chronic pain-back pain. To investigate the effects of back pain characteristics on the performance of left/right trunk judgment tasks, a method of testing the integrity of cortical maps. A total of 1008 volunteers completed an online left/right trunk judgment task in which they judged whether a model was rotated or laterally flexed to the left or right in a series of images. Participants who had back pain at the time of testing were less accurate than pain-free controls (P=0.027), as were participants who were pain free but had a history of back pain (P<0.01). However, these results were driven by an interaction such that those with current back pain and a history of back pain were less accurate (mean [95% CI]=76% [74%-78%]) than all other groups (>84% [83%-85%]). Trunk motor imagery performance is reduced in people with a history of back pain when they are in a current episode. This is consistent with disruption of cortical proprioceptive representation of the trunk in this group. On the basis of this result, we propose a conceptual model speculating a role of this measure in understanding the development of chronic back pain, a model that can be tested in future studies.

  10. Specific Physician Orders Improve Pain Detection and Pain Reports in Nursing Home Residents: Preliminary Data

    PubMed Central

    Monroe, Todd B.; Misra, Sumathi; Habermann, Ralf C.; Dietrich, Mary S.; Bruehl, Stephen P.; Cowan, Ronald L.; Newhouse, Paul A.; Simmons, Sandra F.

    2015-01-01

    Background Despite evidence that many pain nursing home residents is poorly managed, reasons for this poor management remain unanswered. Aims The aim of this study was to determine if specific order sets related to pain assessment would improve pain management in nursing home (NH) residents. Outcomes included observed nurse pain assessment queries and resident reports of pain. Design Pre-test / post-test. Setting 240-bed for-profit nursing home in the mid-southern region of the United States. Subjects 43 nursing home residents capable of self-consent. Methods Medical chart abstraction during a two-week (14-day) period prior to the implementation of specific order sets for pain assessment (intervention) and a two-week (14-day) period following the intervention. Trained research assistants observed medication administration passes and performed subject interviews after each medication pass. One month after intervention implementation, one additional day of observations was conducted to determine data reliability. Results Nurses were observed to ask residents about pain more frequently, and nurses continued to ask about pain at higher rates one month after the intervention was discontinued. The proportion of residents who reported pain also significantly increased in response to increased nurse queries (e.g., “Do you have any pain right now?”), which underscores the importance of nurses directly asking residents about pain. Notably 70% of this long-stay NH population only told the nurses about their pain symptoms when asked directly. Conclusions Findings uncover that using specific pain order sets seems to improve the detection of pain, which should be a routine part of nursing assessment. PMID:26259882

  11. Temporomandibular joint pain assessment.

    PubMed

    Stegenga, B; de Bont, L G; Boering, G

    1993-01-01

    The aim of this study was to evaluate pain characteristics of patients with temporomandibular joint-related pain and propose a rationale for the assessment of pain and its impact on patients with temporomandibular disorders. Based on anamnestic information, the 88 patients in the sample were classified according to pain grade: (1) acute/subacute nonrecurrent or recurrent pain, n = 41 (46.6%); (2) persistently recurring pain in relatively high frequency, or nonsevere persistent pain, n = 32 (36.4%); (3) persistent and impairing pain, n = 8 (9.1%); (4) persistent and disabling pain, n = 7 (7.9%); and (5) persistent and handicapping pain, n = 0. Regarding TMJ pain provoked during the clinical examination, there was a significant difference among diagnostic subgroups, subgroups with different pain intensity levels, and pain grade subgroups, but no significant differences could be found based on the duration of the pain symptoms. Subgroups also did not significantly differ in scores on the Multi-dimensional Pain Inventory and the General Health Questionnaire. Based on the results of the study, the assessment of nonchronic TMJ pain may generally be limited to an accurate description of the pain complaint and thorough clinical assessment. Multidimensional assessment may be useful when the TMJ pain persists or is persistently recurring. Depending on individual circumstances, additional assessment procedures may prove to be useful. A general strategy for pain assessment in temporomandibular disorders is proposed.

  12. Medications for back pain

    MedlinePlus

    ... doses of these medicines can help with chronic low back pain , even if the person does not feel sad ... notices pain. Antidepressants most commonly used for chronic low back pain also help you sleep. Antidepressants most often used ...

  13. Side Effects: Pain

    Cancer.gov

    Controlling pain is an important part of your cancer treatment plan. Learn how to track levels of pain. Find out how pain, a side effect of cancer treatment, is treated using acupuncture, biofeedback, and physical therapy.

  14. Low back pain - chronic

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007422.htm Low back pain - chronic To use the sharing features on this page, please enable JavaScript. Low back pain refers to pain that you feel in your ...

  15. How Is Pain Managed?

    MedlinePlus

    ... Goggins Lab Sol Goldman Center Discussion Board Pain Management Pain is a very common symptom in patients ... significantly reduce a patient’s quality of life. Proper management of this pain is therefore important, and patients ...

  16. Pain Information Brochure

    MedlinePlus

    ... Registries IOM Report: Relieving Pain in America HHS Pathways to Safer Oploid Use About About the NIH ... Registries IOM Report: Relieving Pain in America HHS Pathways to Safer Oploid Use Home Health Information Pain ...

  17. Active Mapping.

    ERIC Educational Resources Information Center

    Day, Dennis

    1994-01-01

    Explains a social studies lesson for third graders that uses KidPix, a computer software graphics program to help students make maps and map keys. Advantages to using the computer versus hand drawing maps are discussed, and an example of map requirements for the lesson is included. (LRW)

  18. Exploring maps

    USGS Publications Warehouse

    ,

    1993-01-01

    Exploring Maps is an interdisciplinary set of materials on mapping for grades 7-12. Students will learn basic mapmaking and map reading skills and will see how maps can answer fundamental geographic questions: "Where am I?" "What else is here?" "Where am I going?"

  19. Hawaii electric system reliability.

    SciTech Connect

    Silva Monroy, Cesar Augusto; Loose, Verne William

    2012-09-01

    This report addresses Hawaii electric system reliability issues; greater emphasis is placed on short-term reliability but resource adequacy is reviewed in reference to electric consumers' views of reliability %E2%80%9Cworth%E2%80%9D and the reserve capacity required to deliver that value. The report begins with a description of the Hawaii electric system to the extent permitted by publicly available data. Electrical engineering literature in the area of electric reliability is researched and briefly reviewed. North American Electric Reliability Corporation standards and measures for generation and transmission are reviewed and identified as to their appropriateness for various portions of the electric grid and for application in Hawaii. Analysis of frequency data supplied by the State of Hawaii Public Utilities Commission is presented together with comparison and contrast of performance of each of the systems for two years, 2010 and 2011. Literature tracing the development of reliability economics is reviewed and referenced. A method is explained for integrating system cost with outage cost to determine the optimal resource adequacy given customers' views of the value contributed by reliable electric supply. The report concludes with findings and recommendations for reliability in the State of Hawaii.

  20. Hawaii Electric System Reliability

    SciTech Connect

    Loose, Verne William; Silva Monroy, Cesar Augusto

    2012-08-01

    This report addresses Hawaii electric system reliability issues; greater emphasis is placed on short-term reliability but resource adequacy is reviewed in reference to electric consumers’ views of reliability “worth” and the reserve capacity required to deliver that value. The report begins with a description of the Hawaii electric system to the extent permitted by publicly available data. Electrical engineering literature in the area of electric reliability is researched and briefly reviewed. North American Electric Reliability Corporation standards and measures for generation and transmission are reviewed and identified as to their appropriateness for various portions of the electric grid and for application in Hawaii. Analysis of frequency data supplied by the State of Hawaii Public Utilities Commission is presented together with comparison and contrast of performance of each of the systems for two years, 2010 and 2011. Literature tracing the development of reliability economics is reviewed and referenced. A method is explained for integrating system cost with outage cost to determine the optimal resource adequacy given customers’ views of the value contributed by reliable electric supply. The report concludes with findings and recommendations for reliability in the State of Hawaii.

  1. Reliability, Recursion, and Risk.

    ERIC Educational Resources Information Center

    Henriksen, Melvin, Ed.; Wagon, Stan, Ed.

    1991-01-01

    The discrete mathematics topics of trees and computational complexity are implemented in a simple reliability program which illustrates the process advantages of the PASCAL programing language. The discussion focuses on the impact that reliability research can provide in assessment of the risks found in complex technological ventures. (Author/JJK)

  2. Monte Carlo Reliability Analysis.

    DTIC Science & Technology

    1987-10-01

    to Stochastic Processes , Prentice-Hall, Englewood Cliffs, NJ, 1975. (5) R. E. Barlow and F. Proscham, Statistical TheorX of Reliability and Life...Lewis and Z. Tu, "Monte Carlo Reliability Modeling by Inhomogeneous ,Markov Processes, Reliab. Engr. 16, 277-296 (1986). (4) E. Cinlar, Introduction

  3. Contour Mapping

    NASA Technical Reports Server (NTRS)

    1995-01-01

    In the early 1990s, the Ohio State University Center for Mapping, a NASA Center for the Commercial Development of Space (CCDS), developed a system for mobile mapping called the GPSVan. While driving, the users can map an area from the sophisticated mapping van equipped with satellite signal receivers, video cameras and computer systems for collecting and storing mapping data. George J. Igel and Company and the Ohio State University Center for Mapping advanced the technology for use in determining the contours of a construction site. The new system reduces the time required for mapping and staking, and can monitor the amount of soil moved.

  4. Chapter 9: Reliability

    SciTech Connect

    Algora, Carlos; Espinet-Gonzalez, Pilar; Vazquez, Manuel; Bosco, Nick; Miller, David; Kurtz, Sarah; Rubio, Francisca; McConnell,Robert

    2016-04-15

    This chapter describes the accumulated knowledge on CPV reliability with its fundamentals and qualification. It explains the reliability of solar cells, modules (including optics) and plants. The chapter discusses the statistical distributions, namely exponential, normal and Weibull. The reliability of solar cells includes: namely the issues in accelerated aging tests in CPV solar cells, types of failure and failures in real time operation. The chapter explores the accelerated life tests, namely qualitative life tests (mainly HALT) and quantitative accelerated life tests (QALT). It examines other well proven and experienced PV cells and/or semiconductor devices, which share similar semiconductor materials, manufacturing techniques or operating conditions, namely, III-V space solar cells and light emitting diodes (LEDs). It addresses each of the identified reliability issues and presents the current state of the art knowledge for their testing and evaluation. Finally, the chapter summarizes the CPV qualification and reliability standards.

  5. Reliability of a clinical test for deep cervical flexor endurance.

    PubMed

    Olson, Lee E; Millar, A Lynn; Dunker, Jeremy; Hicks, Jennifer; Glanz, Devin

    2006-02-01

    Endurance deficiencies of the deep cervical flexors are associated with pain, increased lordosis, and headache. A need exists for reliable clinical tests of flexor endurance. This study determined intrarater and interrater reliability of such a test in persons without neck pain. Twenty-seven subjects (aged 20-35 years) without a history of neck pain or injury were tested. Supine subjects were timed in maintaining a position involving two components: (1) craniovertebral flexion (chin tuck) and (2) lower cervical flexion (holding the occiput at a fixed height). Each subject was examined twice by 3 different examiners with 1 to 2 days between trials. When two values were averaged, interrater reliability for the 3 testers was 0.83, 0.85, and 0.88. Intrarater reliability values were 0.78 and 0.85 for tests 1 and 2, respectively. The flexor endurance test showed good intertester and intratester reliability when two values were averaged and, thus, may represent a useful clinical tool for practitioners involved in treating and preventing neck pain.