Barbero M, Moresi F, Leoni D, Gatti R, Egloff M, Falla D
Department of Business, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland.
Rehabilitation Department, San Raffaele Hospital, Milan, Italy.
Eur J Pain. 2015 Sep;19(8):1129-38. doi: 10.1002/ejp.636. Epub 2015 Jan 6.
Pain drawings (PDs) are an important component of the assessment of a patient with pain. The aim of this work is to present the test-retest reliability of a novel method of quantifying the extent and location of pain. Additionally, the association between PD variables and clinical features in patients with chronic neck pain (CNP) and chronic low back pain (CLBP) was explored.
Fifty-one patients with CLBP and 56 patients with CNP participated. Each patient shaded two consecutive PDs using a digital tablet. Software was developed to quantify the pain extent, to analyse the pain overlap between PDs and to produce pain frequency maps. Correlations were obtained between pain extent and clinical features including the level of pain intensity, disability, and psychological distress and cognitive function.
The intraclass correlation coefficients for pain extent in CLBP and CNP were very high: 0.97 (95% CI: 0.95-0.98) and 0.92 (95% CI: 0.87-0.98), respectively. The Bland Altman showed a mean difference close to zero: 5.4% pixels in CNP group and 3% pixels in the CLBP group. Significant correlations were observed between pain extent and pain intensity in CLBP and CNP and pain extent and disability in CNP. There was no relation between pain extent and the level of distress or cognitive function.
A novel method for the acquisition of PD was presented. Test-retest reliability of reporting pain extent and pain location was supported in people with CNP and CLBP. Future research is needed to establish psychometric properties of PD.
疼痛图（PDs）是评估疼痛患者的重要组成部分。本研究的目的是展示一种量化疼痛范围和部位的新方法的重测信度。此外，还探讨了慢性颈痛（CNP）和慢性腰痛（CLBP）患者的疼痛图变量与临床特征之间的关联。
51例CLBP患者和56例CNP患者参与了研究。每位患者使用数位板连续绘制两张疼痛图。开发了软件来量化疼痛范围，分析疼痛图之间的疼痛重叠情况，并生成疼痛频率图。获取了疼痛范围与包括疼痛强度、残疾程度、心理困扰和认知功能水平在内的临床特征之间的相关性。
CLBP和CNP患者疼痛范围的组内相关系数非常高：分别为0.97（95%CI：0.95 - 0.98）和0.92（95%CI：0.87 - 0.98）。Bland Altman分析显示平均差异接近零：CNP组为5.4%像素，CLBP组为3%像素。CLBP和CNP患者的疼痛范围与疼痛强度之间以及CNP患者的疼痛范围与残疾程度之间存在显著相关性。疼痛范围与困扰程度或认知功能水平之间没有关系。
提出了一种获取疼痛图的新方法。CNP和CLBP患者报告疼痛范围和疼痛部位的重测信度得到了支持。需要进一步的研究来确定疼痛图的心理测量特性。
