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Barbero M, Cescon C, Schneebeli A, Falla D, Landolfi G, Derboni M, Giuffrida V, Rizzoli AE, Maino P, Koetsier E. Reliability of the Pen-on-Paper Pain Drawing Analysis Using Different Scanning Procedures. J Pain Symptom Manage 2024; 67:e129-e136. [PMID: 37898312 DOI: 10.1016/j.jpainsymman.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/05/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Pen-on-paper pain drawing are an easily administered self-reported measure that enables patients to report the spatial distribution of their pain. The digitalization of pain drawings has facilitated the extraction of quantitative metrics, such as pain extent and location. This study aimed to assess the reliability of pen-on-paper pain drawing analysis conducted by an automated pain-spot recognition algorithm using various scanning procedures. METHODS One hundred pain drawings, completed by patients experiencing somatic pain, were repeatedly scanned using diverse technologies and devices. Seven datasets were created, enabling reliability assessments including inter-device, inter-scanner, inter-mobile, inter-software, intra- and inter-operator. Subsequently, the automated pain-spot recognition algorithm estimated pain extent and location values for each digitized pain drawing. The relative reliability of pain extent analysis was determined using the intraclass correlation coefficient, while absolute reliability was evaluated through the standard error of measurement and minimum detectable change. The reliability of pain location analysis was computed using the Jaccard similarity index. RESULTS The reliability analysis of pain extent consistently yielded intraclass correlation coefficient values above 0.90 for all scanning procedures, with standard error of measurement ranging from 0.03% to 0.13% and minimum detectable change from 0.08% to 0.38%. The mean Jaccard index scores across all dataset comparisons exceeded 0.90. CONCLUSIONS The analysis of pen-on-paper pain drawings demonstrated excellent reliability, suggesting that the automated pain-spot recognition algorithm is unaffected by scanning procedures. These findings support the algorithm's applicability in both research and clinical practice.
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Affiliation(s)
- Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland (M.B., C.C., A.S.).
| | - Corrado Cescon
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland (M.B., C.C., A.S.)
| | - Alessandro Schneebeli
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland (M.B., C.C., A.S.)
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom (D.F.)
| | - Giuseppe Landolfi
- Institute of Systems and Technologies for Sustainable Production, ISTePS, SUPSI, Lugano, Switzerland (G.L.)
| | - Marco Derboni
- Dalle Molle Institute for Artificial Intelligence, IDSIA, USI-SUPSI, Lugano, Switzerland (M.D., V.G., A.E.R.)
| | - Vincenzo Giuffrida
- Dalle Molle Institute for Artificial Intelligence, IDSIA, USI-SUPSI, Lugano, Switzerland (M.D., V.G., A.E.R.)
| | - Andrea Emilio Rizzoli
- Dalle Molle Institute for Artificial Intelligence, IDSIA, USI-SUPSI, Lugano, Switzerland (M.D., V.G., A.E.R.)
| | - Paolo Maino
- Pain Management Center, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland (P.M., E.K.); Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland (P.M.,E.K.)
| | - Eva Koetsier
- Pain Management Center, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland (P.M., E.K.); Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland (P.M.,E.K.)
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Boudreau SA, Jakobsen TL, Haraldsson BÞ, Clausen MB. Digital mapping of shoulder pain in patients with shoulder disorders: a reliability study. Physiother Theory Pract 2024:1-13. [PMID: 38214518 DOI: 10.1080/09593985.2023.2300753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Digital body mapping can be used to document and quantify the area and location (distribution) of pain and discomfort and support assessment, monitoring, and treatment in clinical populations. This study determines the test-retest reliability of drawings detailing pain and pins and needles using digital body charts and their relationship to pain intensity and patient-reported shoulder function. METHODS Sixty-two participants with shoulder disorder completed pain and pins and needles drawings with test-retest interval of 30 minutes. Pain intensity in the last week and the patient-reported shoulder function questionnaires were completed. Area and radiating extent were determined using customized software. To assess relative and absolute test-retest reliability, the intraclass correlation coefficient (ICC3,1), standard error of measurement (SEM) and minimal detectable change (MDC95) were calculated. Regression analysis evaluated relation between area and radiating extent of pain and pins and needles with patient-reported function questionnaires. RESULTS Relative reliability for pain area and radiating extent was excellent (>0.90). Absolute reliability (SEM and MDC95) values for the pain area and radiating extent were 0.20%/34 pixels and 0.57%/94 pixels. Absolute reliability improves for smaller pain areas. Regression analysis revealed the area and radiation extent for both pain and pins and needles are independent constructs to the patient-reported function outcome when adjusted for pain intensity. CONCLUSIONS Digital body mapping assessing pain area and radiation extent in patients with shoulder disorders are reliable. The magnitude of absolute reliability suggests other sources of variability on repeat testing in this population. Pain area and radiation extent appear to be independent constructs.
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Affiliation(s)
- Shellie Ann Boudreau
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | - Bjarki Þór Haraldsson
- Physiotherapy Degree Programme, Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen NV, Denmark
| | - Mikkel Bek Clausen
- Physiotherapy Degree Programme, Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen NV, Denmark
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Wagemans J, Taeymans J, Kuppens K, Baur H, Bleakley C, Vissers D. Determining key clinical predictors for chronic ankle instability and return to sports with cost of illness analysis: protocol of a prospective cohort study. BMJ Open 2023; 13:e069867. [PMID: 37164478 PMCID: PMC10174038 DOI: 10.1136/bmjopen-2022-069867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
INTRODUCTION Ankle sprains are common in sports and the general population. Although considered innocuous, a large proportion has residual complaints such as recurrent ankle sprains and develop chronic ankle instability. Although some predicting factors are identified, there is no unequivocality regarding the development of chronic ankle instability, nor about the optimal rehabilitation for an acute ankle sprain. Alongside the biomechanical impairments, ankle sprains are a burden on society due to substantial economic costs. Therefore, we aim to identify key clinical predictors of chronic ankle instability or recovery after acute lateral ankle sprain. Additionally, we aim to determine cost-of-illness of patients who developed chronic ankle instability. METHODS AND ANALYSIS This prospective cohort study (Clinicaltrials.gov: NCT05637008 - pre-results) aims to recruit adult (18-55 years) patients with an acute lateral ankle sprain who are active in sports. Clinical assessments and patient-reported outcome measures will be used to collect data at 7-14 days, 6 weeks, 12 weeks and 12 months after enrolment in the study. The primary outcome will be chronic ankle instability at 12-month follow-up. Salient outcomes will be analysed by logistic regression to determine association with the development of chronic ankle instability. Participants will fill in a cost diary containing direct and indirect costs related to their injury. ETHICS AND DISSEMINATIONS The ethical committee of the Antwerp University Hospital (B3002022000138) has given approval of the protocol and consent forms on 10 October 2022. We perform this study according to the Helsinki Declaration. We will present results at conferences or webinars and publish in peer-reviewed articles.NCT05637008.
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Affiliation(s)
- Jente Wagemans
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Jan Taeymans
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Kevin Kuppens
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
| | - Heiner Baur
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Chris Bleakley
- School of Health Sciences, Faculty of Life and Health Science, Ulster University, Newtownabbey, UK
| | - Dirk Vissers
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
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Abudawood K, Yoon SL, Garg R, Yao Y, Molokie RE, Wilkie DJ. Quantification of Patient-Reported Pain Locations: Development of an Automated Measurement Method. Comput Inform Nurs 2023; 41:346-355. [PMID: 36067491 PMCID: PMC9981814 DOI: 10.1097/cin.0000000000000875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patient-reported pain locations are critical for comprehensive pain assessment. Our study aim was to introduce an automated process for measuring the location and distribution of pain collected during a routine outpatient clinic visit. In a cross-sectional study, 116 adults with sickle cell disease-associated pain completed PAIN Report It Ⓡ . This computer-based instrument includes a two-dimensional, digital body outline on which patients mark their pain location. Using the ImageJ software, we calculated the percentage of the body surface area marked as painful and summarized data with descriptive statistics and a pain frequency map. The painful body areas most frequently marked were the left leg-front (73%), right leg-front (72%), upper back (72%), and lower back (70%). The frequency of pain marks in each of the 48 body segments ranged from 3 to 79 (mean, 33.2 ± 21.9). The mean percentage of painful body surface area per segment was 10.8% ± 7.5% (ranging from 1.3% to 33.1%). Patient-reported pain locations can be easily analyzed from digital drawings using an algorithm created via the free ImageJ software. This method may enhance comprehensive pain assessment, facilitating research and personalized care over time for patients with various pain conditions.
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Affiliation(s)
- Khulud Abudawood
- College of Nursing, King Saudi bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Saunjoo L. Yoon
- Department of Biobehavioral Nursing Science,College of Nursing, University of Florida, Gainesville, Florida
| | - Rishabh Garg
- Herbert Wertheim College of Engineering, University of Florida, Gainesville, Florida
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science,College of Nursing, University of Florida, Gainesville, Florida
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL
| | - Robert E. Molokie
- Department of Medicine, College of Medicine, University of Illinois at Chicago and Jesse Brown Veterans Administration Medical Center, Chicago, IL
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science,College of Nursing, University of Florida, Gainesville, Florida
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL
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Abudawood K, Yoon SL, Yao Y, Grundmann O, Ezenwa MO, Molokie RE, Wilkie DJ. A Novel Measure of Pain Location in Adults with Sickle Cell Disease. Pain Manag Nurs 2022; 23:693-702. [PMID: 36261305 PMCID: PMC10314740 DOI: 10.1016/j.pmn.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Pain intensity remains a primary focus clinically for sickle cell disease pain assessment despite the fact that pain quality and pain location and distribution are critical for clinical diagnosis and treatment of its etiology. However, in part because of measurement issues, scant evidence is available about pain location or its relationship to intensity and quality in adults with SCD. AIM Our study aim was to examine sickle cell disease pain location for relationships with pain quality and intensity measured in outpatient and inpatient settings. METHODS We used an existing longitudinal dataset prospectively collected with the valid and reliable tablet-based PAINReportItⓇ. Adults with sickle cell disease (n = 99) reported pain location, intensity, and quality during a routine outpatient clinic visit and again during a subsequent hospitalization. From their digital body outline drawings and using the ImageJ software, we computed the pain-affected body surface area. With Pearson's correlations and paired t tests, we examined relationships between pain-affected body surface area and other pain variables across outpatient and inpatient visits. RESULTS The mean pain-affected body surface area was 14.4% ± 15.0% of the total body surface area for outpatient visits (min-max: 0.0%-90.2%) and 13.5% ± 14.7% (min-max: 0.0%-73.0%) for inpatient stay. Pain-affected body surface area was positively correlated with pain quality scores for both visits but not significantly correlated with pain intensity at either visit. Compared with the outpatient visit, mean pain intensity for inpatient stay was higher (p < .001); pain quality (p = .12) and pain-affected body surface area (p = .60) did not differ significantly between visits. CONCLUSIONS Unknown is the explanation for pain-affected body surface area association with SCD pain quality but not pain intensity at outpatient and inpatient visits. Additional research is warranted to explore these findings and examine the clinical utility of pain-affected body surface area for chronic sickle cell disease pain and acute sickle cell disease crisis pain.
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Affiliation(s)
- Khulud Abudawood
- College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Saunjoo L Yoon
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida.
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida; Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Oliver Grundmann
- College of Pharmacy, University of Florida, Gainesville, Florida
| | - Miriam O Ezenwa
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida; Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Robert E Molokie
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois; Jesse Brown Veterans Administration Medical Center, Chicago, Illinois
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida; Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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Boudreau SA. Visualizing and quantifying spatial and qualitative pain sensations. Scand J Pain 2022; 22:681-683. [PMID: 36136613 DOI: 10.1515/sjpain-2022-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 11/15/2022]
Abstract
Similar to the purpose of an infographic, visualizing spatial and qualitative sensations on a body chart is a fast and digestible method for communicating complex information and experiences. Further, digitizing these body charts into an interactive medium creates unprecedented opportunities for collecting extensive data. Moreover, applying simple rule-based algorithms or more advanced machine learning approaches to these charts catapults the quantification and spatiotemporal relations of pain and qualitative pain sensations into a new field ripe for pioneering discoveries.
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Affiliation(s)
- Shellie Ann Boudreau
- Center For Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Plinsinga ML, Boudreau SA, Coombes BK, Mellor R, Hayes S, Vicenzino B. Comparing what the clinician draws on a digital pain map to that of persons who have greater trochanteric pain syndrome. Scand J Pain 2022; 22:506-514. [PMID: 35119798 DOI: 10.1515/sjpain-2021-0135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/20/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess the agreements and differences in pain drawings (pain area, shape and location) between individuals who have greater trochanteric pain syndrome (GTPS) and their clinician. METHODS In this study, 23 patients with GTPS (21 female, pain duration range 8-24 months) underwent clinical evaluation by a registered physiotherapist. Digital 2d full body pain drawings were independently performed by the clinician during the subjective examination and by the patient following the physical examination. Levels of agreement [LoA] in the pain area were assessed with Bland-Altman plots. Differences in pain drawings were assessed visually by overlaying images, and by quantifying the differences in shape and location with the bounding box, and Jaccard index, respectively. RESULTS Pain areas (/total pixels of the charts) did not differ in size (LoA mean difference less than -0.5%; range -2.35-1.56%) or shape (bounding box p>0.17). However, there was minimal overlap in location (Jaccard index range 0.09-0.18/1 for perfect overlap). CONCLUSIONS Patients and the clinician displayed differences in location of pain areas, but not size or shape, when they independently performed digital pain drawings. The reasons that underlie and the clinical impact of these differences remains unclear.
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Affiliation(s)
- Melanie L Plinsinga
- University of Queensland School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, St Lucia, QLD4102, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, QLD4111, Australia
| | - Shellie A Boudreau
- Center for Neuroplasticity and Pain (CNAP), SMI®, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Brooke K Coombes
- School of Allied Health Sciences, Nathan Campus, Griffith University, Nathan, QLD4111, Australia
| | - Rebecca Mellor
- University of Queensland School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, St Lucia, QLD4102, Australia
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Newdegate Street, Greenslopes, QLD4121, Australia
| | - Sandi Hayes
- Menzies Health Institute Queensland, Griffith University, Nathan, QLD4111, Australia
| | - Bill Vicenzino
- University of Queensland School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, St Lucia, QLD4102, Australia
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Kellner RL, Agathis AZ, Moon JK, Garfinkle S, Appel J, Coakley BA. A new student-led digital drawing course: an initiative to bridge patient health literacy through medical illustrations. J Vis Commun Med 2022; 45:182-187. [DOI: 10.1080/17453054.2022.2061431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
| | - Alexandra Z. Agathis
- Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James K. Moon
- Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Suzanne Garfinkle
- Department of Medical Education, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jacob Appel
- Department of Psychiatry, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian A. Coakley
- Division of Pediatric Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Location of anterior knee pain affects load tolerance in isometric single leg knee extension. J Sci Med Sport 2022; 25:569-573. [DOI: 10.1016/j.jsams.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 01/24/2022] [Accepted: 03/20/2022] [Indexed: 11/21/2022]
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The Symmetry of Lower Back Pain as a Potential Screening Factor for Serious Pathology: A Survey Study. Symmetry (Basel) 2021. [DOI: 10.3390/sym13111994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Pain maps provide reliable information on pain location in various conditions. This study explored the feasibility of pain maps as a screening tools for serious underlying conditions. The pain symmetry was evaluated as the possible distinguishing feature. Methods: A Web-based survey on the correlation of pain-related disability and pain pattern was developed. Respondents with lower back pain were asked to mark the exact location of their pain over the pain chart. The symmetry index was calculated and used to divide subjects into two groups that were then compared in terms of the prevalence of red flags for serious pathologies, as well as the pain-related disability measured with COMI and ODI instruments. Results: Of the 4213 respondents who completed the survey, 1018 were included in the study. The pain related disability was greater in respondents with asymmetrical pain patterns, as shown with all instruments. The distribution of red flags was also dependent on pain symmetry. The history of weight loss (6.70 vs. 1.76 p < 0.001) and fever (4.91 vs. 2.14 p < 0.001) were more prevalent with symmetrical pain patterns, and the history of trauma was more frequent with asymmetrical pain (21.41 vs. 10.71 p < 0.001). Conclusions: It was shown that the symmetry of pain is correlated to the prevalence of red flags and pain-related disability.
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Hannington M, Tait T, Docking S, Cook J, Owoeye O, Bonello C, Emery C, Pasanen K, Edwards S, Rio E. Prevalence and pain distribution of anterior knee pain in college basketball players. J Athl Train 2021; 57:319-324. [PMID: 34329433 DOI: 10.4085/1062-6050-0604.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Causes of anterior knee pain (AKP) in jumping athletes include patellofemoral pain and patellar tendinopathy. Differential diagnosis of AKP is challenging, with variation in clinical presentations. No previous research has used pain location to describe AKP in basketball athletes. OBJECTIVES To describe the prevalence and pain distribution of AKP in college basketball. To report the prevalence of focal inferior pole pain using two outcome measures. DESIGN Cross-sectional study Setting: University and college basketball facilities in Alberta, Canada. PATIENTS OR OTHER PARTICIPANTS 242 collegiate basketball athletes Main Outcome Measure(s): The single leg decline squat test (SLDS) was used to capture pain location using pain mapping (dichotomised into focal/diffuse) and pain severity (numerical rating scale). The Oslo Sports Trauma Research Centre Knee questionnaire (OSTRC-Knee) and adapted version for patellar tendinopathy (OSTRC-P) were used to report the prevalence of anterior knee pain (AKP) and patellar tendinopathy respectively. Focal inferior pole pain during the SLDS was used to classify patellar tendinopathy. RESULTS Of the 242 players (138 women, 104 men), 146 (60%) reported pain with the SLDS [unilateral n=64, (26%); bilateral n=82 (34%)]. 101 (43%) reported knee pain using the OSTRC-Knee. Pain mapping captured variability in pain location. Diffuse pain was more prevalent [left 70%; right 72%] than focal pain [left 30%; right 28%]. There was low prevalence of patellar tendinopathy with either outcome measure; OSTRC-P [n=21, 8.7%] and inferior pole pain during the SLDS [n=25, 10.3%] Conclusions: Diffuse AKP was common in Canadian basketball players, however pain mapped to the inferior pole of the patella was not. Few players reported tendinopathy using the OSTRC-P, suggesting that patellar tendinopathy was not a primary knee pain presentation in this jumping cohort. Pain location rather than presence or severity of pain alone may better describe the clinical presentations of AKP in jumping athletes.
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Affiliation(s)
- Madeline Hannington
- 1La Trobe Sport and Exercise Medicine Research Centre; College of Science, Health and Engineering; La Trobe University; Australia
| | - Tyler Tait
- 2Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Sean Docking
- 1La Trobe Sport and Exercise Medicine Research Centre; College of Science, Health and Engineering; La Trobe University; Australia
| | - Jill Cook
- 1La Trobe Sport and Exercise Medicine Research Centre; College of Science, Health and Engineering; La Trobe University; Australia
| | - Oluwatoyosi Owoeye
- 2Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,8Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, St. Louis, MO, United States
| | - Christian Bonello
- 1La Trobe Sport and Exercise Medicine Research Centre; College of Science, Health and Engineering; La Trobe University; Australia
| | - Carolyn Emery
- 2Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,4Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,5Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,6McCaig Research Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Kati Pasanen
- 2Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,5Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,6McCaig Research Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.,7Tampere Research Center of Sport Medicine, UKK Institute, Tampere, Finland
| | - Suzi Edwards
- 2Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Ebonie Rio
- 1La Trobe Sport and Exercise Medicine Research Centre; College of Science, Health and Engineering; La Trobe University; Australia
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Hasani F, Haines TP, Munteanu SE, Vicenzino B, Malliaras P. Efficacy of different load intensity and time-under-tension calf loading protocols for Achilles tendinopathy (the LOADIT trial): protocol for a randomised pilot study. Pilot Feasibility Stud 2020; 6:99. [PMID: 32685183 PMCID: PMC7359581 DOI: 10.1186/s40814-020-00639-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 06/29/2020] [Indexed: 02/08/2023] Open
Abstract
Background Modifying variables in exercise prescription can produce specific effects on Achilles tendinopathy outcomes. This study aims to determine the feasibility of conducting an adequately powered randomised trial in the future to assess the efficacy of different load intensity and time-under-tension exercise parameters for improving pain and function in individuals with persistent midportion Achilles tendinopathy. Methods The trial is designed as prospective, four-armed feasibility and randomised pilot trial with 3 months follow-up. Interventions will be provided in a gym setting. The investigator, who will be blind to the allocation of participants, will conduct all pre- and post-intervention assessments. Forty-eight male participants with Achilles tendinopathy will be recruited from the community. We will use a 2 × 2 factorial design with factors of load intensity (six or eighteen repetitions maximum) and time-under-tension (two or six second repetitions). Participants will be randomised into one of the testing groups: six RM with two second repetitions, six RM with six second repetitions, eighteen RM with two second repetitions or eighteen RM with six second repetitions. Trial feasibility will be indicated by the rate of conversion, recruitment and retention, adherence to the interventions by participants, the utility of videoconferencing mode for weekly exercise supervision, incidence of adverse events, and feasibility of future economic evaluation. The secondary clinical outcomes will assess pain and disability, participant impression of change, satisfaction, health-related quality of life, physical activity, work absenteeism, psychological measures at baseline, 6 and 12 weeks, and plantarflexor contractile dysfunction (torque, rate of force development and muscle force steadiness) at baseline and 12 weeks. These clinical outcomes are primarily measured to provide information regarding potential treatment effects and trends. Discussion The proposed study and follow-up powered randomised trial will be a first step towards determining exercise dose parameters that may optimise outcomes for Achilles tendinopathy. We have chosen to focus on load intensity and time-under-tension, as these parameters are important for tendon adaptation. This work has the potential to lead to more effective exercise loading interventions for Achilles tendinopathy. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12618001315202. Registered retrospectively on August 6th, 2018.
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Affiliation(s)
- Fatmah Hasani
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Frankston, Victoria 3199 Australia.,Physiotherapy Department, Security Forces Hospital Program, Riyadh, 11481 Kingdom of Saudi Arabia
| | - Terry P Haines
- School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Frankston, Victoria 3199 Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria 3086 Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria 3086 Australia
| | - Bill Vicenzino
- Sports Injuries Rehabilitation and Prevention for Health Research Unit, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland Australia
| | - Peter Malliaras
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Frankston, Victoria 3199 Australia
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Jibb LA, Khan JS, Seth P, Lalloo C, Mulrooney L, Nicholson K, Nowak DA, Kaur H, Chee-A-Tow A, Foster J, Stinson JN. Electronic Data Capture Versus Conventional Data Collection Methods in Clinical Pain Studies: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e16480. [PMID: 32348259 PMCID: PMC7351264 DOI: 10.2196/16480] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/21/2020] [Accepted: 03/22/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The most commonly used means to assess pain is by patient self-reported questionnaires. These questionnaires have traditionally been completed using paper-and-pencil, telephone, or in-person methods, which may limit the validity of the collected data. Electronic data capture methods represent a potential way to validly, reliably, and feasibly collect pain-related data from patients in both clinical and research settings. OBJECTIVE The aim of this study was to conduct a systematic review and meta-analysis to compare electronic and conventional pain-related data collection methods with respect to pain score equivalence, data completeness, ease of use, efficiency, and acceptability between methods. METHODS We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), and Cochrane Central Register of Controlled Trials (CENTRAL) from database inception until November 2019. We included all peer-reviewed studies that compared electronic (any modality) and conventional (paper-, telephone-, or in-person-based) data capture methods for patient-reported pain data on one of the following outcomes: pain score equivalence, data completeness, ease of use, efficiency, and acceptability. We used random effects models to combine score equivalence data across studies that reported correlations or measures of agreement between electronic and conventional pain assessment methods. RESULTS A total of 53 unique studies were included in this systematic review, of which 21 were included in the meta-analysis. Overall, the pain scores reported electronically were congruent with those reported using conventional modalities, with the majority of studies (36/44, 82%) that reported on pain scores demonstrating this relationship. The weighted summary correlation coefficient of pain score equivalence from our meta-analysis was 0.92 (95% CI 0.88-0.95). Studies on data completeness, patient- or provider-reported ease of use, and efficiency generally indicated that electronic data capture methods were equivalent or superior to conventional methods. Most (19/23, 83%) studies that directly surveyed patients reported that the electronic format was the preferred data collection method. CONCLUSIONS Electronic pain-related data capture methods are comparable with conventional methods in terms of score equivalence, data completeness, ease, efficiency, and acceptability and, if the appropriate psychometric evaluations are in place, are a feasible means to collect pain data in clinical and research settings.
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Affiliation(s)
- Lindsay A Jibb
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - James S Khan
- Department of Anesthesia, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Anesthesia, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Puneet Seth
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Chitra Lalloo
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Lauren Mulrooney
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Kathryn Nicholson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Dominik A Nowak
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Harneel Kaur
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Joel Foster
- Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jennifer N Stinson
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Hannington M, Docking S, Cook J, Edwards S, Rio E. Self-reported jumpers’ knee is common in elite basketball athletes – But is it all patellar tendinopathy? Phys Ther Sport 2020; 43:58-64. [DOI: 10.1016/j.ptsp.2020.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 01/20/2020] [Accepted: 01/20/2020] [Indexed: 12/30/2022]
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Galve Villa M, D. Mørch C, S. Palsson T, Boudreau SA. Modifiable motion graphics for capturing sensations. PLoS One 2020; 15:e0229139. [PMID: 32092081 PMCID: PMC7039426 DOI: 10.1371/journal.pone.0229139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/30/2020] [Indexed: 11/25/2022] Open
Abstract
Objective The purpose of this study was to assess the relationship between an embodied sensory experience and the ability to translate the perception of this experience visually using modifiable motion graphics. Methods A custom-designed software was developed to enable users to modify a motion graphic in real-time. The motion graphics were designed to depict realistic visualizations of pain quality descriptors, such as tingling and burning. Participants (N = 34) received an electrical stimulation protocol known to elicit sensations of tingling. The protocol consisted of eight stimulation intensities ranging from 2—6mA delivered, in a randomized fashion and repeated three times, to the index finger. Immediately after each stimulus, participants drew the area of the evoked sensation on a digital body chart of the hand. Participants then modified the motion graphic of tingling by adjusting two parameters, namely the speed (rate of dots disappearing and re-appearing) and density of these dots in the drawn area. Then, participants rated the perceived intensity and selected the most appropriate pain quality descriptor. Results There was an increase in the area, density, and perceived intensity ratings as the electrical stimulation intensity increased (P<0.001). The density of the motion graphic, but not speed, correlated with perceived intensity ratings (0.69, P<0.001) and electrical stimulation intensities (0.63, P<0.01). The descriptor ‘tingling’ was predominantly selected in the range of 3–4.5mA and was often followed by ‘stabbing’ as the electrical intensity increased. Discussion The motion graphic tested was perceived to reflect a tingling sensation, the stimulation protocol elicited a tingling sensation, and participants adjusted one of the two motion graphic features systematically. In conclusion, an embodied sensation, such as tingling, maybe visually represented similarly between individuals. These findings create research, clinical, and commercial opportunities that utilize psychophysics to explore, visualize, and quantify changes in embodied sensory experiences in response to known stimuli.
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Affiliation(s)
- Maria Galve Villa
- Center for Neuroplasticity and Pain (CNAP), Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Carsten D. Mørch
- Center for Neuroplasticity and Pain (CNAP), Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Thorvaldur S. Palsson
- Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Shellie A. Boudreau
- Center for Neuroplasticity and Pain (CNAP), Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- * E-mail:
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Distinct patterns of variation in the distribution of knee pain. Sci Rep 2018; 8:16522. [PMID: 30410031 PMCID: PMC6224396 DOI: 10.1038/s41598-018-34950-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/22/2018] [Indexed: 12/11/2022] Open
Abstract
The patient’s expression of pain using digital-body maps expands analytic opportunities for exploring the spatial variation of bodily pain. A common knee pain condition in adolescents and adults is patellofemoral pain (PFP) and recently PFP was shown to be characterized by a heterogeneous distribution of pain. Whether there are important patterns in these distributions remains unclear. This pioneering study assesses the spatial variation of pain using principal component analysis and a clustering approach. Detailed digital-body maps of knee pain were drawn by 299 PFP patients of mixed sex, age, and pain severity. Three pain distribution patterns emerged resembling an Anchor, Hook, and an Ovate shape on and around the patella. The variations in pain distribution were independent of sex, age, and pain intensity. Bilateral pain associated with a longer duration of pain and the majority characterized by the Hook and Ovate pain distributions. Bilateral and/or symmetrical pain between the left and right knees may represent symptoms associated with longstanding PFP. The distinct patterns of pain location and area suggest specific underlying structures cannot be ruled out as important drivers, although central neuronal mechanisms possibly exemplified by the symmetrical representation of pain may play a role in individuals with longstanding symptoms.
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