Table 4.
Summary of Articles on Pain Assessment with Level of Evidence Included in Systematic Review
| Reference | Psychometric property | Sample size (no.) | Inclusion and exclusion criteria | Study population | Injury features | Instrument | LOE |
|---|---|---|---|---|---|---|---|
| Davidoff et al., 1987 | Convergent construct validity | 166 total DPS = 19 MRSCICS = 147 |
Patients with DPS of at least 1 mo, who failed to respond to conventional treatments, and had: disturbance of sleep-wake cycle, inability to perform self-care activities, or inability to fully comply with a therapeutic exercise program. Pts with traumatic myelopathy were excluded. | Mean age (DPS), 36.6 yr; mean age (MRSCICS), 32 yr | Level of injury • Tetraplegia (DPS) = 15.8% • Tetraplegia (MRSCICS) = 54.4% Severity of injury • Complete (DPS) = 26.3% • Complete (MRSCICS) = 48.6% |
MPQ, Sternbach Pain Intensity, Zung Pain, and Distress Index | 4 |
| Cohen et al., 1988 | Convergent construct validity | 147 total SCI = 49 |
Patients with at least 6-mo history of chronic pain were included. | Mean age (SCI), 47.2 yr; male (SCI), 95% | NR | MPQ | 4 |
| Song et al., 1993 | Convergent construct validity | 47 total SCI = 31 |
Included individuals with traumatic SCI at T1 or below, without central or peripheral nerve disease, and without recent history of ethanol abuse. In addition, a SCI subgroup included individuals with DPS after SCI. Control group included healthy volunteers. | SCI & pain: mean age, 57 yr; range, 32 − 70 yr; SCI, no pain: mean age, 57 yr; range, 33−73 yr; Controls: mean age, 50 yr; range, 30−73 yr |
SCI & pain: level of SCI = T1-L4 SCI, no pain: level of SCI = T1-L3 |
VAS | 4 |
| Curtis et al., 1995 | Internal consistency | 64 total SCI = 57 |
Patients with wheelchairs as their primary means of mobility for at least 1 yr were included. | Mean age, 42.9 yr; males/females, 62/2 | Level of injury • Cervical = 13 • Thoracic = 38 • Lumbar = 6 |
Wheelchair Users Shoulder Pain Index | 4 |
| Quigley and Veit, 1996 | Convergent construct validity | 27 | All SCI patients with complete data were included. | Mean age, 47 yr; males/females, 26/1 | Level of injury • Tetraplegia = 9 • Paraplegia = 18 |
McGill-Melzack Pain Questionnaire | 4 |
| Kennedy et al., 1997 | Convergent construct validity | 76 | Included all patients with traumatic SCI between 16 and 65 yr | Male, 76% | Level of injury • Tetraplegia = 32% • Paraplegia = 68% |
6-point Likert scale | 4 |
| Widerstrom-Noga et al., 2001 | Convergent construct validity | 217 | Included all SCI individuals with chronic pain who had complete data in the Miami Project Database and answered survey. | Mean age, 39 yr; male, 75.4% | Level of injury • Tetraplegia = 54% • Paraplegia = 46% Mean time since SCI = 8.2 yr |
VAS | 4 |
| Defrin et al., 2001 | Convergent construct validity | 39 total SCI = 21 |
Included individuals with incomplete traumatic SCI at L3-T4 and healthy volunteers. | SCI & pain: mean age, 38.9 yr SCI, no pain: mean age, 37.6 yr Controls: mean age, 35.6 yr |
NR | VAS | 4 |
| Cardenas et al., 2002 | Inter-rater reliability | 163 | Included SCI patients age 18 or older whose data were collected in the Northwest Regional Spinal Cord Injury System. | Mean age, 40.6 yr (males), 43.9 yr (females); male, 69.9% | Cause of injury • MVA = 49.1% • Fall = 19.6% Mean years since SCI = 8.3 |
Pain classification | 4 |
| Putzke et al., 2002 | Convergent construct validity | 29 | Adults with traumatic SCI who experienced at least one pain site. | Mean age, 45.2 yr; males/females, 24/5 | Level of injury • Paraplegia = 22 • Tetraplegia = 7 Severity of injury • Complete = 14 • Incomplete = 15 |
Verbal descriptors | 4 |
| Richards et al., 2002 | Inter-rater reliability | 28 | Adults with traumatic SCI who developed chronic pain in 1 or more sites at 1 yr after SCI were included. Pts with a fourth grade reading level or lower or history of TBI or chronic pain prior to SCI were excluded. | Mean age, 45.5 yr; males/females, 23/5 | Level of injury Paraplegia = 21 • Tetraplegia = 7 Severity of injury • Complete = 13 • Incomplete = 15 |
Donovan Pain Classification Scheme | 4 |
| Turner et al., 2002 | Convergent construct validity | 174 | Included SCI individuals with chronic pain who had data collected in the Northwest Regional SCI System and answered survey. | Mean age, 41.5 yr; male, 70.7% | Level of injury • Tetraplegia = 54% • Paraplegia = 46% Time since SCI = 8.1 yr |
VAS | 4 |
| Putzke et al., 2003a | Test-retest reliability; Inter-rater reliability |
28 | Adults with traumatic SCI and chronic pain were included. Pts with fourth grade reading level or lower or history of TBI or chronic pain prior to SCI were excluded. | Mean age, 45.5 yr; males/females, 23/5 | Level of injury • Paraplegia = 21 • Tetraplegia = 7 Severity of injury • Complete = 13 • Incomplete = 15 |
Donovan Pain Classification Scheme | 4 |
| Putzke et al., 2003b | Inter-rater reliability | 29 | Adults with traumatic SCI and chronic pain were included. Pts with fourth grade reading level or lower or history of TBI orchronic pain prior to SCI were excluded. | Mean age, 45.2 yr; males/females, 24/5 | Level of injury • Paraplegia = 22 • Tetraplegia = 7 Severity of injury • Complete = 14 • Incomplete = 15 |
International Assoc. for the Study of Pain and Tunks SCI pain classification | 4 |
| Samuelsson et al., 2004 | Convergent construct validity | 66 | Only individuals with paraplegia for more than 1 yr were included. | Mean age, 49 yr; males/females, 44/12 | All paraplegics, mean time since SCI = 13.9 yr | Constant Murley Scale | 4 |
| Roth et al., 2004 | Convergent construct validity | 69 total SCI = 12 |
Only hospital inpatients, outpatients, or nursing home residents with chronic stage 2, 3, or 4 pressure sores were included. Patients with mental incompetence were excluded. | Mean age, 59 yr; male, 100% | NR | MPQ | 4 |
| Hanley et al., 2006a | Convergent construct validity | 481 | Included adults (18 yr or older) with a chronic SCI (>6 mo since injury). | Mean age, 42.6 yr; male, 72% | NR | VAS | 4 |
| Bryce et al., 2006 | Inter-rater reliability | 39 | NR | NR | NR | Bryce/Ragnarsson SCI Pain Taxonomy | 4 |
| Raichle et al., 2006 | Convergent construct validity | 127 | SCI patients with pain were included. | Mean age, 48.6 yr; males/female, 92/35 | Level of injury • Cervical = 58 • Thoracic = 56 • Lumbosacral = 1 • Other = 13 |
VAS | 4 |
| Salisbury et al., 2006 | Convergent construct validity | 27 | Individuals with tetraplegia between 2 and 4 yr post-SCI under rehabilitation. | Mean age, 42.5 yr; males/females, 20/7 | All tetraplegics | VAS, MPQ, and Wheelchair Users Shoulder Pain Index | 4 |
| Widerstrom-Noga et al., 2006 | Convergent construct validity | 161 | Adults with traumatic SCI and chronic pain were included. | Mean age, 43.5 yr; males/females, 138/23 | Level of Injury • Cervical = 76 • Below cervical = 84 • Unknown = 1 Severity of injury • Complete = 93 • Incomplete = 50 • Unknown = 18 |
Multidimensional Pain Inventory-SCI version | 4 |
| Budh and Osteraker, 2007 | |||||||
| Attal et al., 2008 | Content validity | 482 total SCI = 78 |
Included adults with pain due to primary lesion of the peripheral or central nervous system. | Mean age, 57 yr; males/females, 258/224 | NR | Neuropathic Pain Symptom Inventory | 4 |
| Hanley et al., 2008 | Convergent construct validity | 40 | Adults with traumatic SCI and chronic pain were included. | Mean age, 49.3 yr; male, 70% | Level of injury • Cervical = 48% • Thoracic = 42% • Lumbosacral= 10% Severity of injury • Complete = 40% • Incomplete = 50% • Unknown = 10% Cause of injury • MVA = 30% • Fall = 18% • Diving = 10% • Sports = 8% • Gunshot = 8% • Other = 36% |
VAS | 4 |
DPS, dysestheic pain syndrome; LOE, level of evidence; MPQ, McGill Pain Questionnaire; MRSCICS, Midwest Regional Spinal Cord Injury Care System; MVA, motor vehicle accident; NR, not reported; pt(s), patient(s); SCI, spinal cord injury; TBI, traumatic brain injury; VAS, visual analog scale.