Measuring musculoskeletal pain by questionnaires: the manikin versus written questions

A picture of a human figure (manikin) on which pain can be indicated can be used to measure musculoskeletal pain in self administered or web-based questionnaires. In this paper we present an analysis of the agreement between pain reported on a manikin and pain reported using written questions as assessed in the follow-up questionnaire of the Dutch population-based Musculoskeletal Conditions and Consequences Cohort (DMC(3)-study). Both a manikin and extensive questions on pain were included and the agreement between the two measures was studied for nine pain locations. For a similar pain definition - pain lasting at least a week - the manikin gave slightly higher prevalences than the written questions. Around three quarter of those who reported pain on the written questionnaire also indicated pain on the manikin on the same anatomical location. There were no differences in the percentage of agreement by sex, age group or level of education, except for a lower percentage of agreement of the manikin among the elderly for pain in the lower extremities, neck and shoulder and among the lower level of education group for neck pain. Almost 6% of the participants reported pain according to the questions only and more than 10% (especially men) reported pain on the manikin only. We concluded that a manikin gives similar findings on prevalence of pain as written questions and could therefore be a good alternative for written questions only.