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Reporting the Location and Extent of Pain in Adolescents: A Test-Retest Reliability Study
Anna Folli1, Deborah Falla2, Corrado Cescon3
1Centre 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; Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
Adolescents with musculoskeletal pain reliably reported pain extent and location using pain drawings in a test-retest study. This validated the tool for assessing pain in this age group.
Area of Science:
- Pain research
- Adolescent health
- Musculoskeletal disorders
Background:
- Pain drawings are self-administered tools for patients to indicate pain areas on a body chart.
- Previous studies have validated pain drawings in adult populations.
Purpose of the Study:
- To establish the test-retest reliability of paper-based pain drawings for reporting pain extent and location in adolescents.
- To validate pain drawing use in pediatric patients with musculoskeletal pain.
Main Methods:
- A one-day test-retest reliability study was conducted with adolescents (aged 11-16) experiencing musculoskeletal pain.
- Participants completed a pain drawing, followed by a questionnaire and personal data collection, then a second pain drawing.
- Scanned pain drawings were analyzed digitally to extract pain extent and location data, with reliability assessed using intraclass correlation coefficient, Bland-Altman analysis, and Jaccard similarity coefficient.
Main Results:
- Excellent test-retest reliability was found for reporting pain extent (ICC2,1: 0.959).
- Bland-Altman analysis indicated a mean difference close to 0 for pain extent reporting (-0.010%).
- Reliable reporting of pain location was confirmed by a mean Jaccard index score of 0.82 (± 0.19).
Conclusions:
- Paper-based pain drawings demonstrate high reliability for reporting both the extent and location of pain in adolescents with musculoskeletal pain.
- Findings support the use of pain drawings as a valid assessment tool for this demographic.
- Potential variations in reliability may be influenced by pain characteristics, duration, disorder type, and involved body areas.
