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Updated: Sep 27, 2026
A Protocol of Manual Tests to Measure Sensation and Pain in Humans
Published on: December 19, 2016
Inter-Rater Reliability of the Progressive Pain Check Method for Standardized Pain Assessment in Lipedema
Laura Patton1, Lorenzo Ricolfi1, Heba Safwat Mhmoued Abdo Elhadidy2
1Endocrinology and Lymphology Clinic, 38096 Vallelaghi, Italy.
Background:
Lipedema is a chronic progressive condition affecting approximately 10% of women, characterized by disproportionate subcutaneous adipose tissue accumulation and pain in the lower extremities. Standardized assessment methods for pain evaluation in lipedema remain limited. The Progressive Pain Check (PPC) method represents a potentially valuable tool for standardized pain assessment in lipedema patients.
Objective:
To evaluate the inter-rater reliability of the PPC method for clinical assessment of evoked pain in lipedema patients.
Methods:
Two independent assessors performed PPC evaluations. Inter-rater reliability was assessed using the Intraclass Correlation Coefficient [ICC(2,1), two-way random-effects, absolute agreement, single-measurement] with 95% confidence intervals (CI).
Results:
This study included 429 women diagnosed with lipedema (mean age 41.2 ± 11.5 years, mean disease duration 27.2 ± 12.6 years). Patient characteristics revealed mean BMI of 29.5 ± 6.9 kg/m2, predominantly Type III lipedema presentation, and disease onset during adolescence (mean age 14 ± 9.3 years). The PPC method demonstrated excellent inter-rater reliability between two independent assessors across all examined anatomical districts.
Conclusions:
The PPC method shows promise as a simple, repeatable, and standardized clinical tool for evoked pain assessment in lipedema patients. The demonstrated inter-rater reliability supports its potential utility in clinical practice. Further research is warranted to evaluate its intra-rater reliability, concurrent validity, and responsiveness in monitoring treatment effects.
