Abstract
Objective: A mechanism-based clinical framework for spine-related pain differentiates (i) somatic referred pain, ii) heightened nerve mechanosensitivity, iii) radicular pain, iv) radiculopathy and mixed-pain. This study aimed to determine the reliability of proposed framework. Method: Fifty-one people with unilateral spine-related neck-arm pain were assessed and categorized by examiner-1. The classifications were compared to those made by two other examiners, based on written documentation of examiner-1. Cohens kappa was calculated between examiner-pairs; Fleiss Kappa among all examiners to assess agreement in classifying subgroups and entire framework. Result: Inter-rater-reliability showed moderate to almost perfect reliability (somatic: no variation, mechanosensitivity: 0.96 (95% CI 0.87–1.0) to 1.0 (95% CI: 1.0–1.0), radicular pain: 0.46 (95% CI: 0.19–0.69) to 0.62 (95% CI: 0.42–0.81), radiculopathy: 0.65 (95% CI: 0.43–0.84) to 0.80 (95% CI: 0.63–0.96) mixed-pain: 0.54 (95% CI: 0.21–0.81) to 0.75 (95% CI: 0.48–0.94). There was almost perfect to moderate reliability among all examiners (somatic: no variation, mechanosensitivity: 0.97 (95% CI: 0.82–1.0), radicular pain: 0.56 (95% CI: 0.40–0.71), radiculopathy: 0.74 (95% CI: 0.58–0.90), mixed-pain: 0.63 (95% CI: 0.47–0.79), entire framework: 0.64 (95% CI: 0.57–0.71)). Intra-rater-reliability showed substantial to almost perfect reliability (somatic: no variation, mechanosensitivity: 0.96 (95% CI: 0.87–1.0), radicular pain: 0.76 (95% CI: 0.57–0.92), radiculopathy: 0.84 (95% CI: 0.67–0.96), mixed-pain: 0.83 (95% CI: 0.60–1.0), entire framework: 0.80 (95% CI: 0.61–0.92). Conclusion: Moderate to almost perfect reliability in subgrouping people with spine-related neck-arm pain and substantial reliability for entire framework support this classification's reliability.
| Original language | English |
|---|---|
| Article number | 102853 |
| Journal | Musculoskeletal Science and Practice |
| Volume | 67 |
| ISSN | 2468-8630 |
| DOIs | |
| Publication status | Published - 10.2023 |
Funding
The project was supported by a scholarship from the Hochschule Osnabrueck, University of Applied Sciences and by a research grant from Physio Deutschland. A.B. Schmid is supported by a Wellcome Trust Clinical Career Development Fellowship ( 222101/Z/20/Z ) and the Medical Research Foundation (Emerging Leaders Prize in Pain Research) . The funders played no role in the design, conduct, or reporting of this study. The authors report no conflict of interest. We are very grateful to all participants and for the support from our physiotherapy colleagues as well as MVZ Hagen a.T.W. and the medical doctors from FOURBs Osnabrueck with recruitment. This study was supported by the Hochschule Osnabrueck, University of Applied Sciences and Physio Deutschland . ABS is supported by a Wellcome Trust Clinical Career Development Fellowship ( 222101/Z/20/Z ) and the Medical Research Foundation ( MRF-160-0013-ELP-SCHM-C0842 ; Emerging Leaders Prize in Pain Research).
Research Areas and Centers
- Health Sciences
DFG Research Classification Scheme
- 2.23-07 Clinical Neurology, Neurosurgery and Neuroradiology
