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1、Published by Maney Publishing (c) W. S. Maney additionally, physical therapy treatment approaches must be demonstrated to be clinically effective, as part of which observed changes in patient status as a result of physical therapy interventions, should be demon- strably clinically meaningful and sta
2、tistically signifi- cant. Physical therapists must go beyond the routine of performing specific tests or measures, but rather must understand the theoretical basis for the mea- surement; understand what the instrument is measur- ing; know how to chose the most appropriate tool; understand potential
3、sources of error; know how to interpret the clinical information obtained; andunderstand measurement issues, including concepts of validity and reliability.1,2 Pain is one of the primary reasons patients seek medical attention; therefore, patient perceived pain levels are commonly used as an outcome
4、 measure and indicator of clinical change. Unlike measurements of physical impairments such as range of motion or strength, pain is a subjective and multidimensional phenomenon, its presentation depending upon a vari- ety of aetiologies and influencing factors.36The sub- jective nature of pain leads
5、 to some of the difficulty encountered in its measurement: instruments must translate subjective information into objective mea- sures.4Numerous pain measurement tools are com- monly used by both clinicians and researchers.418As a result of the subjective and multidimensional char- acteristics of pa
6、in, most clinical studies use a combi- nation of pain measures in an attempt to ensure a true representation of the patients pain experience. The purpose of this literature review is to explore, compare, and contrast the psychometric properties of W. S. Maney however, pain is a multidimensional expe
7、rience that is often difficult to measure. A variety of instruments have been developed in an attempt to obtain an accurate measure of patients perceived level of pain. Three of the most common outcome measures utilised by physical therapists include the visual analogue scale, the numeric pain ratin
8、g scale and the McGill Pain Questionnaire. The purpose of this review is to describe the psychometric properties, including reliability and responsiveness, of these outcome measures.Keywords: Outcome measures, psychometric properties, pain, VAS, NPRS, MPQPhysical Therapy Reviews 2005; 10: 123128Publ
9、ished by Maney Publishing (c) W. S. Maney 2,22the testretest reliability for the NPRS has been demonstrated to be moderateto high, varying from 0.67 to 0.96.2123Validity is defined as the ability of a test to measure what it is intended to measure; the extent to which inferences can be made from the
10、 measurement obtained.2,22Criterion validity determines the degree to which a measurement correlates to a gold standard, or criterion test mea- sure.22Criterion validity has not been established for the NPRS as there are no gold standards for pain mea- surement; however, when correlated with the VAS
11、, the NPRS is determined to have 0.79 to 0.95 convergent validity.21,23These values support the use of the NPRS, as convergent validity indicates that two measures assessing the same phenomenon measure the same con- struct, and yield similar results.22 Responsiveness of a scale is defined as its abi
12、lity to detect change over time.22Finch21reports that a three- point change in the NPRS is necessary to demon- strate a true change in pain intensity, implying that there are limitations in the responsiveness of a 010 scale. Despite the ease in administration and scoring of the NPRS, it has been est
13、ablished that individuals with cognitive deficits may have trouble interpreting the numbers and words on the NPRS, and may not be able to use this scale accurately.4,21Visual analogue scaleThe VAS is considered by some to be one of the best measures of pain intensity.8,13Similar to the NPRS, the VAS
14、 is a self-reported measurement consisting of a vertical or horizontal line with extreme anchors of no pain to extreme pain.4,10,13,21This line represents a continuum of pain intensity and is most often 10 cm in length.13,21The patient is asked to mark their per- ceived level of pain intensity (for
15、a specified time frame) on the line.21The examiner scores the instru- ment by measuring the distance, in millimetres, from the no pain anchor to the mark, which the patient identified as their level of pain.21The simplicity of its construction and use are considered the main advan- tages of the VAS.
16、4The measurement continuum is also believed to provide greater sensitivity than a numerical scale.4,9Of great significance, at least for research purposes, is the fact that the VAS provides ratio data and permits the use of parametric statis- tics.4,8,24Disadvantages include the fact that individu- als with visual or cognitive deficits may not be able to use it accurately. A significant correlation between the number of incorrect responses to the VAS and age appears to exist
