Effect of Specific Verbal Instructions on the Identification of Pain Location during a Passive Straight Leg Raise Test  

作　　者：Masae Ikeya Takumi Jiroumaru Hitomi Bunki Noriyuki Kida Teruo Nomura Masae Ikeya;Takumi Jiroumaru;Hitomi Bunki;Noriyuki Kida;Teruo Nomura(Department of Physical Therapy, Biwako Professional University of Rehabilitation, Higashiomi City, Japan;Department of Applied Biology, Graduate School of Science and Technology, Kyoto Institute of Technology, Kyoto City, Japan;Department of Physical Therapy, Bukkyo University, Kyoto City, Japan;Kanazawa Orthopedic & Sports Medicine Clinic, Ritto City, Japan)

机构地区：[1]Department of Physical Therapy, Biwako Professional University of Rehabilitation, Higashiomi City, Japan [2]Department of Applied Biology, Graduate School of Science and Technology, Kyoto Institute of Technology, Kyoto City, Japan [3]Department of Physical Therapy, Bukkyo University, Kyoto City, Japan [4]Kanazawa Orthopedic & Sports Medicine Clinic, Ritto City, Japan

出　　处：《Open Journal of Therapy and Rehabilitation》2023年第2期45-53,共9页康复医学（英文）

摘　　要：Musculoskeletal pain is common. Because pain is subjective, objectively describing it is crucial. However, pain assessment may cause distress in patients;therefore, physical therapists (PTs) should conduct these tests quickly and accurately. Simple and clear instructions are recommended for pain assessment. However, few studies have provided evidence to support this hypothesis. Correspondingly, this study aimed to confirm the effectiveness of specific verbal instructions for pain location during five consecutive Passive Straight Leg Raise (PSLR) tests. The 28 asymptomatic participants (age 27.4 ± 9.6 years) who provided informed consent received five consecutive PSLR tests: three without and two with specific verbal instructions to ascertain pain intensity, quality, and location. The participants drew pain locations on a body chart and described the pain intensity and quality after each test. All participants were interviewed regarding the differences they noted in the presence and absence of specific verbal instructions. Each pain location was classified into one of ten areas for statistical analysis. The proportion of participants who changed the pain location was compared between the tests using McNemar’s test, and the kappa coefficient was confirmed for consistency of pain location. There was a significant difference in the proportion of participants who changed their pain location between the second and third tests and from the third to the fourth test (McNemar’s test: p = 0.003). Kappa coefficients had low consistency (κ = 0.28) just after receiving the specific verbal instructions in the fourth test compared to the third test. Consistency improved in the fifth test (κ = 0.57);93% of the participants answered that the pain location had become clearer. This study revealed the effects of specific verbal instructions in identifying pain locations. This detailed information may help PTs provide appropriate treatment and contribute to reducing pain in clinical settings.Musculoskeletal pain is common. Because pain is subjective, objectively describing it is crucial. However, pain assessment may cause distress in patients;therefore, physical therapists (PTs) should conduct these tests quickly and accurately. Simple and clear instructions are recommended for pain assessment. However, few studies have provided evidence to support this hypothesis. Correspondingly, this study aimed to confirm the effectiveness of specific verbal instructions for pain location during five consecutive Passive Straight Leg Raise (PSLR) tests. The 28 asymptomatic participants (age 27.4 ± 9.6 years) who provided informed consent received five consecutive PSLR tests: three without and two with specific verbal instructions to ascertain pain intensity, quality, and location. The participants drew pain locations on a body chart and described the pain intensity and quality after each test. All participants were interviewed regarding the differences they noted in the presence and absence of specific verbal instructions. Each pain location was classified into one of ten areas for statistical analysis. The proportion of participants who changed the pain location was compared between the tests using McNemar’s test, and the kappa coefficient was confirmed for consistency of pain location. There was a significant difference in the proportion of participants who changed their pain location between the second and third tests and from the third to the fourth test (McNemar’s test: p = 0.003). Kappa coefficients had low consistency (κ = 0.28) just after receiving the specific verbal instructions in the fourth test compared to the third test. Consistency improved in the fifth test (κ = 0.57);93% of the participants answered that the pain location had become clearer. This study revealed the effects of specific verbal instructions in identifying pain locations. This detailed information may help PTs provide appropriate treatment and contribute to reducing pain in clinical settings.

关 键 词：Specific Verbal Instructions Pain Location Pain Assessment Passive Straight Leg Raise Test 

分 类 号：R24[医药卫生—中医临床基础]