TITLE:
Effect of Specific Verbal Instructions on the Identification of Pain Location during a Passive Straight Leg Raise Test
AUTHORS:
Masae Ikeya, Takumi Jiroumaru, Hitomi Bunki, Noriyuki Kida, Teruo Nomura
KEYWORDS:
Specific Verbal Instructions, Pain Location, Pain Assessment, Passive Straight Leg Raise Test
JOURNAL NAME:
Open Journal of Therapy and Rehabilitation,
Vol.11 No.2,
May
11,
2023
ABSTRACT: 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.