A systematic review of psychometric evaluations of outcome assessments for complex regional pain syndrome

Abstract

Purpose: To conduct a systematic review of the quality and extent of psychometric examinations of disease-specific outcome measures for complex regional pain syndrome (CRPS). Methods: Health database searches yielded 23 papers covering 19 assessment instruments. Each article was scored for quality using a 12-item structured tool; data were also extracted for comparison of tool content. Results: Article quality ratings ranged from 25 to 88%. Six of the tools were specific to the upper extremity; 5 for the lower extremities while the remaining 8 were general. Many ‘general’ tools focused on a single construct, such as pain, skin temperature or allodynia. Most psychometric data was based on small studies (mean n = 33); only one study addressed all relevant issues of reliability, validity and responsiveness. Conclusions: Despite the variety of outcome measurement tools reported for CRPS rehabilitation, large gaps in both comprehensiveness and supporting psychometric evidence remain. Comprehensive, relevant and psychometrically sound tools for monitoring treatment outcomes are needed to address the pain and functional limitations experienced by this population.

Implications for Rehabilitation

• Complex regional pain syndrome (CRPS) is a neurological disorder with signs and symptoms that vary with activity, environment and stress.

• Although there is no diagnostic test for this syndrome, a need exists for tools to monitor treatment outcomes that address the pain and functional limitations experienced by this population.

• This review suggests that at present, there is no single comprehensive outcome measure for clinical practice and/or research which has strong supporting psychometric evidence for the evaluation of persons with CRPSAPPENDIX, a scoring sheet and scoring guidelines for critical appraisals for the evaluation of persons with CRPS.

Keywords::

• Complex regional pain syndrome
• outcome measurement
• psychometric evaluations
• systematic review

Declaration of Interest: The authors report no conflict of interests. This article was adapted from a portion of a masters’ thesis prepared by T. Packham, and a poster presentation on this material was presented at the 2011 American Society of Hand Therapists annual meeting in Nashville, Tennessee.