• Li-ling Chuang, Ching-yi Wu, Keh-chung Lin, and Ching-ju Hsieh.
• L. Chuang, PT, PhD, Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, and Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan.
• Phys Ther. 2014 Jan 1;94(1):129-38.

BackgroundPain is a serious adverse complication after stroke. The combination of a vertical numerical pain rating scale (NPRS) and a faces pain scale (FPS) has been advocated to measure pain after stroke.ObjectiveThis study was conducted to investigate whether an NPRS supplemented with an FPS (NPRS-FPS) would show good test-retest reliability in people with stroke. The relative and absolute reliability of the NPRS-FPS were examined.DesignA test-retest design was used for this study.MethodsFifty people (>3 months after stroke) participating in an outpatient occupational therapy program were recruited through medical centers to rate current pain intensity twice, at a 1-week interval, with the NPRS-FPS (on a scale from 0 to 10). The relative reliability of the NPRS-FPS was analyzed with the intraclass correlation coefficient for determining the degree of consistency and agreement between 2 measures. The standard error of measurement, the smallest real difference, and Bland-Altman limits of agreement were the absolute reliability indexes used to quantify measurement errors and determine systematic biases of repeated measurements.ResultsThe relative reliability of the NPRS-FPS was substantial (intraclass correlation coefficient=.82). The standard error of measurement and the smallest real difference at the 90% confidence interval of the NPRS-FPS were 0.81 and 1.87, respectively. The Bland-Altman analyses revealed no significant systematic bias between repeated measurements for the NPRS-FPS. The range of the limits of agreement for the NPRS-FPS was narrow (-2.50 to 1.90), indicating a high level of stability and little variation over time.LimitationsThe pain intensity of the participants ranged from no pain to a moderate level of pain.ConclusionsThese findings suggest that the NPRS-FPS is a reliable measure of pain in people with stroke, with good relative and absolute reliability.

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