TITLE:
Effect of Verbal Instructions in Pain Assessment during a Passive Straight Leg Raise Test in People with Chronic Low Back Pain
AUTHORS:
Masae Ikeya, Takumi Jiroumaru, Hitomi Bunki, Michio Wachi, Noriyuki Kida, Teruo Nomura
KEYWORDS:
Chronic Low Back Pain, Pain Assessment, Passive Straight Leg Raise Test, Verbal Instructions
JOURNAL NAME:
Open Journal of Therapy and Rehabilitation,
Vol.10 No.4,
November
2,
2022
ABSTRACT: The most prevalent issue in physical therapy is pain. Due to the
subjective nature of pain, assessment tools are essential in understanding it
as objective data. However, assessment of pain may result in distress for the
patient. A physical therapist (PT) should conduct these tests as quickly and
accurately as possible. Straightforward instructions are vital in such cases.
This study aimed to clarify the effect of verbal instructions for pain
assessment during a passive straight leg raise (PSLR) test for participants
with chronic low back pain (CLBP). This study included 22 participants who provided
informed consent and received three consecutive PSLR tests with measurement of
the hip flexion range of motion (HFROM) and were instructed to cease the test
at submaximal pain before the first test. Following the second and third tests,
participants were given specific verbal instructions to remember pain
intensity, quality, and location. After each test, participants were to circle
the pain location on the body chart and rate their pain intensity on a numeric
rating scale (NRS) and pain quality. All participants were then interviewed
about the differences between having and not having specific verbal
instructions. The results of HFROM, NRS, and pain extent were not significantly
different between the first and second tests or between the second and third
tests using a paired t-test. Eleven changes in pain location were found in the
second test compared to those in the first test. In the third test, only three
participants circled a different area than in the second test. Ten participants
showed similar changes with pain location in pain quality in the three PSLR
tests. This study revealed the effect of specific verbal instructions prior to
PSLR tests. Particularly, participants could notice exact pain location. Our
findings may help PT to understand pain cause and reduce patients’ stress
during pain assessment in clinical settings.