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Rehab Measures: Donovan Spinal Cord Injury Pain Classification Scale

Link to instrument

 

Title of Assessment

Donovan Spinal Cord Injury Pain Classification Scale 

Acronym

Instrument Reviewer(s)

Initially reviewed by Rachel Tappan, PT, NCS; Eileen Tseng, PT, DPT, NCS; and the SCI EDGE task force of the Neurology Section of the APTA in 3/2012

Summary Date

1/3/2014 

Purpose

The Donovan classification scheme classifies pain after Spinal Cord Injury (SCI) according to one of five pain types: segmental nerve/cauda equina, spinal cord, visceral, mechanical, and psychogenic.

Description

  • Each area of pain is classified according to one of the five categories of pain above based on the following parameters of pain (Donovan et al, 1982):
    • Time of onset post-injury
    • Character of pain
    • Duration of pain
    • Aggravating factors
    • Diminishing factors
    • Possible causative factors

Area of Assessment

Pain 

Body Part

 

ICF Domain

Body Function 

Domain

 

Assessment Type

 

Length of Test

06 to 30 Minutes 

Time to Administer

5-15 minutes

Number of Items

5 possible categories for each area of pain 

Equipment Required

None

Training Required

No training required

Type of training required

No Training 

Cost

Free 

Actual Cost

Free

Age Range

Adult: 18-64 years 

Administration Mode

 

Diagnosis

Spinal Cord Injury 

Populations Tested

  • Spinal Cord Injury (SCI)

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Not Applicable

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Not Established

Normative Data

Not Established

Test-retest Reliability

Chronic SCI:

(Putzke et al, 2003; n = 28; mean age = 45.5(10.02) years; mean time post-SCI = 10.3(7.20) years; 79% motor complete/AIS A and B, 21% motor incomplete/AIS C and D)

  • 78% of pain sites were classified consistently on the second trial compared to the first trial within raters.

Interrater/Intrarater Reliability

Chronic SCI:

(Richards et al, 2002; n = 28; mean age = 45.5(10.02) years; mean time post-SCI = 10.3(7.20) years; 79% motor complete/AIS A and B, 21% motor incomplete/AIS C and D)

  • Adequate interrater reliability (kappa coefficient = 0.55)
  • Agreement between pairs of raters ranged 62% to 73%

Internal Consistency

Not Established

Criterion Validity (Predictive/Concurrent)

Not Established

Construct Validity (Convergent/Discriminant)

Not Established

Content Validity

Not Established

Face Validity

Not Established

Floor/Ceiling Effects

Not Established

Responsiveness

Not Established

Professional Association Recommendations

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

 

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

Abbreviations:

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post)

(Vestibular < 6 months post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

SCI EDGE

NR

NR

NR

 

Recommendations based on SCI AIS Classification:

 

AIS A/B

AIS C/D

SCI EDGE

NR

NR

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

SCI EDGE

No

No

No

Not reported

Considerations

  • The Donovan Spinal Cord Injury Pain Classification Scheme is one of many systems developed prior to a recent meeting of experts during which a pain classification system for people with SCI was developed by expert consensus resulting in the ISCIP classification.
  • Also, this pain classification is a system for classifying type of pain rather than a true outcome measure that can measure change in pain over time.
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Bibliography

Donovan, W. H., Dimitrijevic, M. R., et al. (1982). "Neurophysiological approaches to chronic pain following spinal cord injury." Paraplegia 20(3): 135-146. Find it on PubMed

Putzke, J. D., Richards, J. S., et al. (2003). "Test-retest reliability of the Donovan spinal cord injury pain classification scheme." Spinal Cord 41(4): 239-241. Find it on PubMed

Richards, J. S., Hicken, B. L., et al. (2002). "Reliability characteristics of the Donovan spinal cord injury pain classification system." Archives of Physical Medicine and Rehabilitation 83(9): 1290-1294. Find it on PubMed

Year published

1982 

Instrument in PDF Format

No 
Approval Status Approved 
 
Attachments
Created at 9/26/2012 4:59 PM  by Jason Raad 
Last modified at 9/3/2014 10:36 AM  by Jason Raad