Skip to main content
  

Rehab Measures: Bryce-Ragnarsson Pain Taxonomy

Link to instrument

Full text available on PubMed (other languages available below) 

Title of Assessment

Bryce-Ragnarsson Pain Taxonomy 

Acronym

BR-SCI-PT

Instrument Reviewer(s)

Initially reviewed by the Rehabilitation Measures Team in 2011; Updated by Rachel Tappan, PT, NCS, Eileen Tseng, PT, DPT, NCS, and the SCI EDGE task force of the Neurology Section of the APTA in 2012

Summary Date

1/1/2011 

Purpose

Classifies pain in SCI patients in terms of pain localization in one of three higher-order regions (above, at, or below level of injury). Regional pain categories are then defined as either nociceptive or neuropathic. Finally, categories are subdivided into 1 of 15 specific subtypes.

Description

The BR-SCI-PT is based on a 3-tiered decision schema
  • Pain in Tier 1 is localized relative to the level of SCI (i.e. either above, at or below level)
  • Pain in Tier 2 is identified as either nociceptive or neuropathic
  • Pain in Tier 3 is stratified by subtypes of the area of localized nociceptive or neuropathic pain

Tier 1 Tier 2 Tier 3
Location
Type
Etiologic Subtype
Above Level
nociceptive
1
mechanical / musculoskeletal
2
autonomic dysreflexia headache
3
other
at level
neuropathic
4
compressive neuropathy
5
other
below level
nocioceptive
6
mechanical / musculoskeletal
7
visceral
neuropathic
8
radicular
9
compressive neuropathy
10
complex neuropathy
11
complex regional pain syndrome
nociceptive
12
mechanical / musculoskeletal
13
visceral
neuropathic
14
central
15
other

Area of Assessment

Pain 

Body Part

Not Applicable 

ICF Domain

Body Function 

Domain

Sensory 

Assessment Type

Patient Reported Outcomes 

Length of Test

06 to 30 Minutes 

Time to Administer

10 to 20 minutes

Number of Items

15 

Equipment Required

None

Training Required

None

Type of training required

No Training; Reading an Article/Manual 

Cost

Free 

Actual Cost

Free

Age Range

Adolescent: 13-17 years; Adult: 18-64 years; Elderly adult: 65+ 

Administration Mode

Paper/Pencil 

Diagnosis

Spinal Cord Injury 

Populations Tested

SCI

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Not Established

Normative Data

Not Established

Test-retest Reliability

Not Established

Interrater/Intrarater Reliability

Spinal Cord Injury: (Bryce et al, 2006; n = 39; 135 vignettes describing people with SCI were presented to 5 groups of physicians)
  • 83% of physicians correctly rated pain into one of 15 BR-SCI-PT pain types
  • 93% of physicians correctly categorized pain in terms of level (at/Above/Below level of injury)
  • 90% of physicians correctly categorized pain as either nociceptive or neuropathic
  • Adequate interrater reliability (k = 0.70)

Internal Consistency

Not Applicable

Criterion Validity (Predictive/Concurrent)

Not Established

Construct Validity (Convergent/Discriminant)

Not Established

Content Validity

Literature Review: (Bryce et al, 2007; Expert occupations; Physicians, Psychologists, Physical therapists, Occupational therapist, Nurses & Others)
 
Voting on Pain Classification Validity / Usefulness
Instrument and number of experts voting
Valid and useful % (n)
Useful but requires more validation % (n)
Useful but requires changes/improvement then further validation % (n)
Not useful or valid for research in SCI % (n)
BR-SCI-PT (n = 59)
14 (8)
42 (25)
36 (21)
8 (5)
Cardenas (n = 56)
4 (2)
20 (11)
52 (29)
25 (14)
IASP (n = 59

19 (11)

47 (28)

31 (18)

3 (2)

Face Validity

Not Statistically Assessed

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

LS

LS

LS

 

Recommendations based on SCI AIS Classification:

 

AIS A/B

AIS C/D

SCI EDGE

LS

LS

 

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

Yes

Not reported

Considerations

Bryce-Ragnarsson Pain Taxonomy translations:

French (p98):
http://www.sofmer.com/download/sofmer/APRM_52_(2009)_83-102.pdf

Spanish (p52):
http://revista.sedolor.es/pdf/2001_04_06.pdf

These translations, and links to them, are subject to the Terms and Conditions of Use of the Rehab Measures Database. RIC is not responsible for and does not endorse the content, products or services of any third-party website, and does not make any representations regarding its quality, content or accuracy. If you would like to contribute a language translation to the RMD, please contact us at rehabmeasures@ric.org.

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Bibliography

Bryce, T. N., Budh, C. N., et al. (2007). "Pain after spinal cord injury: an evidence-based review for clinical practice and research. Report of the National Institute on Disability and Rehabilitation Research Spinal Cord Injury Measures meeting." Journal of Spinal Cord Medicine 30(5): 421-440. Find it on PubMed

Bryce, T. N., Dijkers, M. P., et al. (2006). "Reliability of the Bryce/Ragnarsson spinal cord injury pain taxonomy." J Spinal Cord Med 29(2): 118-132. Find it on PubMed

Year published

2001 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 1/27/2011 4:15 PM  by Jason Raad 
Last modified at 1/14/2015 8:33 PM  by Jason Raad