New Outcome Measures for Pain and Fatigue During a Typical Day: Pain and Fatigue Graphs

Patients with a neuralgic amyotrophy (NA) often experience pain, fatigue and difficulties performing activities of daily life, which is correlated to scapular instability, increased fatigability and overuse of compensating muscles in NA. To obtain insight in the relation between daily activities and their complaints, patients are asked to draw graphs for their pain and fatigue during a typical day. On the x-axis 24 hours of the day are represented and on the y-axis pain or fatigue are represented using numerical rating scales with 1 referring to no pain/no fatigue and 10 to maximum pain/maximum fatigue. To know whether these graphs can be used as outcome measures psychometric properties are studied. To study reliability, the graphs were completed by 8 patients with NA twice within one week (test-retest reliability) and at two moments while two different therapists gave instructions (interrater reliability). To study construct validity and responsiveness, the graphs were correlated with valid measures of pain (Shoulder Rating Questionnaire) and fatigue (Checklist Individual Strength-subscale fatigue) in 70 patients before and after multidisciplinary rehabilitation. Test-retest and interrater reliability appears good with high (>0,08) and significant (p < 0,001) ICC's and Pearson correlation coefficients. Data for the construct validity and responsiveness are being analyzed. The graphs representing pain and fatigue during a typical day provide reliable data and validity data will be presented at the conference. These two new promising outcome measures for pain and fatigue during a typical day maybe a practical tool to study pain and fatigue in daily life.