Patient-Generated Graphs to Measure Pain and Fatigue in Persons with Neuralgic Amyotrophy

Background: Patients with neuralgic amyotrophy (NA) often experience limitations in daily activities because of pain and fatigue. Visual analogue graphs with a 24-hour x-axis can be used to rate pain and fatigue severity during a typical day. This study aimed to investigate the reliability and validity of the visual analogue graphs in patients with NA. Method: Eight patients completed pain and fatigue graphs on three moments to examine inter-rater and test-retest reliability using Intraclass Correlation Coefficients (ICCs). Concurrent validity (n = 47) was tested by determining correlations between mean pain graph scores and numerical rating scale for pain (NRS-pain) and between mean fatigue graph scores and checklist individual strength-subscale fatigue (CIS-fatigue). Results: ICC for test-retest reliability varied from 0.72– 0.93 for pain and 0.67–0.85 for fatigue scores. ICC for inter-rater reliability varied from 0.76–0.97 for pain and 0.47–0.97 for fatigue scores. Correlation between the mean pain graph score and NRS-pain was strong (rs = 0.75, ps = 0.42, p = 0.003). Conclusion: The visual analogue graph for pain appears reliable and valid in patients with NA. Test-retest reliability and concurrent validity for the fatigue graph warrant further research.