Eliciting Information on Differential Sensation of Heat in Those With and Without Poststroke Aphasia Using a Visual Analogue Scale

Abstract

Background and Purpose-Aphasia can result in an inability to communicate the presence, location, or intensity of pain.Although visual analogue scales (VASs) exist, it is unknown whether they are useful in assessing pain in individuals with aphasia. The objective was to determine whether those with poststroke aphasia could respond differentially to thermal stimuli of varying intensities using a standardized VAS. Methods-Five groups of participants were assessed: those without stroke, those with stroke but without aphasia, and 3 groups with varying degrees of aphasia. A 10-cm vertical VAS was used to measure responses to varying thermal intensities delivered on the participant's forearm. Results-Across all 5 groups, a similar proportion demonstrated ability to discriminate between 2 temperatures ( 2 ϭ1.899; Pϭ0.75). When presented with 4 temperatures, all groups performed more poorly, yet with similar success rates across groups ( 2 ϭ0.1267; Pϭ0.88). The repeated-measures ANOVA revealed no effect of group but a significant effect of temperature (PϽ0.0001). Conclusion-

Pain and pain assessment in stroke patients with aphasia: a systematic review

“…Two articles reported data from the same original research (Cruice, Worrall, & Hickson, 2010;Cruice, Worrall, Hickson, & Murison, 2005). Five studies were conducted at a stroke unit of a university or general hospital (Kehayia et al, 1997;Korner-Bitensky et al, 2006;Mazzocato, Michel-Nemitz, Anwar, & Michel, 2010;Price, Curless, & Rodgers, 1999;Smith et al, 2013) and one study at a rehabilitation centre (Jackson, Jackson, Kersten, & TurnerStokes, 2006). Data from three studies were collected at a community setting (Cruice et al, 2005(Cruice et al, , 2010Pomeroy et al, 2000).…”

“…The number of PWA varied from 13 to 138 PWA. The following types of aphasia were reported in the studies included in the review mild-moderate aphasia, receptive aphasia, severe aphasia, aphasia with severe expressive deficits and aphasia with both comprehension and expressive deficits (Kehayia et al, 1997;Korner-Bitensky et al, 2006;Pomeroy et al, 2000). Four of the 10 studies used a control group.…”

“…Control groups including individuals with stroke, aphasia and the presence of cognitive or psychiatric disorders or neurological disease were excluded from the review. (Benaim et al, 2007(Benaim et al, , 2010Cruice et al, 2005;Korner-Bitensky et al, 2006 Figure 1. PRISMA flow chart of study selection.…”

“…The pain assessment instruments used in the studies involving PWA were the vertical, horizontal and mechanical VAS (Benaim et al, 2007;Korner-Bitensky et al, 2006;Pomeroy et al, 2000;Price et al, 1999), the FPS (Benaim et al, 2007), the NRS (Price et al, 1999), the Verbal Rating Scale (VRS) (Benaim et al, 2007;Herr, Spratt, Mobily, & Richardson, 2004;Price et al, 1999), a categorical site-of-pain shoulder scale (Pomeroy et al, 2000) and the Scale Pain Intensity (SPIN) for patients with communication impairments (Jackson et al, 2006). Parallel to pain measurement instruments, the studies with pain registered as a subdomain of quality of life also used different quality of life instruments the International Quality of Life Assessment (IQOLA) SF-36 Health Survey (Ware & Gandek, 1998) and the Dartmouth COOP Charts (Nelson, Wasson, & Kirk, 1987).…”

“…A summary of pain scales, the methodological quality and their accompanying LOE is presented in Table 3. The use of self-report pain scales in individuals with severe aphasia after stroke was not possible in some studies due to their inability to two studies included individuals with severe aphasia (Benaim et al, 2007;Cruice et al, 2010;Kehayia et al, 1997;Korner-Bitensky et al, 2006;Price et al, 1999;Smith et al, 2013). Four articles, evaluating four pain measurement scales and two quality of life scales, were assessed with the COSMIN checklist to evaluate methodological quality for each pain measurement instrument and measurement property (Benaim et al, 2007;Cruice et al, 2005;Korner-Bitensky et al, 2006;Pomeroy et al, 2000).…”