Results of the current study showed that women have a multi-site pain pattern associated with PD. Pain drawing is a reliable and valid tool for assessing PD-related pain and moderately correlates with NRS. Excellent ICC values were observed for all reliabilities (test-retest, intra-rater and inter-rater). ICC values are excellent, but CCC was insufficient for testing and retesting, but sufficient for inter-rater evaluation.For measurement error, most measurements were within her LoA . However, her SDC at the individual level of the second cycle inter-rater rating was higher than her LoA at the same rating, indicating real change in the measured structure.
Women who have PD usually report having menstrual cramps in the lower abdomen and pelvis [1]Our current results support these findings and show that women with PD reported lower abdominal pain. Nevertheless, most of them reported pain in other areas such as the lower back, head, and lower extremities, which were present in more than 50% of the participants. and one of the hallmarks of these syndromes is the multisite nature of the pain. [18]which can be found in this study.
A moderate correlation was found between pain maps and NRS. This result goes beyond our initial hypothesis, as NRS and MAP assess pain intensity and location, respectively. Therefore, pain drawing proved to be effective in assessing pain location in PD. Women may perceive pain intensity as the site of pain increases, but this is not clear in the literature.To the best of our knowledge, there is a correlation between pain intensity and total pain area in women with PD. No studies have evaluated the relationship.
Test-retest, inter-rater and intra-rater reliability results show that pain drawing is a reliable measure of women with PD, menstrual pain location and pain affected by different raters and times. has been shown to help identify regions of In addition, women may have different PD sites and pain intensity depending on their cycle. So, for example, some women may have less pain only in the lower abdomen and more pain in the next cycle and pain in other areas such as the lower back and head. You can observe the occurrence of outliers. Pain drawings are commonly used to localize pain in various musculoskeletal conditions. [19]but there is no gold standard method for measuring painful areas on paper figures [9]It is therefore very common for these pain diagrams to be digitized using software. Because computers provide a more accurate analysis of painful areas. [8]Additionally, some studies have shown good inter- and intra-rater reliability in measuring painful areas. [8, 9, 19, 20].
Regarding measurement error, SDC was higher than SEM in both intra- and inter-rater analyses, demonstrating the ability of the instrument to detect changes in pain area and measurement error. His detected SEM values confirm the results of Caseiro et al. [9]found good to very good SEM values of pain maps in patients with orthopedic or rheumatic conditions.
To our knowledge, this was the first study to assess the test-retest, inter- and intra-rater reliability and measurement error of the pain drawing for pain assessment in women with PD. Additionally, the total area of pain was assessed by digitizing the paper by a medical professional using appropriate methods. This will enhance the use of electronic pain maps in clinical practice, especially remote assessment with patients. In this survey, many women had problems printing or filling out the body map twice her. This was a limitation as many women did not have printers. Some women reported that they had completed many surveys during the pandemic and she refused to complete one anymore.
Nevertheless, the lack of studies on reliability in the use of pain drawing in women with PD limited the comparison of our results with the literature. Furthermore, the difficulty in defining analytical methods may compromise the clinical application of these pain diagrams. In this case, using ImageJ as a tool to measure areas of pain was useful because the software helped identify specific areas of pain and spread the discomfort caused by PD to other body areas. , which was found to be acceptable. [8]Also, this is the first study to assess the presence of PD-related pain in various body sites other than the pelvis and abdomen. Other body regions most prominent were the hips, head, and lower legs. The second most prominent area was the lower back, which affected nearly 80% of the women in this study, while the head was her third most prominent area (55%).Our data support other studies showing PD pain in several different areas [21, 22]indicating the multisite nature of PD-related pain.
Considering that women with dysmenorrhea are a characteristic symptom of menstrual pain and its detection in clinical care and scientific research is important, it is recommended to use pain drawings for pain assessment in women with PD. There are favorable data to support.Daily activities, studies, social and sexual relationships [23]Physiotherapy interventions or medications can improve pain in certain areas of the body. However, some pain can persist, so a pain diagram that assesses the presence of pain throughout the body may better guide clinical decision-making.
Impact on practice
This study provides evidence to support the application of commonly used pain drawings in other painful conditions as an easy-to-use tool for assessing the total area of pain in women with primary dysmenorrhea. I’m here. This leads to a complete clinical evaluation of the patient, including the site of pain. Furthermore, future studies are recommended to validate the measured properties of Body Map in health conditions.
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