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Tanaka K, Nishigami T, Mibu A, Manfuku M, Yono S, Shinohara Y, Tanabe A, Ono R. Validation of the Japanese version of the Central Sensitization Inventory in patients with musculoskeletal disorders. PLoS One 2017; 12:e0188719. [PMID: 29216211 PMCID: PMC5720706 DOI: 10.1371/journal.pone.0188719] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 11/13/2017] [Indexed: 12/26/2022] Open
Abstract
Background Many musculoskeletal pain conditions are characterized by hypersensitivity, which is induced by central sensitization (CS). A questionnaire, the Central Sensitization Inventory (CSI), was recently developed to help clinicians identify patients whose presenting symptoms may be related to central sensitivity syndrome (CSS). The aims of the present study were to examine criterion validity and construct validity of the Japanese version of the CSI (CSI-J), and to investigate prevalence rates of CS severity levels in patients with musculoskeletal disorders. Methods Translation of the CSI into Japanese was conducted using a forward-backward method. Two hundred and ninety patients with musculoskeletal pain disorders completed the resultant CSI-J. A subset of the patients (n = 158) completed the CSI-J again one week later. The relationships between CSI and clinical symptoms, EuroQol 5-dimension (EQ-5D) and Brief Pain Inventory (BPI), were examined for criterion validity. EQ-5D assesses Health-related QOL and BPI measures pain intensity and pain interference. The psychometric properties were evaluated with analyses of construct validity, factor structure and internal consistency, and subsequently investigate the prevalence rates of CS severity levels. Results The CSI-J demonstrated high internal consistency (Cronbach’s α = 0.89) and test-retest reliability was excellent value (ICC = 0.85). The CSI-J was significantly correlated with EQ-5D (r = −0.44), pain intensity (r = 0.42), and pain interference (r = 0.48) (p < 0.01 for all). Ten percent of the participants were above the cutoff “40”. The exploratory factor analysis resulted in 5-factor model. Conclusions This study reported that the CSI-J was a useful and psychometrically sound tool to assess CSS in Japanese patients with musculoskeletal disorders. The finding of the prevalence rates of CS severity levels in patients with musculoskeletal disorders may help clinicians to decide strategy of treatment.
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Affiliation(s)
- Katsuyoshi Tanaka
- Department of Rehabilitation, Tanabe Orthopaedics, Osaka, Osaka, Japan
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Tomohiko Nishigami
- Department of Nursing and Physical Therapy, Konan Women’s University, Kobe, Hyogo, Japan
- * E-mail:
| | - Akira Mibu
- Department of Rehabilitation, Tanabe Orthopaedics, Osaka, Osaka, Japan
- Department of Nursing and Physical Therapy, Konan Women’s University, Kobe, Hyogo, Japan
| | - Masahiro Manfuku
- Department of Rehabilitation, Tanabe Orthopaedics, Osaka, Osaka, Japan
| | - Satoko Yono
- Department of Rehabilitation, Tanabe Orthopaedics, Osaka, Osaka, Japan
| | | | - Akihito Tanabe
- Department of Rehabilitation, Tanabe Orthopaedics, Osaka, Osaka, Japan
| | - Rei Ono
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
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Cuesta-Vargas AI, Neblett R, Chiarotto A, Kregel J, Nijs J, van Wilgen CP, Pitance L, Knezevic A, Gatchel RJ, Mayer TG, Viti C, Roldan-Jiménez C, Testa M, Caumo W, Jeremic-Knezevic M, Luciano JV. Dimensionality and Reliability of the Central Sensitization Inventory in a Pooled Multicountry Sample. THE JOURNAL OF PAIN 2017; 19:317-329. [PMID: 29198933 DOI: 10.1016/j.jpain.2017.11.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 11/04/2017] [Accepted: 11/09/2017] [Indexed: 01/01/2023]
Abstract
Central sensitization (CS) involves the amplification of neural signaling within the central nervous system, which evokes pain hypersensitivity. The Central Sensitization Inventory (CSI) assesses 25 overlapping health-related symptom dimensions that have been reported to be associated with CS-related disorders. Previous studies have reported satisfactory test-retest reliability and internal consistency, but factor analyses have exhibited conflicting results in different language versions. The purpose of this cross-sectional study was to thoroughly examine the dimensionality and reliability of the CSI, with pooled data from 1,987 individuals, collected in several countries. The principal component analysis suggested that 1 general factor of CS best described the structure. A subsequent confirmatory factor analysis revealed that a bifactor model, which accounted for the covariance among CSI items, with regard to 1 general factor and 4 orthogonal factors, fit the CSI structure better than the unidimensional and the 4-factor models. Additional analyses indicated substantial reliability for the general factor (ie, Cronbach α = .92; ω = .95; and ω hierarchical = .89). Reliability results for the 4 specific factors were considered too low to be used for subscales. The results of this study clearly suggest that only total CSI scores should be used and reported. PERSPECTIVE As far as we know, this is the first study that has examined the factor structure and reliability of the CSI in a large multicountry sample. The CSI is currently considered the leading self-report measure of CS-related symptoms worldwide.
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Affiliation(s)
- Antonio I Cuesta-Vargas
- Department of Physiotherapy of the Faculty of Health Science at the University of Malaga, IBIMA, Málaga, Spain; Faculty of Health at the Queensland University of Technology, Brisbane, Australia.
| | | | - Alessandro Chiarotto
- Department of Epidemiology and Biostatistics, VU Medical Center, Amsterdam, The Netherlands; Department of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, The Netherlands; Amsterdam Public Health, Amsterdam, The Netherlands
| | - Jeroen Kregel
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Pain in Motion International Research Group, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion International Research Group, Brussels, Belgium; Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - C Paul van Wilgen
- Pain in Motion International Research Group, Brussels, Belgium; Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Transcare; transdisciplinary pain center, The Netherlands
| | - Laurent Pitance
- Neuro Musculo Skeletal Lab, Institute of clinical research (IREC), Université Catholique de Louvain, Brussels, Belgium; Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Aleksandar Knezevic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Medical Rehabilitation Clinic, Clinical Centre of Vojvodina, Novi Sad, Serbia
| | - Robert J Gatchel
- Department of Psychology, College of Science, University of Texas at Arlington, Arlington, Texas
| | - Tom G Mayer
- Department of Orthopedic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas
| | - Carlotta Viti
- FACEit, Italian Association of Integrated Therapy for Cervico-Cranio-Facial Pain and Dysfunction, Italy; Department of Biomedical Sciences, University of Padova, Padova, Italy; Studio Fisioterapico Viti, Bologna, Italy
| | - Cristina Roldan-Jiménez
- Department of Physiotherapy of the Faculty of Health Science at the University of Malaga, Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Savona, Italy
| | - Wolnei Caumo
- Post-graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Anesthesiologist, Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre, Laboratory of Pain and Neuromodulation at UFRGS, Porto Alegre, Brazil; Pain and Anesthesia in Surgery Department, School of Medicine, UFRGS, Porto Alegre, Brazil
| | | | - Juan V Luciano
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain; Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
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Scerbo T, Colasurdo J, Dunn S, Unger J, Nijs J, Cook C. Measurement Properties of the Central Sensitization Inventory: A Systematic Review. Pain Pract 2017; 18:544-554. [PMID: 28851012 DOI: 10.1111/papr.12636] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 08/05/2017] [Accepted: 08/09/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVE Central sensitization (CS) is a phenomenon associated with several medical diagnoses, including postcancer pain, low back pain, osteoarthritis, whiplash, and fibromyalgia. CS involves an amplification of neural signaling within the central nervous system that results in pain hypersensitivity. The purpose of this systematic review was to gather published studies of a widely used outcome measure (the Central Sensitization Inventory [CSI]), determine the quality of evidence these publications reported, and examine the measurement properties of the CSI. DATABASES AND DATA TREATMENT Four databases were searched for publications from 2011 (when the CSI was developed) to July 2017. The Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist was applied to evaluate methodological quality and risk of bias. In instances when COSMIN did not offer a scoring system for measurement properties, qualitative analyses were performed. RESULTS Fourteen studies met inclusion criteria. Quality of evidence examined with the COSMIN checklist was determined to be good to excellent for all studies for their respective measurement property reports. Interpretability measures were consistent when publications were analyzed qualitatively, and construct validity was strong when examined alongside other validated measures relating to CS. CONCLUSIONS An assessment of the published measurement studies of the CSI suggest the tool generates reliable and valid data that quantify the severity of several symptoms of CS.
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Affiliation(s)
- Thomas Scerbo
- Physical Therapy Division, Department of Orthopaedics, Duke University, Durham, North Carolina, U.S.A
| | - Joseph Colasurdo
- Physical Therapy Division, Department of Orthopaedics, Duke University, Durham, North Carolina, U.S.A
| | - Sally Dunn
- Physical Therapy Division, Department of Orthopaedics, Duke University, Durham, North Carolina, U.S.A
| | - Jacob Unger
- Physical Therapy Division, Department of Orthopaedics, Duke University, Durham, North Carolina, U.S.A
| | - Jo Nijs
- Vrije Universiteit Brussel and University Hospital Brussels, Brussels, Belgium
| | - Chad Cook
- Physical Therapy Division, Department of Orthopaedics, Duke University, Durham, North Carolina, U.S.A
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