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RehabMeasures Instrument

Donovan Spinal Cord Injury Pain Classification Scale

Last Updated

Purpose

The Donovan classification scheme classifies pain after Spinal Cord Injury (SCI) according to one of five pain types: segmental nerve/cauda equina, spinal cord, visceral, mechanical, and psychogenic.

Link to Instrument

Instrument Details

Area of Assessment

Pain

Cost

Free

Diagnosis/Conditions

  • Spinal Cord Injury

Populations

Key Descriptions

  • Each area of pain is classified according to one of the five categories of pain above based on the following parameters of pain (Donovan et al, 1982):
    1) Time of onset post-injury
    2) Characteristics of pain
    3) Duration of pain
    4) Aggravating factors
    5) Diminishing factors
    6) Possible causative factors

Number of Items

5

Time to Administer

5-15 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Instrument Reviewers

Initially reviewed by Rachel Tappan, PT, NCS; Eileen Tseng, PT, DPT, NCS; and the SCI EDGE task force of the Neurology Section of the APTA in 3/2012

ICF Domain

Body Function

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post) 

(Vestibular < 6 months post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

SCI EDGE

NR

NR

NR

 

Recommendations based on SCI AIS Classification:

 

AIS A/B

AIS C/D

SCI EDGE

NR

NR

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

SCI EDGE

No

No

No

Not reported

Considerations

  • The Donovan Spinal Cord Injury Pain Classification Scheme is one of many systems developed prior to a recent meeting of experts during which a pain classification system for people with SCI was developed by expert consensus resulting in the ISCIP classification. 
  • Also, this pain classification is a system for classifying type of pain rather than a true outcome measure that can measure change in pain over time. 

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Spinal Injuries

back to Populations

Test/Retest Reliability

Chronic SCI:

(Putzke et al, 2003; = 28; mean age = 45.5(10.02) years; mean time post-SCI = 10.3(7.20) years; 79% motor complete/AIS A and B, 21% motor incomplete/AIS C and D) 

  • 78% of pain sites were classified consistently on the second trial compared to the first trial within raters.

Interrater/Intrarater Reliability

Chronic SCI:

(Richards et al, 2002; = 28; mean age = 45.5(10.02) years; mean time post-SCI = 10.3(7.20) years; 79% motor complete/AIS A and B, 21% motor incomplete/AIS C and D) 

  • Adequate interrater reliability (kappa coefficient = 0.55) 
  • Agreement between pairs of raters ranged 62% to 73%

Bibliography

Donovan, W. H., Dimitrijevic, M. R., et al. (1982). "Neurophysiological approaches to chronic pain following spinal cord injury." Paraplegia 20(3): 135-146. Find it on PubMed

Putzke, J. D., Richards, J. S., et al. (2003). "Test-retest reliability of the Donovan spinal cord injury pain classification scheme." Spinal Cord 41(4): 239-241. Find it on PubMed

Richards, J. S., Hicken, B. L., et al. (2002). "Reliability characteristics of the Donovan spinal cord injury pain classification system." Archives of Physical Medicine and Rehabilitation 83(9): 1290-1294. Find it on PubMed