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RehabMeasures Instrument

Multidimensional Pain Inventory (Spinal Cord Injury Version)

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Purpose

The MPI-SCI assesses pain and the behavioral and psychosocial factors associated with chronic pain in people with spinal cord injury.

Acronym MPI-SCI

Area of Assessment

Pain

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Spinal Cord Injury

Populations

Key Descriptions

  • The MPI-SCI was developed as a modification of the West Haven-Yale Multidimensional Pain Inventory for use in people with spinal cord injury.

    The MPI-SCI is composed of 50 items across three sections.

    The three sections are: 1) Pain Impact, 2) Responses by Significant Others, 3) Impact of Pain on Activities.

    Subscales are: Life Interference, Affective Distress, Solicitous Responses, Distracting Responses, Pain Interference with Activities, Pain Severity, Negative Responses, Support, Life Control, and General Activity.

    Items are completed by questionnaire or interview.

    Score is reported as a mean of the completed items.

Number of Items

50

Time to Administer

15-20 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 03/2012.

ICF Domain

Body Structure
Body Function

Measurement Domain

Sensory

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 (VEDGE) 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 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

SCI EDGE

LS

LS

R

 

Recommendations based on SCI AIS Classification: 

 

AIS A/B

AIS C/D

SCI EDGE

R

R

  

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

Yes

Yes

Not reported

Considerations

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Spinal Injuries

back to Populations

Test/Retest Reliability

Spinal Cord Injury:

(Widerstrom-Noga et al, 2006; = 161; mean age = 43.5(13.4) years, mean time post-SCI = 10.9(7.8) years; 58% complete/31% incomplete, 47% cervical injury/52% below cervical injury; MPI-SCI administered in interview format) 

  • Excellent test-retest reliability for Life Interference (ICC = 0.81), Solicitous Responses (ICC = 0.86), Distracting Responses (ICC = 0.85), and Pain Interference with Activities (ICC = 0.78) Subscales 
  • Adequate test-retest reliability for Pain Severity (ICC = 0.69), Affective Distress (ICC = 0.71), Support (ICC = 0.59), and Negative Responses (ICC = 0.69), and General Activity (ICC = 0.69) Subscales 
  • Poor test-retest reliability for Life Control (ICC = 0.26) Subscale

Internal Consistency

Spinal Cord Injury:

(Widerstrom-Noga et al, 2006) 

  • Excellent internal consistency for Life Interference (Cronbach α = 0.90), Negative Responses (Cronbach α = 0.87), General Activity (Cronbach α = 0.83), Pain Interference with Activities (Cronbach α-0.94) Subscales 
  • Adequate internal consistency for Pain Severity (Cronbach α = 0.76), Support (Cronbach α = 0.72), and Distracting Responses (Cronbach α = 0.71) Subscales 
  • Poor internal consistency for Life Control (Cronbach α = 0.61), Affective Distress (Cronbach α = 0.60), and Solicitous Responses

Criterion Validity (Predictive/Concurrent)

Concurrent Validity

Spinal Cord Injury:

(Widerstrom-Noga et al, 2006) 

  • General Activity subscale: 
    • People with tetraplegia scored lower than people with paraplegia with mean scores of 34.3(16.4) vs. 45.0(19.4) respectively (p < 0.000, moderate effect size (0.6)) 

 

Predictive Validity

Spinal Cord Injury:

(Widerstrom-Noga et al, 2006) 

  • Five subscales (high levels of life control, low levels of affective distress, high general activity levels and low degree of life interference) significantly predicted satisfaction with life on the Satisfaction with Life Scale (p < 0.000)

Construct Validity

Spinal Cord Injury:

(Widerstrom-Noga et al, 2006) 

  • Excellent correlation of Pain Severity subscale with Numeric Rating Scale for pain intensity (r = 0.61) 
  • Excellent and Adequate correlation with Pain Disability Index respectively of Life Interference subscale (r = 0.61) and Pain Interference with Activities subscale (r = 0.59) 
  • Adequate correlation of the General Activity subscale with the Functional Independence Measure (r = 0.41) 
  • Adequate correlation of the Life Control subscale (r = 0.35) with the Internal Health Locus of Control (IHLC) subscale of the Multidimensional Health Locus of Control Scale (MHLC) 
  • Adequate correlation of the Affective Distress subscale (r = 0.51) with the Beck Depression Inventory 
  • Poor correlation of the Support subscale with the Interpersonal Support Evaluation List (r = 0.23), Negative Responses subscale (r = 0.05), Solicitous Responses subscale (r = 0.14), Distracting Responses subscale (r = 0.13) 

 

Discriminant Validity

Spinal Cord Injury:

(Widerstrom-Noga et al, 2006) 

  • Poor correlation between all MPI-SCI subscales except for the Life Control subscale and the IHLC (r = -0.06-0.13), confirming discriminative validity of the scales.

Content Validity

Spinal Cord Injury:

(Widerstrom-Noga et al, 2002; = 120; mean age = 42.1(12.1) years; mean time post-SCI = 9.8(5.2) years; MPI-SCI administered in written questionnaire format) 

  • During development of the MPI-SCI, confirmatory and exploratory factor analyses were performed for each subscale of the Multidimensional Pain Inventory. As a result, six items were removed. An additional question per item of the General Activity subscale was added to determine whether in decrease in activity was due to pain. 

 

Spinal Cord Injury:

(Cruz-Almeida et al, 2009; = 180; mean age = 41.6(13.4) years; mean time post-SCI = 9.5(8.9) years; ASIA A/B=69.5%, ASIA C/D=30%; MPI –SCI administered in written questionnaire format) 

 

  • Life Interference subscale appears to test limitations related to pain rather than other functional impairments related to SCI or average pain intensity as evidenced by the following findings: 
    • Excellent correlation with the Pain Disabilities Index (r = 0.61) 
    • Adequate correlation with the Pain Interference with Daily Activities subscale (r = 0.58) and the Beck Depression Inventory (r = 0.39) 
    • Poor correlation with the Functional Independence Measure (r = -0.17) and the General Activity subscale (r = -0.13) 
    • Poor correlation with Average Pain Intensity on Numeric Rating Scale (r = 0.29)

Face Validity

Spinal Cord Injury:

(Widerstrom-Noga et al, 2002) 

  • 10 people with chronic pain and SCI reviewed the SCI-specific questions during development of the MPI-SCI. All 10 people reported a clear understanding of the questions with no modification to the wording required.

Bibliography

Cruz-Almeida, Y., Alameda, G., et al. (2009). "Differentiation between pain-related interference and interference caused by the functional impairments of spinal cord injury." Spinal Cord 47(19030010): 390-395.

Widerstrom-Noga, E. G., Cruz-Almeida, Y., et al. (2006). "Internal consistency, stability, and validity of the spinal cord injury version of the multidimensional pain inventory." Archives of Physical Medicine and Rehabilitation 87(4): 516-523.

Widerstrom-Noga, E. G., Duncan, R., et al. (2002). "Assessment of the impact of pain and impairments associated with spinal cord injuries." Archives of Physical Medicine and Rehabilitation 83(3): 395-404.Find it on Pubmed

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