Validation of an Electronic Visual Analog Scale mHealth Tool for Acute Pain Assessment: Prospective Cross-Sectional Study.

BACKGROUND: Accurate measurement of pain is required to improve its management and in research. The visual analog scale (VAS) on paper format has been shown to be an accurate, valid, reliable, and reproducible way to measure pain intensity. However, some limitations should be considered, some of which can be implemented with the introduction of an electronic VAS version, suitable to be used both in a tablet and a smartphone. OBJECTIVE: This study aimed to validate a new method of recording pain level by comparing the traditional paper VAS with the pain level module on the newly designed Interactive Clinics app. METHODS: A prospective observational cross-sectional study was designed. The sample consisted of 102 participants aged 18 to 65 years. A Force Dial FDK 20 algometer (Wagner Instruments) was employed to induce mild pressure symptoms on the participants' thumbs. Pain was measured using a paper VAS (10 cm line) and the app. RESULTS: Intermethod reliability estimated by ICC(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, indicating good reliability. Intramethod reliability estimated by ICCa(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, also indicating good reliability. Bland-Altman analysis showed a difference of 0.175 (0.49), and limits of agreement ranged from -0.79 to 1.14. CONCLUSIONS: The pain level module on the app is highly reliable and interchangeable with the paper VAS version. This tool could potentially help clinicians and researchers precisely assess pain in a simple, economic way with the use of a ubiquitous technology.

Actuación interdisciplinar en alteraciones por espina bífi da en el pie / No disponible

La malformación congénita conocida como Espina Bífida se caracteriza por la ausencia de fusión de la línea media posterior de la columna vertebral produciéndose una hernia del contenido del conducto vertebral (médula, meninges y raíces nerviosas). Este síndrome compromete múltiples sistemas del organismo, debiéndose tratar por un equipo multidisciplinar. A nivel del pie se producen deformidades tanto flácidas como espásticas con déficit motores radiculares (55%). Estos problemas estructurales provocaran alteraciones biomecánicas severas con sobrecargas a nivel plantar (33%). Si a esto añadimos alteraciones radiculares sensitivas, con insensibilidad en piernas y pies (60%), nos encontramos ante un paciente de riesgo susceptible de tratamientos preventivos y curativos podológicos. Las probabilidades de padecer una úlcera neuropática son grandes y el Podólogo debe prevenir o, en el peor de los casos, tratar el mal perforante plantar de una forma interdisciplinar. Preventivamente realizaremos quiropodias periódicas y exploración de sensibilidades, tanto exteroceptivas como propioceptivas. A nivel podológico trataremos de una forma integral la úlcera neuropática, incluyendo los drenajes y las “toilettes” quirúrgicas, y realizaremos tratamientos ortopodológicos complejos. En esta comunicación presentamos un caso típico de paciente afecto de Espina Bífida con alteraciones biomecánicas severas y úlcera con recorrido fistuloso, al cual realizamos un drenaje y confeccionamos una férula supramaleolar interna unilateral para redistribuir las presiones y evitar las sobrecargas(AU)

The congenital malformation known as Spina Bifida characterize by the absence of fusion of the half line back of the vertebral column producing a hernia of the content of the pipe vertebral (marrow, meninges and nervous roots). This syndrome engages multiple systems of the organism, having to treat by a multidisciplinary team. To level of the foot produce deformities as much flaccid as spastic with deficit engines radiculars (55%). These structural problems caused biomechanics alterations severe with overload to level plant (33%). If we add sensitive alterations, we are facing a patient risk susceptible of preventive and curative podologyc treatments. The probabilities to suffer a neuropathic ulcer are high and the Podologist must prevent or, in the worst case, treat the evil perforate plant of an interdisciplinary way. Preventing will realize podologycs periodic cures and exploration of sensibilities, both exteroceptives as propriceptives. At the podologyc level, will treat of an integral way the neuropathic ulcer, including the drains and the surgical toilettes, and perform ortopodologyc complex treatments. In this communication we present a typical case of a patient affected of Spina Bifida with biomechanics alterations severe and ulcer with fistulous route, to wich we had drainage and a supramalleolous intern unilateral splints to distribute the pressures and avoid overloading(AU)