Inter-rater agreement of a pathophysiology-derived clinical assessment tool for complex regional pain syndrome type I in physiotherapy: an explorative study.
4 affiliations
- 1Department of Physiotherapy, Balgrist University Hospital, Forchstrasse 340, Zurich, CH-8008, Switzerland.
- 2Department of Physiotherapy, Balgrist University Hospital, Forchstrasse 340, Zurich, CH-8008, Switzerland. [email protected].
- 3Department of Health, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.
- 4Department of Physical Medicine and Rheumatology, Balgrist University Hospital, Forchstrasse 340, Zurich, 8008, Switzerland.
Abstract
Background
Patients with Complex Regional Pain Syndrome Type I (CRPS) typically exhibit highly variable clinical presentations along with significant and prolonged distress. While the role of physiotherapy is considered important, clear evidence-based treatment guidelines are lacking. For development of such in the future, a subgrouping into their underlying pathophysiological mechanisms has been proposed. The aim of this study was to determine the intertester agreement of physiotherapists using a novel clinical assessment tool for patients with CRPS Type I.Methods
A total of 20 patients diagnosed with CRPS Type I underwent a clinical sensory test battery, examinations concerning body perception and measurements of vegetative processes. The examination was recorded, rated and evaluated by a total of four raters. The therapists categorized their findings into four distinct categories: peripheral sensitization, central sensitization, cortical reorganization, and vegetative responses. They then estimated the proportions of these categories for each patient. The intertester agreement on the estimations was calculated using the Bhatthacharyya coefficient, involving the assessments of four different therapists.Results
The agreement coefficient among all raters, determined through a methodology for analyzing compositional data, ranged from 0.75 to 0.93.Conclusion
The multifactorial pathophysiology and its overlap in CRPS pose significant challenges for physiotherapeutic findings and treatments for these patients. In this exploratory study, we have identified good agreement among our findings and gained valuable insights for clinical practice. Furthermore, we hope that our work will aid clinicians in structuring their management approaches for patients with CRPS Type I.
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BibTeX
@article{erni2026interrater,
title = {{Inter-rater agreement of a pathophysiology-derived clinical assessment tool for complex regional pain syndrome type I in physiotherapy: an explorative study.}},
author = {Jasmin Erni and Evelyn Baertschi and Juergen Degenfellner and Hannu Luomajoki and Florian Brunner},
journal = {BMC musculoskeletal disorders},
year = {2026},
month = jul,
doi = {10.1186/s12891-026-10219-y},
url = {https://europepmc.org/article/MED/42928212},
note = {CC BY},
}
RIS
TY - JOUR
TI - Inter-rater agreement of a pathophysiology-derived clinical assessment tool for complex regional pain syndrome type I in physiotherapy: an explorative study.
AU - Jasmin Erni
AU - Evelyn Baertschi
AU - Juergen Degenfellner
AU - Hannu Luomajoki
AU - Florian Brunner
PY - 2026
DA - 2026/07/01
JO - BMC musculoskeletal disorders
DO - 10.1186/s12891-026-10219-y
UR - https://europepmc.org/article/MED/42928212
AB - Background Patients with Complex Regional Pain Syndrome Type I (CRPS) typically exhibit highly variable clinical presentations along with significant and prolonged distress. While the role of physiotherapy is considered important, clear evidence-based treatment guidelines are lacking. For development of such in the future, a subgrouping into their underlying pathophysiological mechanisms has been proposed. The aim of this study was to determine the intertester agreement of physiotherapists using a novel clinical assessment tool for patients with CRPS Type I.Methods A total of 20 patients diagnosed with CRPS Type I underwent a clinical sensory test battery, examinations concerning body perception and measurements of vegetative processes. The examination was recorded, rated and evaluated by a total of four raters. The therapists categorized their findings into four distinct categories: peripheral sensitization, central sensitization, cortical reorganization, and vegetative responses. They then estimated the proportions of these categories for each patient. The intertester agreement on the estimations was calculated using the Bhatthacharyya coefficient, involving the assessments of four different therapists.Results The agreement coefficient among all raters, determined through a methodology for analyzing compositional data, ranged from 0.75 to 0.93.Conclusion The multifactorial pathophysiology and its overlap in CRPS pose significant challenges for physiotherapeutic findings and treatments for these patients. In this exploratory study, we have identified good agreement among our findings and gained valuable insights for clinical practice. Furthermore, we hope that our work will aid clinicians in structuring their management approaches for patients with CRPS Type I.
SN - 1471-2474
ER -