Article

OBJECTIVE: To determine the relation between the patient's actual pain, the
electromyographer's perception of patient pain, and whether an electromyogram
(EMG) is altered. DESIGN: Patients undergoing electromyography reported expected
pain and procedure-related overall pain on a 100-mm visual analog scale (VAS).
Blinded electromyographers estimated patient pain levels and indicated if they
altered the study in any way because of this perception. Multivariable logistic
regression was used to determine predictors of altering the EMG. Paired t tests
were used to compare overall pain with expected pain and electromyographer
perception of pain. SETTING: Tertiary referral center. PARTICIPANTS: Referred
sample of adult subjects (N=304). INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: Patient pain, electromyographer perception of patient pain, and whether
an EMG was altered because of the electromyographer's perception of patient pain.
RESULTS: Mean VAS scores +/- SD were 48+/-25mm for patient-expected pain
(P<.001), 42+/-24mm for electromyographer perception of pain (P<.0001), and
36+/-25mm for actual overall pain. Electromyographers altered their study 31.7%
of the time because of concerns about pain. For every 13-mm increase on the VAS
(a prespecified clinically meaningful difference), the electromyographer
perception of pain increased the odds of altering a study 2.36 times (95%
confidence interval [CI], 1.71-3.26), whereas patient overall pain did not have a
significant effect (odds ratio=1.12; 95% CI, .86-1.47). CONCLUSIONS: Patients
expect EMGs to be more painful than they are. Electromyographers overestimate
patient pain and are more likely to alter their studies when they believe
patients are experiencing more pain, independently of whether patients actually
have more pain. Improving the communication between electromyographers and
patients may prevent unnecessary alterations.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS