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On assessment methods related to pain in dogs with osteoarthritis
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience. Evidensia Djursjukvård. (Fysioterapi)
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Description
Abstract [en]

There is a need of valid and reliable assessment methods that are clinically applicable in canine rehabilitation practice. The aim of this thesis was to psychometrically evaluate measurement properties in assessment methods related to pain in naturally occurring canine osteoarthritis. Assessment methods developed for heart rate variability analysis, i.e. Polar heart rate monitor, and owner-reported perceptions of pain severity and pain interference with functionality, i.e. Canine Brief Pain Inventory, were tested.

Methods: Four observational studies were conducted. Study I was a cross-sectional study consisting of two groups of consecutively recruited dogs. The Canine Brief Pain Inventory was administered to owners of dogs with naturally occurring osteoarthritis (n=61) and clinically sound dogs (n=21). Study II was a descriptive and correlative cross-sectional study based on the same sample of dogs with osteoarthritis (n=71), assessing chronic pain behavior and associations between explanatory variables and chronic pain behavior. Study III and IV were correlative studies, assessing Polar heart rate monitor measuring interbeat intervals and time- and frequency-based heart rate variability parameters, compared to simultaneously recorded electrocardiogram in dogs (n=11).

Results: High internal consistencies and ability to discriminate sound dogs from osteoarthritis dogs were found. The hypothesis of the presented two-factor structure of the Canine Brief Pain Inventory was rejected. Owners reported higher proportions of chronic pain behavior in items targeting physical activities, e.g. getting up, moving after rest and moving after major exercise. A minor proportion of dogs with osteoarthritis showed no owner-perceived behavioural signs of chronic pain. Owner observations were not associated with ongoing antiinflammatory medications. In Study III and IV, 595 errors (12.3%) were identified in Polar data. The number of errors were unequally distributed among the dogs. Interbeat intervals and heart rate variability parameters from electrocardiogram and Polar were strongly associated. Standard error of measurements were high among some heart rate variability parameters in Polar and electrocardiogram.

In conclusion, this thesis contributes to our knowledge about assessment methods related to diverse components of pain in dogs with osteoarthritis, allowing improved pain management in clinical practice.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. , p. 70
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1415
Keyword [en]
assessment methods, behavior, canine, chronic pain, heart rate variability, measurement properties, osteoarthritis, physiotherapy, rehabilitation
National Category
Physiotherapy Veterinary Science
Research subject
Physiotherapy
Identifiers
URN: urn:nbn:se:uu:diva-334679ISBN: 978-91-513-0199-0 (print)OAI: oai:DiVA.org:uu-334679DiVA: diva2:1162693
Public defence
2018-02-16, Gustavianum, Akademigatan 3,753 10 Uppsala, Uppsala, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2018-01-26 Created: 2017-12-05 Last updated: 2018-01-26
List of papers
1. Psychometric evaluation of the canine brief pain inventory in a Swedish sample of dogs with pain related to osteoarthritis
Open this publication in new window or tab >>Psychometric evaluation of the canine brief pain inventory in a Swedish sample of dogs with pain related to osteoarthritis
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2017 (English)In: Acta Veterinaria Scandinavica, ISSN 1751-0147, E-ISSN 1751-0147, Vol. 59, article id 44Article in journal (Refereed) Published
Abstract [en]

Background: To evaluate intervention, implement evidence-based practice and enhance the welfare of dogs with naturally occurring osteoarthritis (OA), access to valid, reliable and clinically relevant outcome measures is crucial for researchers, veterinarians and rehabilitation practitioners. The objectives of the present study were to translate and evaluate psychometric properties, in terms of internal consistency and construct validity, of the owner-reported measure canine brief pain inventory (CBPI) in a Swedish sample of dogs with pain related to OA. Results: Twenty-one owners of clinically sound dogs and 58 owners of dogs with pain related to OA were included in this observational and cross-sectional study. After being translated according to the guidelines for patient-reported outcome measures, the CBPI was completed by the canine owners. Construct validity was assessed by confirmatory factor analysis, by repeating the principal component analysis and by assessing for differences between clinically sound dogs and dogs with pain related to OA. Internal consistency was estimated by Cronbach's a. Confirmatory factor analysis was not able to confirm the factor-structure models tested in our sample. Principal component analysis showed a two-component structure, pain severity and pain interference of function. Two components accounted for 76.8% of the total variance, suggesting an acceptable fit of a two-component structure. The ratings from the clinically sound dogs differed from OA dogs and showed significantly lower CBPI total sum. Cronbach's a was 0.94 for the total CBPI, 0.91 for the pain severity and 0.91 for the pain interference of function. Conclusions: The results indicate that the translated version of the CBPI is valid for use in the Swedish language. The findings suggest satisfying psychometric properties in terms of high internal consistencies and ability to discriminate clinically sound dogs from OA dogs. However, based on the confirmatory factor analysis, the original factor structure in the CBPI is not ideally suited to measure pain related to OA in our sample and the hypothesis of the presented two-factor structure was rejected. Further research needs to be conducted to determine whether the original psychometric results from CBPI can be replicated across different target groups and particularly with larger sample size.

Keyword
CBPI, Dogs, Measurement properties, Osteoarthritis, Pain, Physiotherapy, Rehabilitation
National Category
Veterinary Science
Identifiers
urn:nbn:se:uu:diva-330036 (URN)10.1186/s13028-017-0311-2 (DOI)000404805500001 ()
Available from: 2017-09-29 Created: 2017-09-29 Last updated: 2017-12-05
2. Owner-perceived chronic pain behavior and associated factors in canine osteoarthritis – an observational study
Open this publication in new window or tab >>Owner-perceived chronic pain behavior and associated factors in canine osteoarthritis – an observational study
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(English)In: Article in journal (Refereed) Submitted
National Category
Physiotherapy Veterinary Science
Research subject
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-335286 (URN)
Available from: 2017-12-03 Created: 2017-12-03 Last updated: 2017-12-05
3. Comparison of Polar RS800CX heart rate monitor and electrocardiogram for measuring inter-beat intervals in healthy dogs
Open this publication in new window or tab >>Comparison of Polar RS800CX heart rate monitor and electrocardiogram for measuring inter-beat intervals in healthy dogs
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2015 (English)In: Physiology and Behavior, ISSN 0031-9384, E-ISSN 1873-507X, Vol. 138, p. 247-253Article in journal (Refereed) Published
Abstract [en]

The aim of the present study was to assess the criterion validity, relative reliability and level of agreement of Polar RS800CX heart rate monitor measuring inter-beat intervals (IBIs), compared to simultaneously recorded electrocardiogram (ECG) in dogs. METHODS: Five continuous minutes of simultaneously recorded IBIs from Polar RS800CX and Cardiostore ECG in 11 adult healthy dogs maintaining standing position were analyzed. Polar data was statistically compared to ECG data to assess for systematic differences between the methods. Three different methods for handling missing IBI data were used. Criterion validities were calculated by intraclass correlation coefficients (ICCs) and corresponding 95% confidence intervals (CIs). Relative reliabilities and levels of agreement were calculated by ICCs and the Bland and Altman analysis for repeated measurements per subject. RESULTS: Correlation coefficients between IBI data from ECG and Polar RS800CX varied between 0.73 and 0.84 depending on how missing values were handled. Polar was over- and underestimating IBI data compared to ECG. The mean difference in log transformed (base10) IBI data was 0.8%, and 93.2% of the values were within the limits of agreement. Internally excluding three subjects presenting IBI series containing more than 5% erroneous IBIs resulted in ICCs between 0.97 and 0.99. Bland and Altman analysis (n=8) showed mean difference was 1.8ms, and 98.5% of the IBI values were plotted inside limits of agreement. CONCLUSION: This study showed that Polar systematically biased recorded IBI series and that it was fundamental to detect measurement errors. For Polar RS800CX heart rate monitor to be used interchangeably to ECG, by showing excellent criterion validity and reliable IBI measures in group and individual samples, only less than 5% of artifacts could be accepted.

National Category
Neurosciences
Identifiers
urn:nbn:se:uu:diva-239083 (URN)10.1016/j.physbeh.2014.10.034 (DOI)000348882900034 ()25446208 (PubMedID)
Available from: 2015-01-06 Created: 2014-12-18 Last updated: 2018-01-11Bibliographically approved
4. Validity and reliability properties of canine short-term heart rate variability measures - a pilot study
Open this publication in new window or tab >>Validity and reliability properties of canine short-term heart rate variability measures - a pilot study
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2015 (English)In: Journal of Veterinary Behavior: Clinical Applications and Research, ISSN 1558-7878, E-ISSN 1878-7517, Vol. 10, no 5, p. 384-390Article in journal (Refereed) Published
Abstract [en]

The objective of the pilot study was to compare validity and reliability properties of Polar RS800CX (Polar Electro Oy, Kempele, Finland) against simultaneously recorded electrocardiogram (ECG) measuring time-and frequency-based short-term heart rate variability (HRV) parameters, in dogs during stationary standing position. Five-minute recordings with less than 5% error rates from inter-beat interval (IBI) series obtained by Polar RS800CX and ECG, in 8 adult dogs, were used for HRV analysis. Polar data were statistically compared to the ECG data to assess for systematic differences in time-and frequency-based HRV parameters. Relative and absolute reliabilities were estimated by intraclass correlation coefficient, Spearman rho, Bland and Altman analysis, standard error of measurement, and standard error of measurements in percentage. Paired t test was used to determine the statistical significance of differences between the measurement methods. Results: There were high correlation coefficients between HRV parameters obtained from Polar RS800CX and ECG. Intraclass correlation coefficients were 0.98-1.00, and Spearman r was 0.93-0.98. There were differences between the methods in 2 HRV parameters, the standard deviation of normal-to-normal IBIs (SDNN) (P = 0.035) and the square root of the mean squared differences of successive normal-to normal IBIs (RMSSD) (P = 0.034). Standard error of measurements was between 2.8-11.6% in ECG and between 2.6-11.8% in Polar, indicating rather high measurement error in 3 of the HRV parameters in both measurement methods. Close agreements and high correlation estimates in this pilot study indicated acceptable relative reliability in Polar RS800CX measuring time-and frequency-based HRV parameters in the group of dogs studied. However, the present pilot study revealed differences between Polar RS800CX and ECG in time-based standard deviation of normal-to-normal and square root of the mean squared differences of successive normal-to normal parameters, and that small amounts of erroneous IBI segments from Polar negatively impact on the validity and reliability properties of Polar RS800CX.

Keyword
behavior, dogs, heart rate variability, reliability, validity
National Category
Veterinary Science
Identifiers
urn:nbn:se:uu:diva-264313 (URN)10.1016/j.jveb.2015.05.006 (DOI)000360648200003 ()
Available from: 2015-10-15 Created: 2015-10-09 Last updated: 2018-01-09Bibliographically approved

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