DoD AtMS for Posttraumatic Peripheral Neuropathic Pain

0 is equivalent to no neuropathic pain and 10 indicates the worst possible neuropathic pain

Hamilton Rating Scale for Depression (HRSD) an interviewed asks 21 questions about mood, sleep, appetite, and other symptoms related to depression. The interviewer rates the severity of each symptom based on a pre-defined scale of 0-4. The scores for each item are then summed to produce a total score.

The total score on the HAM-D is used to assess the severity of depression. Lower scores indicate less severe depression, while higher scores indicate more severe depression.

Typical scoring interpretations: Below 7: Absence or remission of depression; 7-17: Mild depression; 18-24: Moderate depression; 25 and above: Severe depression

Daily Sleep Interference Log measures how much neuropathic pain impacts the patients sleep each night. The log is ranked on a 0 to 10 scale, 0 being pain didn't interfere with sleep and 10 being pain completely interfered with sleep, with a lower score representing a better outcome.

Work Productivity and Activity Impairment Questionnaire (WPAI-SHP version 2) metric 1:

Absenteeism (the percentage of work time missed);

***Only those being employed provided answer for absenteeism***

WPAI absenteeism scores are based 2-items (2 and 4); a score cannot be calculated if there is a missing response to the corresponding item. Question 2 represents time in hours lost due to health reasons while question 4 represents the time spent working. Time lost is divided by the total time (sum of 2 and 4) and then multiplied by 100 to express as a percentage.

All WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity

Work Productivity and Activity Impairment Questionnaire (WPAI-SHP version 2) metric 2:

Presenteeism (the percentage of impairment experienced while at work);

***Only those being employed provided answer for presenteeism***

WPAI presenteeism scores are based on 1-item (5) which is divided by 10 and later multiplied by 100 to express as a percentage; a score cannot be calculated if there is a missing response to the corresponding item.

WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity

Work Productivity and Activity Impairment Questionnaire (WPAI-SHP version 2) metric 3:

Overall work productivity loss (an estimate of combination of absenteeism and presenteeism);

***Only those being employed provided answer for absenteeism {Q2/(Q2+Q4)}, presenteeism {Q5/10}***

WPAI overall work productivity scores are computed based on absenteeism and presenteeism scores, using the following formula, Q2/(Q2+Q4)+[(1-(Q2/(Q2+Q4)))x(Q5/10)], and then being multiplied by 100 to express as a percentage; a score cannot be calculated if there is a missing response to the corresponding item.

WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity

Work Productivity and Activity Impairment Questionnaire (WPAI-SHP version 2) metric 4:

Activity impairment (the percentage of impairment in daily activities)

***Only those being employed provided answer for absenteeism, presenteeism, and overall work impairment***

WPAI activity impairment scores are based on 1-item (item 6) which is divided by 10 and later multiplied by 100 to express as a percentage; a score cannot be calculated if there is a missing response to the corresponding item.

WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity

Neuropathic Pain Medication Logs will measure changes in daily neuropathic pain. The log will record if daily neuropathic pain medications are used, the medication name(s), the strength(s) measured in mg, quantity measured by number of pills/sprays/etc. As well as if additional non-daily, typically OTC, pain medications were taken for neuropathy, the medication name(s), strength(s) measured in mg, quantity measured by number of pills/spray/etc.

For this outcome, increases in any medication as well as new medications will be marked as "more" and numerically described with 1; decreases will be marked as "less" and numerically described as -1; no change will result in a 0. Total change will be summed per visit and later used as a percentage of participants positive (representing an increase in medication us) or negative (decrease in medication use) change.

Any negative score will be considered a favorable outcome.

von Frey 5.18 monofilament will be used to measure/map (cm²) out an area of neuropathic allodynia. The instrument will be used by pressing them against the neuropathic pain area and marking roughly 8 points with each. Then the points will be traced on two separate translucent papers, one for each instrument, to create two rough shapes to measure the areas. The area of the shape will be measured using a Compensating Polar Planimeter.

Paintbrush will be used to measure/map (cm²) out an area of neuropathic allodynia. The instrument will be used by pressing them against the neuropathic pain area and marking roughly 8 points with each. Then the points will be traced on two separate translucent papers, one for each instrument, to create two rough shapes to measure the areas. The area of the shapes will be measured using a Compensating Polar Planimeter.

Thermal Sensory Analyzer (Medoc Advanced Medical Systems, Minneapolis) will be used to measure cool, warm, cold, and hot temperature (°C) thresholds.

The participant will first be asked to press the button when the increasing hot temperature becomes uncomfortable. This will be done 3 times and averaged to establish a threshold for the next portion.

The thermode will heat up to the threshold temperature and remain their for a period of time. The participant will then rate their pain experienced via MVAS scale (0-10) with a 0 describing no pain and a 10 describing the worst pain experienced.

A lower pain score will represent a better outcome and a higher score will represent a worse outcome.

Different sized von Frey monofilament (e.g, 5.18) will be used to determine the participants physical pain sensation threshold to the von Frey monofilaments. The von Frey monofilaments will pressed against the neuropathic pain area one by one from smallest to largest until the participants expresses they can feel a sensation of physical pain in the neuropathic area caused by the von Frey monofilament.