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King's Parkinson's Disease Pain Scale (KPPS)
Please visit this website for more information about the instrument: King's Parkinson's Disease Pain Scale
Supplemental: Parkinson's Disease (PD)
Short Description of Instrument
The King's Parkinson's Disease Pain Scale (KPPS) was developed to evaluate the multiple pain modalities present in PD, administered by health professionals.
There is also a patient self-administered version, the King's Parkinson's Disease Pain Questionnaire (KPPQ) which is classified as Exploratory. The KPPQ is a 14-item questionnaire with binary yes/no responses. This version does not correlate well with gold standard questionnaires but does correlate moderately well with KPPS.
Comments/Special Instructions
This scale is recommended to administer if patient answers "YES" to Q#10 on Non-Motor Symptoms Questionnaire (NMSQ) (unexplained pains). It was also used in Safinamide trial - SAFINONMOTOR.
Scoring and Psychometric Properties
Scoring: 14 items, 7 domains (musculoskeletal, chronic, fluctuating, nocturnal, orofacial, edematous, radicular); 4-point Likert scale for severity (0=none, 3=severe) and 5-point Likert scale for frequency (0=never, 4=very frequent), each item scored by severity x frequency, total score 0-168 (higher scorer=higher pain/stronger burden).
Psychometric Properties: Cronbach's alpha 0.78, Item-total correlation mean value 0.40, inter-rater reliability 0.99, test-retest reliability 0.96. Convergent validity with Visual Analog Scale (rS?=?0.55)
Strengths: Translated and validated in multiple languages, easy to administer, 10-15-minute administration time, no ceiling or floor effects for total KPPS score, global assessment of different pain types, and correlates with disease severity and health-related quality of life.
Weaknesses: Floor effects for all individual domains except for musculoskeletal pain, "lumping" of different pain types, weaker correlations with Non-Motor Symptom Scale, and people with dementia excluded from validation study due to presumed unreliable subjective reports of pain.
Key Reference:

Chaudhuri KR, Rizos A, Trenkwalder C, Rascol O, Pal S, Martino D, Carroll C, Paviour D, Falup-Pecurariu C, Kessel B, Silverdale M, Todorova A, Sauerbier A, Odin P, Antonini A, Martinez-Martin P; EUROPAR and the IPMDS Non Motor PD Study Group. King's Parkinson's disease pain scale, the first scale for pain in PD: An international validation. Mov Disord. 2015 Oct;30(12):1623-31.
Additional References:
Behari M, Srivastava A, Achtani R, Nandal N, Dutta RB. Pain Assessment in Indian Parkinson's Disease Patients Using King's Parkinson's Disease Pain Scale. Ann Indian Acad Neurol. 2020 Nov-Dec;23(6):774-780. (Validated in India in Hindi and English)
Coimbra MR, Almeida-Leite CM, de Faria-Fortini I, Christo PP, Scalzo PL. King's Parkinson's Disease Pain Scale (KPPS): Cross-cultural adaptation to Brazilian Portuguese and content validity. Clin Neurol Neurosurg. 2021 Sep;208:106815. (Translated to Brazilian Portugese)
Jost WH, Rizos A, Odin P, LÖhle M, Storch A. King's Parkinson's Disease Pain Scale : Interkulturelle Adaption in deutscher Sprache [King's Parkinson's disease pain scale : Intercultural adaptation in the German language]. Nervenarzt. 2018 Feb;89(2):178-183. (Validated in German)
Martinez-Martin P, Rizos AM, Wetmore J, Antonini A, Odin P, Pal S, Sophia R, Carroll C, Martino D, Falup-Pecurariu C, Kessel B, Andrews T, Paviour D, Trenkwalder C, Chaudhuri KR; EUROPAR and MDS Non-motor PD Study Group. First comprehensive tool for screening pain in Parkinson's disease: the King's Parkinson's Disease Pain Questionnaire. Eur J Neurol. 2018 Oct;25(10):1255-1261.
Stoyanova-Piroth G, Milanov I, Stambolieva K. Translation, adaptation and validation of the Bulgarian version of the King's Parkinson's Disease Pain Scale. BMC Neurol. 2021 Sep 15;21(1):357. (Validated in Bulgarian)
Taghizadeh G, Joghataei MT, Goudarzi S, Bakhsheshi M, Habibi SAH, Mehdizadeh M. King's Parkinson's disease pain scale cut-off points for detection of pain severity levels: A reliability and validity study. Neurosci Lett. 2021 Feb 6;745:135620. (Validated in Persian)
Document last updated August 2022