A prospective short-term study of chronic low back pain patients utilizing novel objective functional measurement

Abstract

The present study utilized recently developed diagnostic tests that permit recognition of functional deficits in spine mobility, trunk strength, endurance, coordination, and dynamic lifting capacity. Changes in these tests were compared to changes in psychological functioning (e.g., self-report of pain) as well as to outcome criteria such as return-to-work and resolution of litigation. The study utilized these tests repeatedly during a new treatment approach to feed back objective information of the patient's functional capacity, not amenable to simple visual inspection, to both the patient and the surgeon. The program itself integrated a low back physical rehabilitation program with a multimodal pain management program and was guided by repeated functional capacity measurements. A total of 66 patients were evaluated. Results demonstrated significant improvement in physical function in these patients, which was also accompanied by changes in self-report of pain complaints. Moreover, an 82% return-to-work rate was achieved in this sample which was initially 92% unemployed. These results indicate that the physician dealing with chronic low back dysfunction can employ objective measures of functional capacity as an alternative to the sole reliance on pain patient self-report or structured tests, such as radiographic imaging, which merely document a universal, progressive degenerative process.

Adaptive Equipment: Its Effectiveness for People with Chronic Lower Back Pain

“…Ten percent of people who experience acute lower back pain may suffer permanent disability (Mayer et al, 1986). The physical manifestations and restrictions of lower back pain are accompanied by a myriad of factors that affect functional, social, and emotional components of the sufferer's life (Gottlieb, Koller, & Alperson, 1982).…”

Lumbar Surgery in Work-Related Chronic Low Back Pain: Can a Continuum of Care Enhance Outcomes?

“…8,9,[25][26][27][28][29][30][31][32] The effectiveness of functional restoration methods have also been well documented in the literature. [33][34][35][36][37][38][39][40][41] …”

MMPI Disability Profile Is Associated With Degree of Opioid Use in Chronic Work-related Musculoskeletal Disorders

“…The patients' subsequent interdisciplinary rehabilitative treatment at PRIDE would consist of a quantitatively directed exercise program supervised by both physical and occupational therapists, in conjunction with a multimodal disability management component, which included individual counseling, group therapy, stress management training, vocational reintegration, and future fitness management. [33][34][35][36][37][38][39][40][41][42][43] Patient demographic data (Table 1) were collected as part of the intake interview noted above, at the end of which the patient was asked to complete a series of physical and functional capacity measures normalized to age, sex, and body weight. On the first day of the intensive treatment phase of the PRIDE rehabilitation program, patients were asked to complete a full battery of psychosocial tests: the Beck Depression Inventory (BDI) 44 ; the Million Visual Analog Scale (MVAS), 45 a Visual Analog Questionnaire used to assess disability; the Oswestry Disability Questionnaire 46 ; the Short-Form 36 Health Survey 47 ; and the Quantified Pain Drawing, 48 an analog self-report measure of perceived pain intensity; the Hamilton Rating Scale for Depression (HAM-D) 49 ; and the MMPI-2 50 .…”