The development of a battery of measures for assessing physical functioning of chronic pain patients

Abstract

The physical performance of chronic pain patients is of major concern both for their assessment and for treatment evaluation. However, there are few widely used physical tests, a shortage of reliability and validity data on published tests, and an over-reliance on self-report or on clinical measures of dubious generalisability. A set of tests was designed to cover speed and endurance in walking, stair climbing, standing up from a chair, sit-ups, arm endurance, grip strength, and peak flow. Standard instructions and testing conditions were used by a trained tester on a population of chronic pain patients before and after a cognitive-behavioural chronic pain management programme. Reliability, validity, and acceptability of each test was examined, and recommendations made for their relative utility.

Long-term follow-up of functional outcomes and radiographic changes at adjacent levels following lumbar spine fusion for degenerative disc disease

“…In our study, performance tests could be carried out in all patients who participated in the study. The reliability and usefulness of performance tests (self-paced walk and the timed up-and-go) have been demonstrated in many studies on elderly populations, including those with medical problems [1,9,14,15,19,20]. Once again, there was no significant difference between the fusion and the non-fusion groups in the results of self-paced walk and the timed up-and-go tests ( Table 2, Table 3).…”

“…They were also asked to rate their perceived exertion during the test using the Borg rating of perceived exertion. The reliability and reproducibility of these tests in the elderly population has been demonstrated [1,9,15].…”

Six month post-treatment deterioration in acceptance (CPAQ-8) and cognitions following multidisciplinary pain treatment

“…The walk was conducted in an empty corridor with permanent marks placed 20 meters apart. The timed-walk has been shown to have good inter-rater reliability in a chronic-pain population; it has also demonstrated sensitivity to change in functioning during treatment (Harding et al, 1994). The test-retest reliability of the measure is 0.94 (Harding et al, 1994).…”

“…Patients were not permitted to use their arms to assist them (Harding et al, 1994). Patients were instructed to perform as many sit-tostand actions as they could in 1 min and were given a reminder at 30 s. The sit-to-stand test has been shown to have good inter-rater reliability in a chronicpain population and to be sensitive to change in function during treatment (Harding et al, 1994).…”

How well do observed functional limitations explain the variance in Roland Morris scores in patients with chronic non-specific low back pain undergoing physiotherapy?

“…Moreover, they can be expensive and time-consuming. In recent years, more clinically relevant measures of physical performance have been developed, using batteries of tests of ''functional activities'' [12,17,18,27,34,43]. The majority of these tests challenge trunk mobility, speed, and coordination of movement, which are often impaired in patients with cLBP.…”