Background & Aims
BACKGROUND: Interdisciplinary pain rehabilitation teams and programs combining pain neuroscience education, physical therapy, exercise, and pain psychology is a gold standard treatment to improve physical function in patients with chronic pain. To evaluate the primary treatment outcomes, physical performance tests [i.e., the 6-minute walk test (6MWT), 30-second sit-to-stand test (STS), lift and carry test (LCT)] are often conducted by a physical therapist. A study is needed to establish the clinical relevance of physical performance tests.
AIM: The current study aimed to understand if physical improvements measured with physical performance tests would be associated with improvement in patient-reported outcome measures such as pain intensity rating, pain interference, and pain related disability. It was hypothesized that greater improvement in physical performance measures would be associated with greater reduction in pain rating, pain interference, and pain-related disability.
Methods
METHODS: The 0-10 numerical rating for average pain, PROMIS-Pain Interference measure, Roland-Morris Disability Questionnaire (RMDQ) were administered to assess the degree of pain intensity, pain interference, and pain-related disability before and after a 6-week outpatient interdisciplinary pain rehabilitation program. First, paired sample t-tests were conducted to examine significant changes of these measures. Then, Spearman Rho correlation analysis was conducted with the change scores (post-score minus pre-score). Our sample consisted of 35 adult patients with chronic pain (82.95% female, mean age = 55.1 with SD of 15.3) that completed an outpatient interdisciplinary pain program called Back in ACTion that included exercise, physical therapy, pain psychology (ACT-based) and medical lectures.
Results
RESULTS: First, t-test results indicated significant changes in all physical performance tests (d = -0.99 for 6MWT, -1.17 for STS, and -1.74 for LCT, p’s < .001) and self-report outcomes (d = 0.85 for pain rating, 0.61 for pain interference, 1.57 for pain-related disability). Then, Spearman Rho correlation analysis revealed that improved functional physical performance measure with the 6MWT test was associated with reduction of the PROMIS-Pain interference (r = -.486, p= .022), but unrelated to changes in pain and pain-related disability (ps > .166).
Conclusions
CONCLUSION: All physical performance tests improved significantly post 6-week interdisciplinary pain treatment intervention. Our results suggest that among the three pain-related outcome variables, improved physical performance was moderately associated with reduced pain interference, but not significantly associated with reduced pain ratings and reduced pain-related disability. Among the three physical performance tests, improvement in the 6MWT test was associated with reduced pain interference. Therefore, the 6MWT test might be more clinically relevant in evaluating treatment responses to an interdisciplinary pain rehabilitation program.
References
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Presenting Author
Corinne Cooley
Poster Authors
Topics
- Treatment/Management: Pharmacology: Psychological and Rehabilitative Therapies