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Functional assessment in patients with chronic pain: can physicians predict performance?
W C Walker1, D X Cifu, M Gardner
1Department of Physical Medicine and Rehabilitation, Medical College of Virginia at Virginia Commonwealth University, Richmond 23298-0677, USA.
American Journal of Physical Medicine & Rehabilitation
|March 10, 2001
Summary
Physicians can reasonably estimate chronic pain patients' functional abilities during work assessments. However, predicting patient effort during these assessments proves more challenging for physicians.
Area of Science:
- Rehabilitation Medicine
- Pain Management
- Occupational Health
Background:
- Assessing functional abilities is crucial for chronic pain patients' return to work.
- Physician estimations of patient capacity are often used but their accuracy is debated.
Purpose of the Study:
- To evaluate the accuracy of physician estimations of functional performance in chronic pain patients.
- To compare physician-predicted effort with objective effort measures.
Main Methods:
- 201 outpatients with chronic pain underwent standardized functional assessments.
- Physicians predicted patient performance and effort; therapists measured actual performance and effort (grip dynamometry).
Main Results:
- Physicians' predicted performance correlated significantly with actual performance in lifting and repetitive tasks for both genders.
- Physician-predicted effort showed poor agreement with objective measures, particularly for men.
Conclusions:
- Trained physicians can accurately estimate work-related functional capacity in chronic pain patients.
- Estimating patient effort during functional assessments is less reliable.