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Functional capacity evaluations in persons with spinal disorders: predicting poor outcomes on the Functional
C M Ruan1, A J Haig, M E Geisser
1Spine Program, Department of Physical Medicine & Rehabilitation, University of Michigan Health System, 325 East Eisenhower Parkway, Second Floor, Ann Arbor, Michigan 48108-0744, USA.
Journal of Occupational Rehabilitation
|November 15, 2001
Summary
Simple functional tests are difficult for chronic back pain patients, with poor performance linked to psychological factors. Extensive physical evaluations may not be valid for this group.
Area of Science:
- Rehabilitation Medicine
- Clinical Biomechanics
- Psychosomatic Medicine
Background:
- Chronic back pain significantly impacts physical function and daily activities.
- Assessing physical capacity in chronic back pain patients is crucial for treatment and return-to-work planning.
- Current functional assessment methods may not accurately reflect the capabilities of this population.
Purpose of the Study:
- To evaluate the relationship between performance on the Functional Assessment Screening Test (FAST) and more extensive physical and psychological assessments.
- To determine the validity and necessity of extensive functional capacity evaluations for individuals with chronic back disability.
Main Methods:
- 188 individuals with chronic back disability and 17 healthy controls completed the FAST, Progressive Isoinertial Lifting Evaluation (PILE), trunk extension endurance, bicycle ergometry, and psychological assessments.
- The FAST included static and dynamic low-exertion tasks.
- Performance and completion rates were analyzed in relation to physical and psychological measures.
Main Results:
- Only 19.7% of back pain patients completed all FAST components, compared to 88% of healthy controls.
- Non-completers with back pain showed poorer performance on PILE and trunk extension endurance.
- Non-completers exhibited more dysfunctional coping, pain avoidance, depression, and self-reported disability.
Conclusions:
- Performance on simple, low-exertion functional tests is poor in chronic back pain patients.
- Psychosocial factors strongly influence test performance in this population.
- Extensive functional capacity evaluations may lack necessity and validity for assessing chronic back pain patients' physical performance.