Related Experiment Video
Updated: Aug 8, 2025
Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Functionally relevant physical exercises as an objective measure of clinical improvement in pediatric chronic pain
1Therapy Services Department, Cleveland Clinic Children's Hospital for Rehabilitation, Cleveland, OH, USA.
Insights
Functionally relevant physical exercises (FRPEs) objectively measure physical functioning in children with chronic pain. These exercises provide valuable data for assessing progress and informing treatment plans.
Area of Science:
- Pediatric Rehabilitation
- Pain Management
- Clinical Assessment Tools
Background:
- Chronic pain significantly impacts children's physical functioning and quality of life.
- Current assessment methods often rely on subjective self-reports, which may not fully capture objective functional capacity.
- Intensive interdisciplinary pain treatment (IIPT) aims for functional improvement as a key outcome.
Purpose of the Study:
- To demonstrate the application of functionally relevant physical exercises (FRPEs) for objective assessment of physical functioning in children with chronic pain.
- To evaluate FRPEs as a tool to enhance clinical assessments and monitor progress during intensive interdisciplinary pain treatment (IIPT).
- To provide objective data for physical and occupational therapies.
Main Methods:
- A study involving 207 children (aged 8-20) undergoing three weeks of IIPT.
- Participants completed subjective measures (Lower Extremity Functioning Scale [LEFS], Upper Extremity Functioning Index [UEFI]) and objective FRPEs (box carry, box lifts, floor to stand, sit to stand, step ups, modified six-minute walk test).
- Data analyzed to assess baseline function, changes post-treatment, and correlations between subjective and objective measures.
Main Results:
- Over 91% of children could perform FRPEs at baseline, establishing a functional strength assessment.
- All participants successfully completed FRPEs after IIPT, indicating improved capacity.
- Statistically significant improvements were observed in subjective reports and FRPE performance (p < 0.001).
- Weak to moderate correlations were found between LEFS/UEFI and FRPEs at admission, with lower correlations at discharge.
Conclusions:
- FRPEs serve as effective objective measures of strength and mobility for pediatric chronic pain patients.
- FRPEs capture patient variability and changes over time, complementing subjective data.
- These exercises offer meaningful, objective data for clinical assessment, treatment planning, and patient monitoring in pediatric pain management.
Purpose:
This exploratory study demonstrates the application of functionally relevant physical exercises (FRPE) to objectively assess physical functioning among children with chronic pain. Intensive interdisciplinary pain treatment (IIPT) focuses on functional improvements as a primary outcome. FRPEs aim to enhance clinical assessments and monitoring by providing relevant data for physical and occupational therapies.
Methods:
Children enrolled in three weeks of IIPT provided data for study. They completed two self-report measures of functioning (Lower Extremity Functioning Scale [LEFS] and Upper Extremity Functioning Index [UEFI]), measure of pain intensity, and six separate FRPEs (box carry, box lifts, floor to stand, sit to stand, step ups, and modified six-minute walk test). Data from 207 participants aged 8-20 years old were analyzed.
Results:
Upon admission, over 91% of children could perform each FRPE at some level to provide clinicians with a baseline assessment of functional strength. Following IIPT, all children were able to complete FRPEs. Overall, children reported statistically significant gains in functioning on all subjective reports and FRPEs (p's < 0.001). Spearman correlations demonstrated that LEFS and UEFI were weakly to moderately correlated to all FRPEs at admission (r's between.43-.64, p's < 0.001 and.36-.50, p's < 0.01 respectively). Correlations between all subjective and objective measures were comparatively lower at discharge.
Conclusion:
FRPEs appear to serve as good objective measures of strength and mobility for children with chronic pain, measuring variability across patients and change over time, which is unique from subjective data gathered via self-report. Due to face validity and objective measurement of functioning, from a clinical practice perspective, FRPEs provide meaningful information to support initial assessment, treatment planning, and patient monitoring. This study offers initial support for a novel measurement method that is easily administered and replicated to effectively measure functional improvement in children with chronic pain.
