Abstract
Background
Self-rated disability scores in patients with chronic LBP (cLBP) do not always relate well to performance in traditional physical tests (e.g. back strength, fatigability, etc.). Therefore tests using “functional activities” that challenge for example trunk mobility and movement speed have been suggested as alternative “objective” outcome measures. We examined the relationship between self-reported disability and a battery of such functional tests.
Methods
37 patients with cLBP took part (45±12y; 23f, 14m); 32 completed 9 weeks' physiotherapy. Before and after therapy, the patients completed the Roland Morris disability questionnaire (RM) and performed a battery of 8 simple tests (stair climb, prolonged flexion, stand to floor, lift test, sock test, roll-up test, pick-up test, fingertip-to-floor test).
Results
Baseline RM scores were significantly correlated with each of the functional test scores (ranging from r=0.33 (sock test) to 0.51 (fingertip to floor); p<0.05), and with a sum index score for all functional tests (r=0.60, p<0.001). The effect size for the change in RM score pre-treatment to post-treatment was 0.54; the corresponding value for the functional test index was 0.73. The correlation between the treatment change-scores for RM and the functional test index was 0.55 (P=0.001).
Conclusion
Self-reported activity limitations and objectively-measured performance were moderately highly correlated. The fingertip-to-floor test delivered the most clinically relevant information, having the strongest relationship with the RM scores. The test battery appears to provide a valid measure of activity limitations in patients with back pain and may be a useful tool to complement or substantiate self-report measures to assess treatment outcome.
Conflicts of Interest
None
Source of Funding
Swiss National Science Foundation.
