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Physical and occupational therapy outcomes: Adolescents’ change in functional abilities using objective measures and self-report

Authors
  • Kempert, Heidi
  • Benore, Ethan
  • Heines, Rachel
Type
Published Article
Journal
Scandinavian journal of pain
Publication Date
Jan 01, 2017
Volume
14
Issue
1
Pages
60–66
Identifiers
DOI: 10.1016/j.sjpain.2016.10.004
PMID: 28850431
Source
De Gruyter
Keywords
Disciplines
  • Clinical pain research
License
Yellow

Abstract

Purpose This study evaluates the clinical usefulness of patient-rated and objective measures to identify physically-oriented functional changes after an intensive chronic pain program in a pediatric setting. Past studies have demonstrated the importance of adolescents’ perception of their abilities and measurement tools used for rehabilitation outcomes within physical and occupational therapy; however, these tools used are not often easily utilized or have not been examined with a pediatric chronic pain population. In chronic pain rehabilitation, it is important to have a primary focus on functional improvement not on pain reduction as a leading outcome. This study examines how both self-report and objective physical activity measures can be meaningful constructs and can be used as reliable outcome measures. It was hypothesized that adolescents completing an interdisciplinary pain rehabilitation program would report functional gains from admission to discharge, and that perceived gains in physical ability would be associated with objective physical activities. Further, it was hypothesized that gains in functioning would be associated with mild pain reduction. Methods Data from 78 children and adolescents with chronic pain that participated in an intensive multidisciplinary treatment program completed self-report measures including the Lower Extremity Functional Scale (LEFS), Upper Extremity Functional Index (UEFI). In addition, adolescents were objectively monitored for repetitions of selected physical activities for 1 min intervals. Results Data demonstrated significant gains in all measures of functioning during the program. Correlations between self-report and objective outcomes suggest they are measuring similar yet distinct factors. Conclusions The LEFS, UEFI, and objective exercises provide a meaningful way to track progress in pediatric chronic pain rehabilitation. Despite similarities, they appear to track separate but related aspects of rehabilitation and capture important short-term response to rehabilitation. Both measures appear distinct from pain as an outcome. These findings increase our understanding of rehabilitation practices provide opportunities to promote clinical improvement in pediatric pain. Implications The use of self-report measures along with objective measures can help therapists gain understanding in regards to a patient’s insight and how that may impact their overall outcome compared to the use of a single outcome measure. Viewing these rated measures at any point in the rehabilitation process can be useful to facilitate discussion about challenges they can identify and how therapies can facilitate improvement and functional gains.

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