1,720,981 research outputs found
Physical function and physical performance in patients with pain: What are the measures and what do they mean?
No full textCharacterizing speed of physical and cognitive performance in individuals with chronic low back pain
No full textThe differential influence of pain and fatigue on physical performance and health status in ambulatory patients with human immunodeficiency virus
No full textObjectives: The purposes of this study were to: 1) characterize physical performance in individuals with human immunodeficiency virus; and 2) examine group differences by pain and fatigue on a multivariate profile of disease, physical, and psychologic symptoms.Methods: One hundred outpatients, 78 men and 22 women (mean age 40.70 +/- 7.49 years) participated. Patients completed a battery of physical performance tests in which the time taken or the distance reached or walked was measured. Self-report questionnaires included measures of pain (0-10 numerical rating scale), fatigue (Brief Fatigue Inventory), and perceived health status (Medical Outcomes Survey-HIV scale).Results: Physical performance was compromised in a task specific manner. Patients took twice as long as healthy individuals on a belt-tie and 4 times as long on a sit-to-stand task and in 6 minutes walked 75% of the distance covered by healthy individuals. Fifty percent of patients (n = 50) had pain at the time of testing (mean 6.3 +/- 2.4), and 98% had fatigue (mean 5.4 +/- 2.3). Multivariate analysis of variance showed pain had a greater influence on performance than fatigue. Pain, distance walked in 6 minutes, and unloaded forward reach accounted for 26% of the variability in quality of life (r = 0.51, P <= 0.0001).Discussion: Pain has a substantial impact on physical performance and quality of life among ambulatory human immunodeficiency virus patients. Fatigue also impacts physical performance. Compromised ability to perform certain physical tasks affects quality of life. Further investigation of the roles of these relevant variables should be investigated in path analyses
Pain, disability, and physical therapy in older adults: issues of patients and pain, practitioners and practice
No full textPain in older adults is a complex multidimensional (biopsychosocial) problem that is always unpleasant and is frequently associated with physical disability, psychosocial distress, and reduced quality of life. Physical therapists knowledgeable about pain are in an excellent position to identify and manage problems related to pain and pain-related dysfunction for this older population. Unfortunately, although pain is prevalent, complex, and integral to health care, it has not been integral to health care education. Inadequate knowledge has led to inadequate assessment and management. Current evidence shows that optimum pain and disability management is predicated on a sound assessment. Optimal management of the person with pain involves education and activity guided by practitioners knowledgeable about the complexities of pain. Recommendations regarding pain and disability assessment and management by physical therapists are provided
Relationships between physical and cognitive performance in individuals with and without back pain
No full textFunctional self-efficacy, perceived gait ability and perceived exertion in walking performance of individuals with low back pain
No full textThe purpose of this study was to examine psychological and perceptual factors that influence walking in individuals with low back pain (LBP). In Study 1 59 subjects with LBP recruited from an orthopedic surgeon participated. Perceived gait ability was measured with the Distorted Ambulation subscale of Pain Behavior Checklist (DAS-PBCL). The psychological factor of functional self-efficacy (FSE) was assessed on the FSE scale. These scales were completed before performing a 50-foot speed walk (50 FT WALK) and a 5-minute distance walk (5 MIN WALK) tests. DAS-PBCL had stronger correlations with walking performance (r = 0.11 to 0.58) than FSE (r = 0.03 to 0.49). DAS-PBCL had a stronger relationship with 50 FT WALK ( r = 0.18 to 0.58) than 5 MIN WALK (r = 0.11 to 0.50). In Study 2 48 healthy pain-free subjects and an independent sample of 40 subjects with LBP referred from an orthopedic surgeon participated. They completed the 5 MIN WALK followed by the modified Borg's rating of perceived exertion scale (CR10). Subjects with LBP walked a significantly shorter distance (t = 4.69, p<.005) but perceived a similar amount of exertion (Mann-Whitney U = 861.5, p = .40) compared with those without LBP. Perceived gait ability appears to account for more variability in walking performance than functional self-efficacy of walking in individuals with LBP. Perceived gait ability, in particular, accounted for more variance in walking speed than in walking endurance. Individuals with LBP also experience more exertion during walking than those without LBP. These results suggest that clinicians may need to consider patients' perceptions of gait ability and exertion when assessing walking performance in patients with LBP
Physical performance tasks: what are the underlying constructs?
No full textOBJECTIVES: To investigate the structural validity of a battery of physical performance tasks and to investigate the construct validity of the resulting factors.DESIGN: A measurement study.SETTING: A large, private orthopedic clinic and a physical therapy clinic in an urban area. PARTICIPANTS: One hundred three consecutive adult patients with low back pain who were referred for physical therapy assessment.INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: The physical performance battery was composed of the 50-foot speed walk, 5-minute walk, repeated trunk flexion, sit to stand, loaded reach, rollover tasks, and Sorensen upper-body lift. Participants also completed 5 self-report measures.RESULTS: Two correlated (.74) factors, speed and coordination and endurance and strength, were derived from the physical performance tasks. The Sorenson upper-body lift task was the only indicator that was not useful in defining the factors. Both factors had statistically significant correlations with measures of physical disability, lack of self-efficacy, and negative affect. Both factors had a trivial correlation with a numeric rating of pain intensity.CONCLUSIONS: There is support for 2 meaningful empiric groupings (ie, the derived factors) of the performance tasks. Pain intensity had a trivial overlap with speed-coordination and endurance-strength factors
Pain in the physical therapy curriculum
No full textPain is a leading cause of distress and disability and is central to clinical practice, but may not be central to the education of physical therapists. The purpose of this study was to determine the current status of pain topics taught in PT curricula. A questionnaire was mailed to 169 accredited PT programs in North America. Information was obtained on PT faculty's perception of the adequacy with which pain and pain related topics were taught within PT curricula, and the competency of their graduates to assess and manage pain. A response rate of 63.3 percent was obtained. Key results were as follows. The modal amount of time spent on pain was four hours. The majority of faculty thought that pain was adequately covered in their curriculum although their perceptions of graduates' competency to assess and treat individuals with pain were higher for acute than chronic pain. Unidimensional pain assessment scales were perceived as adequately covered in more programs (81.7%) than multidimensional scales (61.5%). Pain management techniques were thought to be adequately covered in over 80 percent of the programs. However, pain in the elderly and in children were not thought to be adequately covered in 57.3 percent and 76.2 percent of the programs, respectively.
Only 33 percent of the respondents thought that cognitive-behavioural approaches to pain management were adequately covered. Although a large proportion of faculty perceived that the time spent on pain topics, in general, was inadequate, most perceived that an adequate time was spent when asked about specific pain topics in the curriculum. It is difficult to reconcile the discrepancy between the scant number of hours spent on the topic of pain with faculty's perceptions that, for most topics, adequate time is devoted to the area
Self-reports and clinician-measured physical function among patients with low back pain: a comparison
No full textOBJECTIVE: To determine the relationships among self-reported activity limitation and clinician-measured functional performance tests.DESIGN: Case series survey.SETTING: A referral-based orthopedic spine clinic in Houston, TX.PATIENTS: Eighty-three patients (48 women, 35 men) with low back pain (LBP). INTERVENTIONS: The Roland-Morris Disability Questionnaire (RMDQ) and a physical performance test (PPT) battery.MAIN OUTCOME MEASURES: Self-reported activity limitation (eg, walking, bending, getting out of chair, putting on sock, doing heavy jobs) was assessed by the RMDQ. Clinician-measured functional performance was assessed with the PPT, a battery comprised 6 tests: lumbar flexion range of motion, a 50-foot walk at fastest speed, a 5-minute walk, 5 repetitions of sit-to-stand, 10 repetitions of trunk flexion, and loaded reach task (patients reached forward while holding a weight weighing 5% of their body weight).RESULTS: Pearson's product-moment correlations between total RMDQ score and each of the performance tests ranged from.29 to.41. Point biserial correlations between individual RMDQ items and their corresponding performance tests were slightly lower, ranging from.20 to.33.CONCLUSION: There were moderate correlations between self-reported activity limitation and corresponding clinician-measured performance tests. The unique perspective each method provides appears to be useful for a comprehensive understanding of physical function in patients with LBP
Back pain, physical function, and estimates of aerobic capacity: what are the relationships among methods and measures?
No full textObjectives: To establish the correlations of measures of self-reported disability, self-efficacy, physical performance, level of pain, and estimates of aerobic capacity (Pvo2) in subjects with low back pain.Design: Fifty-one low back pain subjects, ranging in age from 26 to 65 yr, entered the study. Participants completed the Roland-Morris Disability Questionnaire and the self-efficacy questionnaire. Physical performance was evaluated by the loaded-reach test, sit/stand test, 5-min walk test, 50-foot walking test, and time to roll from right to left. Pain intensity and pain affect were measured using two visual analog scales. Pvo2 was predicted from an equation.Results: The correlation coefficient among the physical performance outcomes ranged from 0.47 to 0.78. Pain measures had low correlations with measures of function but stronger correlations with other self-report measures. The disability measure correlated moderately with physical performance. Correlations between Pvo2 and all other measurements were minimal, except for the 5-min walk test.Conclusion: Performance and disability were more consistent in evaluating low back pain. Pvo2 failed to correlate with most other aspects of low back pain. This study suggests that aerobic capacity might not be a primary concern for patients with low back pain
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