Self-reported assessment of disability and performance-based assessment of disability are influenced by different patient characteristics in acute low back pain

Abstract

For an individual, the functional consequences of an episode of low back pain is a key measure of their clinical status. Self-reported disability measures are commonly used to capture this component of the back pain experience. In non-acute low back pain there is some uncertainty of the validity of this approach. It appears that self-reported assessment of disability and direct measurements of functional status are only moderately related. In this cross-sectional study, we investigated this relationship in a sample of 94 acute low back pain patients. Both selfreported disability and a performance-based assessment of disability were assessed, along with extensive profiling of patient characteristics. Scale consistency of the performance-based assessment was investigated using Cronbach's alpha, the relationship between self-reported and performance-based assessment of disability was investigated using Pearson's correlation. The relationship between clinical profile and each of the disability measures were examined using Pearson's correlations and multivariate linear regression. Our results demonstrate that the battery of tests used are internally reliable (Cronbach's alpha = 0.86). We found only moderate correlations between the two disability measures (r = 0.471, p \ 0.001). Self-reported disability was significantly correlated with symptom distribution, medication use, physical well-being, pain intensity, depression, somatic distress and anxiety. The only significant correlations with the performance-based measure were symptom distribution, physical well-being and pain intensity. In the multivariate analyses no psychological measure made a significant unique contribution to the prediction of the performance-based measure, whereas depression made a unique contribution to the prediction of the self-reported measure. Our results suggest that selfreported and performance-based assessments of disability are influenced by different patient characteristics. In particular, it appears self-reported measures of disability are more influenced by the patient's psychological status than performance-based measures of disability.

Factors associated with attitudes and beliefs of elders with acute low back pain: data from the study Back Complaints in the Elders (BACE)

“…Some aspects, such as kinesiophobia and social isolation, could reduce self-efficacy and increase the chance of developing symptoms of depression and disability 25 . Corroborating the present study, Misterska et al 26 found that coping strategies for LBP were related to beliefs about the management of pain, depression, and disability, and in another study 27 , associations were found between LBP and psychological factors and between negative perception of the consequences of the disease and low-efficacy and depression.…”

“…According to Wand et al 25 , pain-related disability impairs aspects of daily life and causes psychological distress. As noted in this study, older adults with complaints of musculoskeletal pain and symptoms of depression were less willing to perform daily activities and follow recommended directions and treatments 25 .…”

Manual Wheelchair Skills: Objective Testing Versus Subjective Questionnaire

“…confidence, anxiety, and depression) to a greater degree than objective, performance-based measures. [22][23][24] However, our study showed little difference between the WST and WST-Q scores. We know that this sample of manual wheelchair users had high wheelchair confidence and low anxiety and depression.…”

“…For example, Gandhi et al 22 found a low correlation between preoperative objective Timed-Up-and-Go and the subjective SF-36 scores among patients undergoing hip and knee arthroplasty. Wand et al 23 found a low correlation between the subjective Roland and Morris Disability Questionnaire (RMDQ) and the objective Timed 5…”

Comparação entre capacidade aferida e desempenho referido para avaliação de atividades básicas em idosos

“…Embora foco de muita discussão na década de 1990 [99][100][101] , atualmente poucos estudos abordam similaridades e divergências entre avaliação funcional de maneira aferida ou referida e ainda são observados estudos que utilizam de maneira equivocada ostermos 35,36,94,[102][103][104] . Estudos anteriores mostraram que existe grande diferença para populações de idosos institucionalizados entre a auto-avaliação e avaliação aferida.…”