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A COMPARISON OF FUNCTIONAL ASSESSMENT INSTRUMENTS AND WORK STATUS IN BACK PAIN RESEARCH



Abstract

Background and Objective: The influence of back pain on work status is normally implied from the severity of the functional limitations. The aim of this cross sectional study was to analyse whether functional assessment instruments correlate well with impact on work status.

Patients and Methods: 375 chronic low back pain patients attending back pain outpatient clinics of a University Hospital and a specialist rehabilitation centre over a period of one year were assessed. The three functional outcome scores measured were Oswestry Disability Index (ODI), Roland Morris disability questionnaire (RMQ) and Orebro Musculoskeletal Pain Questionnaire (OMPQ). The effect of back pain on patient’s work status was recorded in 6 options – work not affected, slightly affected, seriously affected, reduced number of hours, change job or give up job. The work status score was then correlated to the above three instrument values.

Results: There was good correlation among the three instrument values (rho > 0.70) suggesting they are interchangeable. However, there was only a modest correlation between the work status scale and the three functional scores; the rho values were 0.47 for OMPQ, 0.43 for ODI and 0.39 for RMQ. There was no influence of age, duration of pain or type of work on this correlation.

Conclusion: Back pain instruments (which measure pain and functional limitations) and work status are not interchangeable. The impact on work status cannot be implied from these functional scores and should be recorded as a separate outcome measure.

Correspondence should be addressed to SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.