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Using the Patient-Specific Functional Scale (PSFS) to Predict Recovery in Workers' Compensation Claims
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Posted on: 07/30/2008
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Workers injured on the job become Workers' Compensation (WC) claimants. The goal in rehab is to get them back to work as soon as possible. Employers bear the indirect costs of work disability while the WC system covers the direct cost of care. Both sides want to see a quick turn around time with maximal recovery possible.
For this reason, WC claimants' progress is evaluated and measured with a variety of tools. In this study, researchers looked at the validity of the Patient-Specific Functional Scale (PSFS) for this group of patients.
The hope is to find a tool that measures both ability to return-to-work and ability to enjoy recreational, family, and personal activities. Workers are more functional and able to return-to-work faster when they are able to perform well at work tasks while also pursuing personal interests. In the Workers' Compensation world, return-to-work is also known as time to claim closure.
The PSFC is a self-report questionnaire filled out by the individual. It can be used by patients with a wide range of musculoskeletal problems. It has tested out well when used with neck and low back pain patients. Studies show that it is able to detect clinical change and is more responsive than other tests available.
Since Workers' Compensation claimants often have many different problems, this tool might be suitable for them. This is the first time it has been used to test for limitations and barriers to recovery in WC patients.
The test asks WC patients to list three activities that are difficult or impossible to do because of their injury. Then they rate (from zero to 10) their ability to perform each activity. Zero means they can't do it at all. Ten is the level they were at before the injury or accident. If none of the three activities were work-related, then they were asked to list at least one work activity in this category.
Each WC claimant also completed three other measures of pain, general health, and perceived disability. These included the Pain Disability Index (PDI), Visual Analog Scale (VAS), and the Short Form-36 (SF-36).
The researchers compared the PSFS scores to the scores from the three other tests. They looked at scores for patients who were able to return-to-work successfully. The idea was to find factors that might predict functional limitations in WC patients. The time it took to go through rehab and rate of injury recurrence were also recorded.
The authors found that the PSFS does provide useful predictions of return-to-work capacity. It's an easy, low-cost test to administer. And even though WC claimants were asked to include at least one work-related activity that they had difficulty with, it was really the non-work-related items that were most predictive of return-to-work.
It appears that the PSFS appeals to patients because it includes personal areas that are important to them. By listing the three most difficult activities, they are able to discuss areas that cause them the most problems -- even when these are at home and not at work.
The results of this study support the use of the PSFS as a valid and meaningful measure of disability for WC claimants. Further study is needed to find predictive factors or indicators of functional limitations in workers after injury or accident.
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References:
Douglas P. Gross, PhD, et al. The Patient-Specific Functional Scale: Validity in Workers' Compensation Claimants. In Archives of Physical Medicine and Rehabilitation. July 2008. Vol. 89. No. 7. Pp. 1294-1299.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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