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Measuring Pain and Physical Function for Adults with Osteoarthritis
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Posted on: 11/30/2006
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Health care professionals often rely on patient report of pain and function to assess their status. Self-report may not be accurate. In this study, physical therapists in Canada measure the validity of four specific tests as a better measure of pain and function in adults with osteoarthritis (OA).
The four performance activities are well-known to physical therapists. They include 1) 40-meter Walk Test (self-paced), 2) Stair Test, 3) Timed Up & Go Test (TUGT), and 4) Six-Minute Walk Test. All patients had either hip or knee OA and were on the waiting list for a joint replacement. After each test, patients reported the amount of pain and level of exertion they felt.
The authors suggest that self-report measures may be less expensive and easier to give but they don't really measure physical function. Self-report tests are affected by patients' ability to move around and how they feel (pain, exertion) when moving around. Many patients report higher physical function than they really have.
The results of this study showed that three of the four tests were a better measure of pain and function than self-report. The Stair Test did not help give a distinct measure of pain and function. The authors warn that a patient's ability to manage stairs is still important and shouldn't be neglected.
Measuring pain and function in patients with OA is important. The information helps guide treatment. The results give feedback on progress. Insurance companies can use these benchmarks to set a reasonable number of maximum patient visits.
Using self-report alone overestimates patients' status and may cut off treatment too soon. The Walk Test, TUGT, and Six-Minute Walk Test are valid measures of physical function in adults with OA and should be used along with self-report tests to gain a better view of a patient's true function.
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References:
Paul W. Stratford, PT, MSc, et al. Performance Measures Provide Assessments of Pain and Function in People with Advanced Osteoarthritis of the Hip or Knee. In Physical Therapy. Vol. 86. No. 11. Pp. 1489-1496.
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