Improvements In Self-reported Functional Ability Of Patients With Musculoskeletal Complaints Following A Restorative Exercise Program

Abstract

PURPOSE Restorative exercise programs have been shown to be effective for improving the functional capacity of patients with musculoskeletal disorders. However, functional outcomes are not frequently assessed in clinical practice, because it is impractical to administer comprehensive physical testing on a regular basis. A new computerized self- report instrument, the Multidimensional Task Ability ProFIle (MTAP), has been shown to be reliable, and valid assessment of functional ability. A retrospective study was conducted to evaluate the effectiveness of a restorative exercise program on self-reported functional ability of patients with spinal and extremity disorders. METHODS The charts of 506 patients with various spinal and extremity complaints (neck, upper back, upper extremity: n=214; low back, lower extremity: n=262; other n=30) who were enrolled in a restorative exercise program at physical therapy centers were reviewed. The restorative exercise program consisted of progressive resistance, coordination, and flexibility exercises customized for each patient. The MTAP was administered at baseline and at a specified follow-up time point (mean number of days between initial test and follow-up: 75.2+/-68.9). Functional ability was assessed with a Rating of Perceived Capacity (RPC) score calculated from the MTAP, which was cross-walked to a Physical Demand Characteristic level (PDC). Pain intensity was assessed with a 100mm visual analog scale. RESULTS At follow-up, the patients displayed a significant improvement in functional ability and a reduction in pain intensity (30.4+/-76.9% and 22.7+/-78.9%, respectively, p<.05). 62.5%of patients with an unemployable PDC level (below sedentary) at baseline improved to an employable level (sedentary to heavy). There was a moderate correlation between change in RPC and change in pain intensity (Spearman's rho = .41, p<.05). CONCLUSIONS A restorative exercise program was effective in improving self-reported functional ability and reducing pain intensity for patients with various musculoskeletal complaints. The MTAP was sensitive to changes in functional status and may be used to assess function in a clinical setting.