Abstract
BackgroundFunctional tests are widely used to measure performance in patients with chronic musculoskeletal pain. Our objective was to determine the Minimal Clinically Important Differences (MCID) for the 6-min walk test (6MWT), the Steep Ramp Test (SRT), the 1-min stair climbing test (1MSCT), the sit-to-stand test (STS), the Jamar dynamometer test (JAM) and the lumbar Progressive Isoinertial Lifting Evaluation (PILE) in chronic musculoskeletal pain patients.MethodsA single-center prospective observational study was conducted in a rehabilitation center. Patients with upper-limb, lower-limb or neck/back lesions were included over a period of 21 months. We used the anchor-based method as a reference method, supplemented by the distribution-based and opinion-based approaches, to determine the MCIDs.Results838 chronic musculoskeletal pain patients were included. The estimation method and thelesion location had a significant influence on the results. MCIDs were estimated at +75m and +60m for the 6MWT (lower-limb and neck/back lesions, respectively), +18 steps for the 1MSCT (lower-limb and neck/back lesions) and +6kg for the JAM (upper limb lesions). The anchor-based method could not provide valid estimations for the three other scales, but distribution and opinion-based methods provided rough values of MCIDs for the SRT (+39w to +61w), the STS (-5 sec to -7 sec) and the PILE (+4kg to +7kg).ConclusionThe above MCID estimations for the 6MWT, 1MSCT and JAM can be used in chronic musculoskeletal pain patients participating in vocational multidisciplinary rehabilitation programs or in therapeutic trials. The use of specific anchors might give better estimations of MCIDs for the three other scales in future research.
Highlights
Functional tests are widely used to measure performance in patients with chronic musculoskeletal pain
We considered that a “slight” improvement (GRC = + 1) was not clinically significant given the multidisciplinary resources invested during the stay
Participants Between May 2014 and January 2016, one thousand and forty-seven patients were admitted to the clinic for the management of chronic pain after trauma to a limb or spine, 838 patients were eligible for inclusion
Summary
Functional tests are widely used to measure performance in patients with chronic musculoskeletal pain. Many performance tests are currently being used by clinicians, especially in rehabilitation centers Among these tests, the 6-min walk test (6MWT) [4], the Steep Ramp Test (SRT) [5], the 1-Minute Stair Climbing Test (1MSCT) [6], the Sit-To-Stand test (STS) [7], the Jamar dynamometer test (JAM) [8] and the lumbar protocol of the Progressive Isoinertial Lifting Evaluation (PILE) [9] are widely used in patients with musculoskeletal, neurological, cardiac or pulmonary disease. The 6-min walk test (6MWT) [4], the Steep Ramp Test (SRT) [5], the 1-Minute Stair Climbing Test (1MSCT) [6], the Sit-To-Stand test (STS) [7], the Jamar dynamometer test (JAM) [8] and the lumbar protocol of the Progressive Isoinertial Lifting Evaluation (PILE) [9] are widely used in patients with musculoskeletal, neurological, cardiac or pulmonary disease These tests are easy to administer and do not require expensive devices
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