Factors that affect functional capacity in patients with musculoskeletal pain: a Delphi study among scientists, clinicians, and patients

Sandra Jorna-Lakke, Harriët Wittink, Jan H Geertzen, Cees van der Schans, Michiel F Reneman

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVE: To reach consensus on the most important biopsychosocial factors that influence functional capacity results in patients with chronic nonspecific musculoskeletal pain, arranged in the framework of the International Classification of Functioning, Disability and Health.

DESIGN: Three-round, internet-based Delphi survey.

SETTING: Not applicable.

PARTICIPANTS: Participants were scientists, clinicians, and patients familiar with functional capacity testing. Scientists were invited through purposive sampling based on the number of relevant publications in peer-reviewed journals. The scientists recruited clinicians and patients through snowball sampling.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Consensus was reached if at least moderate influence (25%) was achieved and an interquartile range of no more than 1 point was reached.

RESULTS: Thirty-three scientists, 21 clinicians, and 21 patients from 9 countries participated. Participants reached consensus on 6 factors that can influence the outcome of the lifting test, having a median of severe influence (50%-95%): catastrophic thoughts and fear, patient adherence to "doctor's orders," internal and external motivation, muscle power, chronic pain behavior, and avoidance behavior. Motivation, chronic pain behavior, and sensation of pain were the top 3 factors affecting postural tolerance and repetitive movement functional capacity tests. Furthermore, participants reported 28 factors having a median of moderate influence (25%-49%) that could influence the outcome of lifting, postural tolerance, and repetitive movement tests.

CONCLUSIONS: Overall, chronic pain behavior, motivation, and sensation of pain are the main factors that can influence functional capacity results. We recommend that scientists and clinicians, respectively, consider the most important factors when planning future studies and when interpreting functional capacity test results.

Original languageEnglish
Pages (from-to)446-457
Number of pages12
JournalArchives of physical medicine and rehabilitation
Volume93
Issue number3
DOIs
Publication statusPublished - Mar 2012

Keywords

  • Activities of Daily Living
  • Adult
  • Age Factors
  • Behavior
  • Chronic Disease
  • Delphi Technique
  • Disabled Persons
  • Fear
  • Female
  • Health Personnel
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Motivation
  • Musculoskeletal Pain
  • Pain
  • Pain Threshold
  • Patient Compliance
  • Patients
  • Research Personnel
  • Sex Factors
  • Journal Article

Cite this

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title = "Factors that affect functional capacity in patients with musculoskeletal pain: a Delphi study among scientists, clinicians, and patients",
abstract = "OBJECTIVE: To reach consensus on the most important biopsychosocial factors that influence functional capacity results in patients with chronic nonspecific musculoskeletal pain, arranged in the framework of the International Classification of Functioning, Disability and Health.DESIGN: Three-round, internet-based Delphi survey.SETTING: Not applicable.PARTICIPANTS: Participants were scientists, clinicians, and patients familiar with functional capacity testing. Scientists were invited through purposive sampling based on the number of relevant publications in peer-reviewed journals. The scientists recruited clinicians and patients through snowball sampling.INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Consensus was reached if at least moderate influence (25{\%}) was achieved and an interquartile range of no more than 1 point was reached.RESULTS: Thirty-three scientists, 21 clinicians, and 21 patients from 9 countries participated. Participants reached consensus on 6 factors that can influence the outcome of the lifting test, having a median of severe influence (50{\%}-95{\%}): catastrophic thoughts and fear, patient adherence to {"}doctor's orders,{"} internal and external motivation, muscle power, chronic pain behavior, and avoidance behavior. Motivation, chronic pain behavior, and sensation of pain were the top 3 factors affecting postural tolerance and repetitive movement functional capacity tests. Furthermore, participants reported 28 factors having a median of moderate influence (25{\%}-49{\%}) that could influence the outcome of lifting, postural tolerance, and repetitive movement tests.CONCLUSIONS: Overall, chronic pain behavior, motivation, and sensation of pain are the main factors that can influence functional capacity results. We recommend that scientists and clinicians, respectively, consider the most important factors when planning future studies and when interpreting functional capacity test results.",
keywords = "Activities of Daily Living, Adult, Age Factors, Behavior, Chronic Disease, Delphi Technique, Disabled Persons, Fear, Female, Health Personnel, Humans, Male, Mental Health, Middle Aged, Motivation, Musculoskeletal Pain, Pain, Pain Threshold, Patient Compliance, Patients, Research Personnel, Sex Factors, Journal Article",
author = "Sandra Jorna-Lakke and Harri{\"e}t Wittink and Geertzen, {Jan H} and {van der Schans}, Cees and Reneman, {Michiel F}",
note = "Copyright {\circledC} 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.",
year = "2012",
month = "3",
doi = "10.1016/j.apmr.2011.10.016",
language = "English",
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pages = "446--457",
journal = "Archives of physical medicine and rehabilitation",
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Factors that affect functional capacity in patients with musculoskeletal pain : a Delphi study among scientists, clinicians, and patients. / Jorna-Lakke, Sandra; Wittink, Harriët; Geertzen, Jan H; van der Schans, Cees; Reneman, Michiel F.

In: Archives of physical medicine and rehabilitation, Vol. 93, No. 3, 03.2012, p. 446-457.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Factors that affect functional capacity in patients with musculoskeletal pain

T2 - a Delphi study among scientists, clinicians, and patients

AU - Jorna-Lakke, Sandra

AU - Wittink, Harriët

AU - Geertzen, Jan H

AU - van der Schans, Cees

AU - Reneman, Michiel F

N1 - Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

PY - 2012/3

Y1 - 2012/3

N2 - OBJECTIVE: To reach consensus on the most important biopsychosocial factors that influence functional capacity results in patients with chronic nonspecific musculoskeletal pain, arranged in the framework of the International Classification of Functioning, Disability and Health.DESIGN: Three-round, internet-based Delphi survey.SETTING: Not applicable.PARTICIPANTS: Participants were scientists, clinicians, and patients familiar with functional capacity testing. Scientists were invited through purposive sampling based on the number of relevant publications in peer-reviewed journals. The scientists recruited clinicians and patients through snowball sampling.INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Consensus was reached if at least moderate influence (25%) was achieved and an interquartile range of no more than 1 point was reached.RESULTS: Thirty-three scientists, 21 clinicians, and 21 patients from 9 countries participated. Participants reached consensus on 6 factors that can influence the outcome of the lifting test, having a median of severe influence (50%-95%): catastrophic thoughts and fear, patient adherence to "doctor's orders," internal and external motivation, muscle power, chronic pain behavior, and avoidance behavior. Motivation, chronic pain behavior, and sensation of pain were the top 3 factors affecting postural tolerance and repetitive movement functional capacity tests. Furthermore, participants reported 28 factors having a median of moderate influence (25%-49%) that could influence the outcome of lifting, postural tolerance, and repetitive movement tests.CONCLUSIONS: Overall, chronic pain behavior, motivation, and sensation of pain are the main factors that can influence functional capacity results. We recommend that scientists and clinicians, respectively, consider the most important factors when planning future studies and when interpreting functional capacity test results.

AB - OBJECTIVE: To reach consensus on the most important biopsychosocial factors that influence functional capacity results in patients with chronic nonspecific musculoskeletal pain, arranged in the framework of the International Classification of Functioning, Disability and Health.DESIGN: Three-round, internet-based Delphi survey.SETTING: Not applicable.PARTICIPANTS: Participants were scientists, clinicians, and patients familiar with functional capacity testing. Scientists were invited through purposive sampling based on the number of relevant publications in peer-reviewed journals. The scientists recruited clinicians and patients through snowball sampling.INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Consensus was reached if at least moderate influence (25%) was achieved and an interquartile range of no more than 1 point was reached.RESULTS: Thirty-three scientists, 21 clinicians, and 21 patients from 9 countries participated. Participants reached consensus on 6 factors that can influence the outcome of the lifting test, having a median of severe influence (50%-95%): catastrophic thoughts and fear, patient adherence to "doctor's orders," internal and external motivation, muscle power, chronic pain behavior, and avoidance behavior. Motivation, chronic pain behavior, and sensation of pain were the top 3 factors affecting postural tolerance and repetitive movement functional capacity tests. Furthermore, participants reported 28 factors having a median of moderate influence (25%-49%) that could influence the outcome of lifting, postural tolerance, and repetitive movement tests.CONCLUSIONS: Overall, chronic pain behavior, motivation, and sensation of pain are the main factors that can influence functional capacity results. We recommend that scientists and clinicians, respectively, consider the most important factors when planning future studies and when interpreting functional capacity test results.

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KW - Adult

KW - Age Factors

KW - Behavior

KW - Chronic Disease

KW - Delphi Technique

KW - Disabled Persons

KW - Fear

KW - Female

KW - Health Personnel

KW - Humans

KW - Male

KW - Mental Health

KW - Middle Aged

KW - Motivation

KW - Musculoskeletal Pain

KW - Pain

KW - Pain Threshold

KW - Patient Compliance

KW - Patients

KW - Research Personnel

KW - Sex Factors

KW - Journal Article

U2 - 10.1016/j.apmr.2011.10.016

DO - 10.1016/j.apmr.2011.10.016

M3 - Article

VL - 93

SP - 446

EP - 457

JO - Archives of physical medicine and rehabilitation

JF - Archives of physical medicine and rehabilitation

SN - 0003-9993

IS - 3

ER -