The Patient-Specific Functional Scale: Validity in Workers' Compensation Claimants

doi:10.1016/j.apmr.2007.11.040

Archives of Physical Medicine and Rehabilitation

Volume 89, Issue 7, July 2008, Pages 1294-1299

https://doi.org/10.1016/j.apmr.2007.11.040 Get rights and content

Abstract

Gross DP, Battié MC, Asante AK. The Patient-Specific Functional Scale: validity in workers' compensation claimants.

Objective

To examine the construct and predictive validity of the Patient-Specific Functional Scale (PSFS) in workers' compensation claimants.

Design

Prospective cohort study with 1-year follow-up.

Setting

A workers' compensation rehabilitation facility.

Participants

Subjects included 294 claimants with a variety of musculoskeletal disorders. The sample was predominantly male (70%), with a mean age of 44 years. Subjects completed a battery of measures at baseline including the PSFS, the Pain Disability Index (PDI), and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).

Interventions

Not applicable.

Main Outcome Measures

Outcomes for determining predictive validity included administrative indicators of timely return to work and recovery during the 1-year follow-up. Analysis included Pearson correlation and multivariable Cox and logistic regression.

Results

At baseline, the PSFS correlated moderately (r range, 0.3−0.5) with other indicators of functional limitation (PDI, SF-36 role−physical subscale) but negligibly with the SF-36 mental health and role−emotional subscales. The PSFS was associated with timely recovery (adjusted hazard ratio, 1.16; 95% confidence interval, 1.07–1.27) with increasing functional limitation related to delayed recovery.

Conclusions

Results provide construct and predictive validity evidence for the PSFS as an indicator of functional limitation in workers' compensation claimants.

Section snippets

Design

Data were collected prospectively as part of a cluster RCT aimed at evaluating the effectiveness of an FCE protocol.⁷ The trial was conducted from October 2004 through May 2006 at the major rehabilitation facility of the WCB Alberta, Canada. The current study included subjects undergoing either a 1- or 2-day functional assessment protocol. All subjects enrolled into the intervention arm of the trial completed the PSFS as part of the functional evaluation and formed our study sample. The

Results

Of 589 claimants meeting study inclusion criteria, 294 (50%) had complete data on the PSFS and predictor variables of interest and were included in subsequent analyses. No statistically significant differences were seen between those with PSFS data and those without on the 16 descriptive variables examined (table 1). Only 158 (54%) had complete data on the SF-36. Subjects were predominantly employed men reporting moderate levels of pain (see table 2 for scores on the self-report

Discussion

We have presented evidence supporting the validity of the PSFS as an indicator of functional limitation in workers' compensation claimants with a wide variety of musculoskeletal conditions. Scores on the scale correlated moderately with other validated self-report measures of disability including the PDI and SF-36 role–physical subscale. The pattern of correlations between the PSFS and the various SF-36 subscales was quite similar to that reported by Chatman et al.¹¹ Remarkably, while claimants

Conclusions

Results provide construct and predictive validity evidence for the PSFS as an indicator of functional limitation in workers' compensation claimants. The tool provides clinically useful, patient-centered information at low administrative burden.

Acknowledgment

The Workers' Compensation Board of Alberta/Millard Health assisted with data acquisition and study implementation.

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Citation Excerpt :
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Supported by the University of Alberta Department of Physical Therapy, Alberta Physical Therapy Association, and the Canada Research Chairs Program.

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

Published online June 5, 2008 at www.archives-pmr.org.

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Original articleThe Patient-Specific Functional Scale: Validity in Workers' Compensation Claimants

Abstract

Objective

Design

Setting

Participants

Interventions

Main Outcome Measures

Results

Conclusions

Section snippets

Design

Results

Discussion

Conclusions

Acknowledgment

J Clin Epidemiol

Arch Phys Med Rehabil

Pain

Pain

J Clin Epidemiol

Economic burden of illness in Canada, 1998

Physical rehabilitation outcome measures: A guide to enhanced clinical decision making

Individualized outcome measures: a review of the literature

Can J Occup Ther

Responsiveness of pain, disability, and physical impairment outcomes in patients with low back pain

Spine

Evaluation of a short-form functional capacity evaluation: less may be best

J Occup Rehabil

Predicting timely recovery and recurrence following multidisciplinary rehabilitation in patients with compensated low back pain

Spine

The patient-specific functional scale: validation of its use in persons with neck dysfunction

J Orthop Sports Phys Ther

The reliability and construct validity of the Neck Disability Index and patient specific functional scale in patients with cervical radiculopathy

Spine

The Patient-Specific Functional Scale: measurement properties in patients with knee dysfunction

Phys Ther

Relationship of subjective disability with pain intensity, pain duration, pain location, and work-related factors in non operated patients with chronic low back pain

Clin J Pain

Relationship of the Pain Disability Index (PDI) and the Oswestry Disability Questionnaire (ODQ) with three dynamic physical tests in a group of patients with chronic low-back and leg pain

Clin J Pain

Original article
The Patient-Specific Functional Scale: Validity in Workers' Compensation Claimants