Analysis of pain behavior profiles and functional disability in outpatient physical therapy clinics.
METHODS
Descriptive, ex post facto.


OBJECTIVE
To determine the proportion of physical therapy outpatients with pain who exhibit various pain behavior profiles, and to determine whether there are differences in functional disability across the profiles.


BACKGROUND
Physical therapists treat many patients who have chronic pain. Research suggests that early identification and multidisciplinary treatment are effective and economical for these patients. The Multidimensional Pain Inventory (MPI) and the Pain Disability Index (PDI) are potential screening tools that could be used in physical therapy clinics to determine which patients should be referred for multidisciplinary treatment.


METHODS
MPI and PDI data were gathered on 57 physical therapy outpatients (mean age 44.3 +/- 14.5 years, 22 men and 35 women) with pain of 3 or more months duration. ANOVA was used to analyze differences in mean PDI scores across the MPI profiles.


RESULTS
Of all patients, 42.1% fit the Adaptive Coper profile, 29.8% fit the Interpersonally Distressed profile, and 28.1% fit the Dysfunctional profile. There were significant differences in PDI scores among profile groups. Post hoc analysis showed that the PDI scores of the Adaptive Coper and Interpersonally Distressed groups were different from the Dysfunctional group, but that there was no difference between the Adaptive Coper and Interpersonally Distressed groups.


CONCLUSIONS
Many patients in outpatient physical therapy settings exhibit behavioral, affective, and cognitive characteristics associated with chronic pain. Thirty-three patients (57.9%) had MPI profiles (interpersonally distressed and dysfunctional) that suggest they might benefit from multidisciplinary treatment.
Hankin
H A
HA
Krannert School of Physical Therapy, University of Indianapolis, Ind 46227, USA.
Spencer
T
T
Kegerreis
S
S
Worrell
T
T
Rice
J M
JM
D000328:Adult; D000554:Ambulatory Care Facilities; D000704:Analysis of Variance; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold / Q000502:physiology* / Q000523:psychology*; D010148:Intractable Pain / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000379:methods; D011446:Prospective Studies; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012803:Sick Role