The Spine Team Assessment for chronic back pain disability. Part 1: basic protocol and performance in 500 patients.
OBJECTIVE
For persons with chronic back pain disability, customized, effective, and efficient treatment depends on the initial assessment. Functional capacity evaluations and intake screenings for particular programs are not independent or goal-directed. This paper describes a standardized independent multidisciplinary assessment for treatment planning, and characteristic findings in a population of chronically disabled persons.


METHODS
The Spine Team Assessment (STA), a (1/2)-day assessment including extensive intake information, evaluations by therapists and counselors, a team meeting with a physician, and a comprehensive report, was performed on 500 consecutive persons with chronic back pain.


RESULTS
Representative findings included maximum cardiac performance of 5.33 (+/-4.08 SD) METS; Progressive Isoinertial Lifting Evaluation floor-to-waist of 36.4% (+/-23.9% of norms, and CESD depression scores of 24.7 (+/-13.5 SD). Fear and avoidance and poor physiologic effort were common.


CONCLUSIONS
Deconditioning, psychosocial factors and functional deficits are common, complex, and variable among chronic back pain patients. This description of the STA provides a potentially reproducible standard for research into individualized treatment. The work provides benchmark data for independent multidisciplinary assessments.
Haig
Andrew J
AJ
Department of Physical Medicine, The Spine Program, University of Michigan, Ann Arbor, MI 48108, USA. Andyhaig@umich.edu
Geisser
Michael E
ME
Michel
Britt
B
Theisen-Goodvich
Mary
M
Yamakawa
Karen
K
Lamphiear
Ruth
R
Legatski
Kathy
K
Smith
Carol
C
Sacksteder
Joan
J
D000328:Adult; D001416:Back Pain / Q000523:psychology / Q000534:rehabilitation*; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010347:Patient Care Planning; D010348:Patient Care Team; D010808:Physical Examination; D011795:Surveys and Questionnaires