Influence of Psychological Factors on Functional Status Outcomes Among Individuals with Lumbar Spine Impairment Receiving Outpatient Rehabilitation

Mentor 1

Dr. Bhagwant Sindhu

Location

Union Wisconsin Room

Start Date

29-4-2016 1:30 PM

End Date

29-4-2016 3:30 PM

Description

Background: The purpose of the present study was to determine the cumulative impact of depression, somatization, and/or fear-of-pain symptoms on rehabilitation outcomes among individuals with lumbar spine disorders. Methods: A sample of 1,026 individuals with musculoskeletal conditions of the lumbar spine, who attended outpatient rehabilitation clinics, was used to conduct a secondary data analysis collected using the Focus On Therapeutic Outcomes, Inc. system. At intake and discharge, function was measured using the lumbar Computerized Adaptive Test, and pain-intensity was measured using a numeric rating scale. At intake, a single-item screen classified patients into low versus elevated fear-of-pain, and the Symptom Checklist 90-Revised, a self-report clinical rating scale, determined the presence of somatization, and depression symptoms. Hierarchal regression analysis determined the predictability of psychological factors on both functional status and pain-intensity outcomes. The independent variables were entered as three blocks. Model R–squared change values were used to determine the amount of variance explained by each block. We used the standardized beta coefficients to determine the gradient of the regression line. Significance level was set as p=.05. Statistical analyses were conducted using the software SPSS version 22. Results: For pain-intensity, Model R-squared change for block two was .589 (p<.0001) and for block three was.006 (p=.002). Depression score was significant (β=.06, t=2.25, p=.025). For functional status, model R-squared change for block two was .469 (p<.0001) and for block three was .008 (p=.001). The psychological factors that were found to be significant were somatization (β=.074, t=2.41, p=.016), and fear-of-pain (β=.057, t=2.45, p=.014). Conclusions: Depression, somatization, and fear-of-pain variables had small yet a statistically significant impact on rehabilitation outcomes. The significance of this finding for clinicians is that all patients must be screened for these risk-factors and those with high scores should be further evaluated and treated in order to improve rehabilitation outcomes.

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Apr 29th, 1:30 PM Apr 29th, 3:30 PM

Influence of Psychological Factors on Functional Status Outcomes Among Individuals with Lumbar Spine Impairment Receiving Outpatient Rehabilitation

Union Wisconsin Room

Background: The purpose of the present study was to determine the cumulative impact of depression, somatization, and/or fear-of-pain symptoms on rehabilitation outcomes among individuals with lumbar spine disorders. Methods: A sample of 1,026 individuals with musculoskeletal conditions of the lumbar spine, who attended outpatient rehabilitation clinics, was used to conduct a secondary data analysis collected using the Focus On Therapeutic Outcomes, Inc. system. At intake and discharge, function was measured using the lumbar Computerized Adaptive Test, and pain-intensity was measured using a numeric rating scale. At intake, a single-item screen classified patients into low versus elevated fear-of-pain, and the Symptom Checklist 90-Revised, a self-report clinical rating scale, determined the presence of somatization, and depression symptoms. Hierarchal regression analysis determined the predictability of psychological factors on both functional status and pain-intensity outcomes. The independent variables were entered as three blocks. Model R–squared change values were used to determine the amount of variance explained by each block. We used the standardized beta coefficients to determine the gradient of the regression line. Significance level was set as p=.05. Statistical analyses were conducted using the software SPSS version 22. Results: For pain-intensity, Model R-squared change for block two was .589 (p<.0001) and for block three was.006 (p=.002). Depression score was significant (β=.06, t=2.25, p=.025). For functional status, model R-squared change for block two was .469 (p<.0001) and for block three was .008 (p=.001). The psychological factors that were found to be significant were somatization (β=.074, t=2.41, p=.016), and fear-of-pain (β=.057, t=2.45, p=.014). Conclusions: Depression, somatization, and fear-of-pain variables had small yet a statistically significant impact on rehabilitation outcomes. The significance of this finding for clinicians is that all patients must be screened for these risk-factors and those with high scores should be further evaluated and treated in order to improve rehabilitation outcomes.