Relationship between perceived level of function and measured performance on a standardized lifting assessment in individuals with chronic low back pain receiving workers compensation

Low back pain is the most common musculoskeletal complaint in adults and one of the leading causes for being off work. The complex biopsychosocial nature of low back pain is recognized extensively in the low back pain literature. Studies have suggested that outcomes of low back pain are more likely related to psychosocial factors than any specific physical factor. More recently there has been a move towards a more client-centred approach to low back pain. Many studies have examined the treatment and assessment of low back pain, but none have included an individualized, client-centred approach. The purpose of this study was to investigate the relationship between the Canadian Occupational Performance Measure (COPM), a client-centred individualized assessment, the Progressive Isoinertial Lifting Evaluation (PILE) and the Oswestry Low Back Pain Disability Questionnaire (ODQ), two standard low back assessments. In addition, the ability of each assessment to differentiate between individuals who returned to work and those that did not at both discharge and at 3-month follow-up was examined. Subjects consisted of those individuals who had sustained a low back injury while at work and who were currently attending or about to attend a rehabilitation program. Forty six individuals (mean age 40.6 years, range 20 to 61) completed initial and discharge assessments and all were contacted 3 months following discharge to determine work status. A significant correlation was found between the COPM Performance and the ODQ (r=-.434, p<.001). No significant correlation was found between the COPM Satisfaction and the ODQ. A weak to moderate relationship was found between the COPM Performance, ODQ and the PILE (r values from -.250 to -.552). No relationship was found between the COPM Satisfaction and the PILE. Results indicate the COPM measures a different aspect of function than both the ODQ and the PILE. Both the COPM Performance and ODQ were able to differentiate between individuals who returned to work at discharge and those that did not (p<.05). This is a new finding and supports the use of an individualized, client-centred outcome measure in a chronic low back pain population. No other variable, including age and duration of injury were able to differentiate return to work status at either discharge or 3-months follow-up. This study confirms previous research which indicate return to work is a complex, multifaceted issue. This is the first study to examine the use of an individualized, clientcentred approach and provides initial support for the use of such measure in a chronic low back pain population.Medicine, Faculty ofGraduat