A patient-specific approach for measuring functional status in low back pain☆1☆2☆3☆4☆5☆6☆7☆8

Background: Activities and their importance for daily living vary widely between patients. Patient-specific measurement of functional status means that the evaluation is focused on activities that an individual patient selected as main complaints. Objective: To develop and to evaluate a patient-specific approach for measuring functional status in low back pain. Study Design: A cohort of 150 patients was measured at baseline and 12 weeks later. Methods: The feasibility of the patient-specific approach was evaluated in patients with nonspecific low back pain. We used effect size statistics to evaluate responsiveness in terms of sensitivity to change and specificity to change. Results: The selection procedure for the main complaint was feasible but labor intensive. The patient-specific approach was able to detect changes in complaints that were highly relevant for the patients. The patient-specific approach appeared to be more sensitive to change but less specific to change compared with other instruments. Conclusions: On the basis of this study it would be valuable to apply the patient-specific approach in future studies, also with the aim of further evaluation. In the meantime a number of practical problems of the method need to be resolved. (J Manipulative Physiol Ther 1999;22:144–8)