Presented at the 2012 AAPM Annual Meeting « Back

A Correlative Study of the Self-Reported Psychosocial Distress Status, from the Pain Disability Questionnaire of the AMA Guides 6th Edition, and the Clinician-Derived Physical Performance Test on Individuals with COPD and Chronic Pain: Rehab Case Series

Armando S. Miciano, MD, drmiciano@me.com, Nevada Rehabilitation Institute, Las Vegas, Nevada

Objectives were to quantify psychosocial distress status (PDS) due to pain-related impairment (PRI) of subjects with COPD and chronic non-malignant pain using the PDS sub-construct of the Pain Disability Questionnaire (PDQ), a quantitative assessment of PRI from the AMA Guides to Evaluation of Permanent Impairment 6th Edition, and investigate the correlation between self-reported PDS and clinician-derived Physical Performance Test (PPT). A retrospective study was done on 29 COPD outpatient subjects with pain. The PDQ, sub-categorized to Functional Status (FS) and PDS components, was stratified by severity. The PPT used was Berg Balance Scale (BBS) . Pearson correlation coefficients (r) examined PDS and PPT association (alpha of .01 used for statistical tests). Total PDQ resulted in: 67% mild; 27% moderate; 3% severe; and 3% extreme PRI. PDS scores ranged 7-59 of 60 points, averaging 19/60. Comparing the effect of PDS over FS revealed that 33% of total PDQ (range 12-50%) was due to PDS of COPD patients with chronic pain. A statistically significant negative correlation was found between PDS score and BBS (r=-.356, p=.058). Majority of COPD outpatients has mild PRI, and their psychosocial distress due to PRI had a statistically significant negative effect on PPT scores. Findings suggest that the self-reported PDQ would be valuable as alternative to PPT in a busy clinical practice. In individuals with COPD, minimizing potential extra-pulmonary complications due to PRI necessitates adequate pain control. Further research into PDQ application amongst other populations, such as in Chronic Fatigue Syndrome, would be beneficial.

Funding: Nevada Rehabilitation Institute