Angela Giertych, Jessica Crane, Sarah Goozeé, Iris Maoz, Nader Mehri, Kasra Amirdelfan, Annu Navani
{"title":"慢性疼痛患者功能恢复计划与传统医疗管理的临床效果：一项多中心回顾性观察分析。","authors":"Angela Giertych, Jessica Crane, Sarah Goozeé, Iris Maoz, Nader Mehri, Kasra Amirdelfan, Annu Navani","doi":"10.1097/PHM.0000000000002713","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to determine clinical effectiveness of an 8-wk functional restoration program compared with conventional medical management in patients with chronic pain after work-related injury in the workers' compensation system.</p><p><strong>Design: </strong>This is an observational retrospective chart review of 485 patients treated between January 1, 2020, and December 31, 2022. Included patients with chronic pain after work-related injury who participated in a multidisciplinary evaluation and were considered appropriate for functional restoration program. Outcomes were analyzed for two groups: functional restoration program group completed an 8-wk program, and conventional medical management group did not receive functional restoration program treatment. The ordinary least squares regression model was used to control confounding factors, and an independent t test was performed to assess functional restoration program effectiveness.</p><p><strong>Results: </strong>Functional restoration program graduates demonstrated improvements in depression, anxiety, self-efficacy, and physical function; Center for Epidemiologic Studies Depression Scale ( P <0.001), Generalized Anxiety Disorder Scale ( P < 0.01), Pain Self-Efficacy Questionnaire ( P < 0.001), Neck Disability Index ( P < 0.001), and Oswestry Low Back Disability Index ( P < 0.001) scores were statistically significant compared to conventional medical management. The Lower Extremity Functional Scale and Quick Disabilities of Arm, Shoulder & Hand scores did not show statistically significant improvement with functional restoration program.</p><p><strong>Conclusion: </strong>Functional restoration program offers a clinically effective treatment option to improve self-efficacy, anxiety, depression, and physical function in patients with chronic pain associated with work-related injury. Prospective, randomized control trials could be key in validating and identifying further variability in outcomes.</p><p><strong>To claim cme credits: </strong>Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.</p><p><strong>Cme objectives: </strong>Upon completion of this article, the reader should be able to: ○ Describe the benefits of a functional restoration program (FRP); ○ Provide additional options to improve function for patients with chronic pain associated with work-related injury; and ○ Enhance clinical applications of multidisciplinary treatment for treating delayed recovery from chronic pain in individuals with work-related injuries.</p><p><strong>Level: </strong>Advanced.</p><p><strong>Accreditation: </strong>The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"735-742"},"PeriodicalIF":2.2000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Effectiveness of a Functional Restoration Program Compared to Conventional Medical Management in Patients With Chronic Pain: A Multicenter, Retrospective Observational Analysis.\",\"authors\":\"Angela Giertych, Jessica Crane, Sarah Goozeé, Iris Maoz, Nader Mehri, Kasra Amirdelfan, Annu Navani\",\"doi\":\"10.1097/PHM.0000000000002713\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The aim of the study was to determine clinical effectiveness of an 8-wk functional restoration program compared with conventional medical management in patients with chronic pain after work-related injury in the workers' compensation system.</p><p><strong>Design: </strong>This is an observational retrospective chart review of 485 patients treated between January 1, 2020, and December 31, 2022. Included patients with chronic pain after work-related injury who participated in a multidisciplinary evaluation and were considered appropriate for functional restoration program. Outcomes were analyzed for two groups: functional restoration program group completed an 8-wk program, and conventional medical management group did not receive functional restoration program treatment. The ordinary least squares regression model was used to control confounding factors, and an independent t test was performed to assess functional restoration program effectiveness.</p><p><strong>Results: </strong>Functional restoration program graduates demonstrated improvements in depression, anxiety, self-efficacy, and physical function; Center for Epidemiologic Studies Depression Scale ( P <0.001), Generalized Anxiety Disorder Scale ( P < 0.01), Pain Self-Efficacy Questionnaire ( P < 0.001), Neck Disability Index ( P < 0.001), and Oswestry Low Back Disability Index ( P < 0.001) scores were statistically significant compared to conventional medical management. The Lower Extremity Functional Scale and Quick Disabilities of Arm, Shoulder & Hand scores did not show statistically significant improvement with functional restoration program.</p><p><strong>Conclusion: </strong>Functional restoration program offers a clinically effective treatment option to improve self-efficacy, anxiety, depression, and physical function in patients with chronic pain associated with work-related injury. 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Clinical Effectiveness of a Functional Restoration Program Compared to Conventional Medical Management in Patients With Chronic Pain: A Multicenter, Retrospective Observational Analysis.
Objective: The aim of the study was to determine clinical effectiveness of an 8-wk functional restoration program compared with conventional medical management in patients with chronic pain after work-related injury in the workers' compensation system.
Design: This is an observational retrospective chart review of 485 patients treated between January 1, 2020, and December 31, 2022. Included patients with chronic pain after work-related injury who participated in a multidisciplinary evaluation and were considered appropriate for functional restoration program. Outcomes were analyzed for two groups: functional restoration program group completed an 8-wk program, and conventional medical management group did not receive functional restoration program treatment. The ordinary least squares regression model was used to control confounding factors, and an independent t test was performed to assess functional restoration program effectiveness.
Results: Functional restoration program graduates demonstrated improvements in depression, anxiety, self-efficacy, and physical function; Center for Epidemiologic Studies Depression Scale ( P <0.001), Generalized Anxiety Disorder Scale ( P < 0.01), Pain Self-Efficacy Questionnaire ( P < 0.001), Neck Disability Index ( P < 0.001), and Oswestry Low Back Disability Index ( P < 0.001) scores were statistically significant compared to conventional medical management. The Lower Extremity Functional Scale and Quick Disabilities of Arm, Shoulder & Hand scores did not show statistically significant improvement with functional restoration program.
Conclusion: Functional restoration program offers a clinically effective treatment option to improve self-efficacy, anxiety, depression, and physical function in patients with chronic pain associated with work-related injury. Prospective, randomized control trials could be key in validating and identifying further variability in outcomes.
To claim cme credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.
Cme objectives: Upon completion of this article, the reader should be able to: ○ Describe the benefits of a functional restoration program (FRP); ○ Provide additional options to improve function for patients with chronic pain associated with work-related injury; and ○ Enhance clinical applications of multidisciplinary treatment for treating delayed recovery from chronic pain in individuals with work-related injuries.
Level: Advanced.
Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
期刊介绍：
American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals.
Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).
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