Skip to main content

Advertisement

SpringerLink
Log in

The Pain Disability Questionnaire: Relationship to One-Year Functional and Psychosocial Rehabilitation Outcomes

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Objective: The Pain Disability Questionnaire (PDQ) is a new functional assessment instrument designed for evaluating chronic disabling musculoskeletal disorders. It is useful for assessing function/disability as affected by pain. This is the first study to assess the predictive validity of the PDQ in its relationship to 1-year post-treatment work- and health-related outcomes in a chronic disabling occupational musculoskeletal disorder (CDOMD) population. Design: A prospective cohort of CDOMD patients (n=150) completed a prescribed functional restoration rehabilitation program, with PDQ and other psychosocial measures evaluated before and immediately after treatment. A structured telephonic interview for objective work- and health-related outcomes took place 1-year following treatment. Results: Lower rates of work retention were associated with more severe pre-treatment PDQ scores. Higher post-treatment PDQ were associated with decreased return-to-work rates, decreased work retention and a greater percentage seeking health care from a new provider. In addition, PDQ scores were also associated with psychosocial measures such as depression and perceived pain intensity, as well as alternative measures of disability. Conclusions: Results demonstrated the ability of this simple and psychometrically-sound disability rating scale for systematic functional assessment in predicting treatment outcomes in patients with CDOMD. Results support the further use of the PDQ as a standard treatment outcomes measure in this area of musculoskeletal disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Fairbank JC, Couper J, Davies JB, O'Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy 1980; 66: 271–273.

    PubMed  CAS  Google Scholar 

  2. Roland M, Fairbank J. The Roland–Morris disability questionnaire and the Oswestry Disability Questionnaire. Spine 2000; 25: 3115–3124.

    Article  PubMed  CAS  Google Scholar 

  3. LeClaire R, Blier F, Fortin L. A cross-sectional study comparing the Oswestry and Roland–Morris functional disability scales in two populations of patients with low back pain of different levels of severity. Spine 1997; 22: 68–71.

    Article  PubMed  CAS  Google Scholar 

  4. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 1992; 30: 473–483.

    Article  PubMed  Google Scholar 

  5. Ware JR, Kosinski N, Bayliss MS. Comparison of methods for the scoring and statistical analysis of SF-36 Health profiles and summary measures. Summary of results of the medical outcomes study. Med Care 1995; 33: AS264–AS279.

    Article  PubMed  Google Scholar 

  6. Million R, Hall R, Nilsen K, Baker R. Assessment of the progress of the back-pain patient. Spine 1982; 7: 204–212.

    Article  PubMed  CAS  Google Scholar 

  7. Anagnostis C, Mayer T, Gatchel R, Proctor T. The million visual analog scale: its utility for predicting tertiary rehabilitation outcomes. Spine 2003; 28: 1051–1060.

    Article  PubMed  Google Scholar 

  8. Anagnostis C, Gatchel R, Mayer T. The development of a comprehensive biopsychosocial measure of disability for chronic musculoskeletal disorders: The Pain Disability Questionnaire. Spine 2004; 29: 2290–2302.

    Article  PubMed  Google Scholar 

  9. Underwood MR, Barnett AG, Vickers MR. Evaluation of two time-specific back pain outcome measures. Spine 1999; 24: 1104–1112.

    Article  PubMed  CAS  Google Scholar 

  10. Gatchel RJ. Occupational low back pain disability: Why function needs to “drive” the rehabilitation process. Am Pain Soc J 1994; 3: 107–110.

    Google Scholar 

  11. Beurskens A, de Vet H, Koke A, Heijden V, Knipschild P. Measuring the functional status of patients with low back pain: Assessment of the quality of four disease-specific questionnaires. Spine 1995; 20: 1017–1028.

    Article  PubMed  CAS  Google Scholar 

  12. Feise RJ, Menke JM. Functional rating index: A new valid and reliable instrument to measure the magnitude of clinical change in spinal conditions. Spine 2001; 26: 78–87.

    Article  PubMed  CAS  Google Scholar 

  13. Kopec J. Measuring functional outcomes in persons with back pain. Spine. 2000; 25: 3110–3114.

    Article  PubMed  CAS  Google Scholar 

  14. Ohnmeiss DD. Oswestry back pain disability questionnaire. In: Gatchel RJ, ed. Compendium of outcome instruments for assessment and research of spinal disorders. LaGrange, IL: North American Spine Society, 2000, pp. 52–54.

  15. Triano JJ, McGregor M, Cramer GD, Emde DL. A comparison of outcome measures for use with back pain patients: Results of a feasibility study. J Manipul Physiol Ther 1993; 16: 67–73.

    CAS  Google Scholar 

  16. Gronblad M, Hupli M, Wennerstrand P. Intercorrelation and test–retest reliability of the pain disability index and the Oswestry disability questionnaire and their correlation with pain intensity in low back pain patients. Clin J Pain 1993; 9: 189–195.

    Article  PubMed  CAS  Google Scholar 

  17. Fisher K, Johnson M. Validation of the Oswestry low back pain disability questionnaire, its sensitivity as a measure of change following treatment and its relationship with other aspects of the chronic pain experience. Physiother Theory Pract 1997; 13: 67–80.

    Article  Google Scholar 

  18. Kaplan G, Wurtele S, Gillis D. Maximal effort during functional capacity evaluations: An examination of psychological factors. Arch Phys Med Rehabil 1996; 77: 161–164.

    Article  PubMed  CAS  Google Scholar 

  19. Ohnmeiss DD, Vanharanta H, Estlander AM, Jamsen A. The relationship of disability (Oswestry) and pain drawings to functional testing. Eur Spine J 2000; 9: 208–212.

    Article  PubMed  CAS  Google Scholar 

  20. Gronblad M, Jarvinen E, Hurri H. Relationship of the Pain Disability Index (PDI) and the Oswestry Disability Questionnaire (ODQ) with three dynamic physical tests in a group of patients with chronic low-back pain and leg pain. Clin J Pain 1994; 10: 197–203.

    PubMed  CAS  Google Scholar 

  21. Kopec J, Esdaile J, Abrahamowicz M, Abenhaim L, Wood-Dauphinee S, Lamping D, et al. The Quebec back pain disability scale: measurement properties. Spine 1995; 20: 341–52.

    PubMed  CAS  Google Scholar 

  22. Capra P, Mary T, Gatchel J. Adding psychological scales to your low back pain assessment. J Musculoskel Med 1985; 7: 41–52.

    Google Scholar 

  23. Taylor S, Taylor A, Foy M, Fogg A. Responsiveness of common outcome measures for patients with low back pain. Spine 1999; 24: 1805–1812.

    Article  PubMed  CAS  Google Scholar 

  24. Gatchel RJ, Mayer T, Dersh J, Robinson R, Polatin PB. The association of the SF-36 health status survey with 1-year socioeconomic outcomes in a chronically disabled spinal disorder population. Spine 1999; 24: 2162–2170.

    Article  PubMed  CAS  Google Scholar 

  25. Gatchel R, Polatin P, Mayer T, Robinson R, Dersh J. Use of the SF-36 health status survey with a chronically disabled back pain population: Strengths and limitations. J Occup Rehab 1998; 8: 237–245.

    Article  Google Scholar 

  26. Polatin P, Kinney R, Gatchel R, Lillo E, Mayer T. Psychiatric illness and chronic low back pain: the mind and the spine–which goes first? Spine 1993; 18: 66–71.

    Article  PubMed  CAS  Google Scholar 

  27. Dersh J, Gatchel R, Polatin P. Chronic spinal disorders and psychopathology: research findings and theoretical considerations. Spine 2001; 1: 88–94.

    Article  CAS  Google Scholar 

  28. Dersh J, Gatchel R, Polatin P, Mayer T. Prevalence of psychiatric disorders in patients with chronic work-related musculoskeletal pain disability. JOEM 2002; 44: 459–468.

    PubMed  CAS  Google Scholar 

  29. Mayer T, Gatchel R, Kishino N, Keeley J, Capra P, Mayer H, et al. Objective Assessment of Spine Function Following Industrial Accident: A Prospective Study with Comparison Group and 1-Year Follow-Up; Volvo Award in Clinical Sciences, 1985. Spine 1985; 10: 482–93.

    Article  PubMed  CAS  Google Scholar 

  30. Mayer T, Gatchel R, Kishino N, Keeley J, Mayer H, Mayer H, et al. A prospective short-term study of chronic low back pain patients utilizing novel objective functional measurement. Pain 1986; 25: 53–68.

    Article  PubMed  CAS  Google Scholar 

  31. Mayer T, Gatchel R, Mayer H, Kishino N, Keeley J, Mooney V. A prospective 2-year study of functional restoration in industrial low back injury: an objective assessment procedure. JAMA 1987; 258: 1763–1767.

    Article  PubMed  CAS  Google Scholar 

  32. Garcy P, Mayer T, Gatchel R. Recurrent or new injury outcomes after return to work in chronic disabling spinal disorders: Tertiary prevention efficacy of functional restoration treatment. Spine 1996; 21: 952–959.

    Article  PubMed  CAS  Google Scholar 

  33. Jordan K, Mayer T, Gatchel R. Should extended disability be an exclusion criterion for tertiary rehabilitation?: Socioeconomic outcomes of early vs. late functional restoration in compensation spinal disorders. Spine 1998; 23: 2110–2117.

    Article  PubMed  CAS  Google Scholar 

  34. Mayer T, Gatchel R, Evans T. Effect of age on outcomes of tertiary rehabilitation for chronic disabling spinal disorders. Spine 2001; 26: 1378–1384.

    Article  PubMed  CAS  Google Scholar 

  35. Mayer T, McMahon M, Gatchel R, Sparks B, Wright A, Pegues P. Socioeconomic outcomes of combined spine surgery and functional restoration in workers' compensation spinal disorders with matched controls. Spine 1998; 23: 598–606.

    Article  PubMed  CAS  Google Scholar 

  36. Wright A, Mayer T, Gatchel R. Outcomes of disabling cervical spine disorders in compensation injuries: A prospective comparison to tertiary rehabilitation response for chronic lumbar spinal disorders. Spine 1999; 24: 178–183.

    Article  PubMed  CAS  Google Scholar 

  37. Mayer T, Gatchel R, Polatin P, Evans T. Outcomes comparison of treatment for chronic disabling work-related upper extremity disorders and spinal disorders. J Occup Environ Med 1999; 41: 761–770.

    Article  PubMed  CAS  Google Scholar 

  38. Mayer T, Anagnostis C, Gatchel R, Evans T. Impact of functional restoration after anterior cervical fusion on chronic disability in work-related neck pain. Spine 2002; 2: 267–273.

    Article  Google Scholar 

  39. Proctor T, Mayer T, Gatchel R, McGeary D. Unremitting health-care-utilization outcomes of tertiary rehabilitation of chronic musculoskeletal disorders. JBJS 2004; 86: 62–69.

    Google Scholar 

  40. Proctor T, Mayer T, Theodore B, Gatchel R. Failure to complete a functional restoration program for chronic musculoskeletal disorders: A prospective 1-year outcome study. Arch Phys Med, 2005; 86(8): 1509–1515.

    Google Scholar 

  41. McGeary D, Mayer T, Gatchel R. High pain ratings predict treatment failure in chronic occupational musculoskeletal disorders. JBJS, 2006; 88: 317–325.

    Google Scholar 

  42. Mayer T, Gatchel R. Functional restoration for spinal disorders: the sports medicine approach. Philadelphia (PA) Lea & Febiger, 1988.

  43. Mayer T, Gatchel R, Keeley J, Mayer H, Richling D. A male incumbent worker industrial database. Part I: Lumbar spinal physical sapacity. Spine 1994; 19: 755–761.

    PubMed  CAS  Google Scholar 

  44. Mayer T, Gatchel R, Keeley J, Mayer H, Richling D. A male incumbent worker industrial database. Part II: Cervical spinal physical capacity. Spine 1994; 19: 762–764.

    PubMed  CAS  Google Scholar 

  45. Mayer T, Gatchel R, Keeley J, Mayer H, Richling D. A male incumbent worker industrial database. Part III: Lumbar/cervical functional testing. Spine 1994; 19: 765–770.

    PubMed  CAS  Google Scholar 

  46. Mayer T, Pope P, Tabor J, Bovasso E, Gatchel R. Physical progress and residual impairment quantification after functional restoration, part I: lumbar mobility. Spine 1994; 18: 389–94.

    Google Scholar 

  47. Brady S, Mayer T, Gatchel R. Physical progress and residual impairment quantification after functional restoration. Part II: Isokinetic trunk strength. Spine 1994; 18: 395–400.

    Article  Google Scholar 

  48. Curtis L, Mayer T, Gatchel R. Physical progress and residual impairment after functional restoration. Part III: Isokinetic and isoinertial lifting capacity. Spine 1994; 18: 401–405.

    Google Scholar 

  49. Ware J, Kosinski M, Keller S. SF-36 physical and mental health summary scores: A user's manual. Boston: The Health Institute, New England Medical Center, 1994

  50. Beck A, Steer R, Garbin W. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psych Rev 1988; 8: 77–100.

    Article  Google Scholar 

  51. Hamilton M. A rating scale for depression. J Neuro, Neurosurg Psychiat 1960; 23: 56–62.

    Article  CAS  Google Scholar 

  52. Gatchel R. Research outcomes compendium. LaGrange, IL: North American Spine Society, 2001.

  53. Mayer T, Prescott M, Gatchel R. Objective outcome evaluation: methods and evidence. In: Mayer T, Gatchel R, Polatin P, eds. Occupational musculoskeletal disorders: Function, outcomes and evidence. Philadelphia, PA: Williams & Wilkins, 1999, pp. 651–667.

  54. Mayer T, McGeary D, Gatchel R. Extreme pain ratings predict treatment failure in chronic occupational spinal disorders. Paper Presented at 19th Annual Meeting at the North American Spine Society, Chicago, IL, October 2004, pp. 26–30.

  55. Eid M, Notz P, Schwenkmezger P, Steyer R. Sind Stimmungsdimensionen monopolar? Ein Überblick über empirische Befunde und Untersuchungen faktorenanalytischen Modellen für kontinuierliche und kategoriale Variablen sowie neuere Ergebnisse [Are mood dimensions monopolar? A review of empirical results and investigations with factor analyses of continuous and categorical variables as well as recent outcomes]. Zeitschrift für Differentielle und Diagnostische Psychologie 1994, 15: 211–233.

    Google Scholar 

  56. Tait R, Chibnall JT. The Pain Disability Index: Psychometric properties. Pain 1990; 40: 171–182.

    Article  PubMed  CAS  Google Scholar 

  57. Hazard R, Haugh L, Reid S, Preble J. Early prediction of chronic disability after occupational low back injury. Spine 1996; 21: 945–951.

    Article  PubMed  CAS  Google Scholar 

  58. Linton S, Gross D, Schultz I, Main C, Cote P, Pransky G, Johnson W. Prognosis and the identification of workers risking disability: Research issues and directions for future research. J Occup Rehabil 2005; 15: 459–474.

    Article  PubMed  Google Scholar 

  59. Loisel P, Buchbinder R, Hazard R, Keller R, Scheel I, van Tulder M. Prevention of work disability due to musculoskeletal disorders: The challenge of implementing evidence. J Occup Rehabil 2005; 15: 507–524.

    Article  PubMed  Google Scholar 

  60. Sullivan M, Feuerstein M, Gatchel R, Linton S, Pransky G. J Occup Rehabil 2005; 15: 475–489.

    Article  PubMed  Google Scholar 

  61. Jette A, Haley S, Ni P. Comparison of functional status tools used in post-acute care. Health Care Financ Rev 2003; 24: 13–24.

    PubMed  Google Scholar 

Download references

ACKNOWLEDGMENTS

The preparation of this manuscript was supported in part by grant nos. 2R01 DE10713, 3R01 MH46452 and 1K05 MH071892 from the National Institutes of Health and grant no. DAMD17-03-1-0055 from the Department of Defence.

Author information

Authors and Affiliations

  1. Department of Psychology, College of Science, University of Texas at Arlington, Arlington, TX, USA

    Robert J. Gatchel

  2. Department of Orthopedic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

    Tom G. Mayer

  3. PRIDE Research Foundation, Dallas, TX, USA

    Brian R. Theodore

Authors
  1. Robert J. Gatchel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tom G. Mayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brian R. Theodore
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gatchel, R.J., Mayer, T.G. & Theodore, B.R. The Pain Disability Questionnaire: Relationship to One-Year Functional and Psychosocial Rehabilitation Outcomes. J Occup Rehabil 16, 72–91 (2006). https://doi.org/10.1007/s10926-005-9005-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-005-9005-0

KEY WORDS:

Search

Navigation