Factors influencing observed and self-reported functional ability in women with chronic widespread pain: a cross-sectional study

OBJECTIVE: To evaluate the relationships between key outcome variables, classified according to the International Classification of Functioning, Disability and Health (ICF), and observed and self-reported functional ability in patients with chronic widespread pain.

DESIGN: Cross-sectional with systematic data collection in a clinical setting.

SUBJECTS: A total of 257 consecutively enrolled women with chronic widespread pain.

METHODS: Multidimensional assessment using self-report and observation-based assessment tools identified to cover ICF categories included in the brief ICF Core Set for chronic widespread pain.

RESULTS: Relationships between ICF variables and observed functional ability measured with the Assessment of Motor and Process Skills (AMPS) were few. Out of 36 relationships analysed, only 4 ICF variables showed a moderate correlation with the AMPS motor ability measure. A moderate to strong correlation between numerous ICF variables and self-reported functioning was noted. Multivariate regression modelling supported significant contributions from pain and psychosocial variables to the variability in self-reported functional ability, but not to the variability in AMPS ability measures.

CONCLUSION: Observation-based assessment of functional ability in patients with chronic widespread pain is less influenced by pain and psychosocial factors than are self-reported evaluations. Valid observation-based assessment tools, such as the AMPS, should be included in clinical evaluation and future research addressing functional outcomes in this patient population.