Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, Groningen, The Netherlands.
Arch Phys Med Rehabil. 2012 Mar;93(3):446-57. doi: 10.1016/j.apmr.2011.10.016.
To reach consensus on the most important biopsychosocial factors that influence functional capacity results in patients with chronic nonspecific musculoskeletal pain, arranged in the framework of the International Classification of Functioning, Disability and Health.
Three-round, internet-based Delphi survey.
Not applicable.
Participants were scientists, clinicians, and patients familiar with functional capacity testing. Scientists were invited through purposive sampling based on the number of relevant publications in peer-reviewed journals. The scientists recruited clinicians and patients through snowball sampling.
Not applicable.
Consensus was reached if at least moderate influence (25%) was achieved and an interquartile range of no more than 1 point was reached.
Thirty-three scientists, 21 clinicians, and 21 patients from 9 countries participated. Participants reached consensus on 6 factors that can influence the outcome of the lifting test, having a median of severe influence (50%-95%): catastrophic thoughts and fear, patient adherence to "doctor's orders," internal and external motivation, muscle power, chronic pain behavior, and avoidance behavior. Motivation, chronic pain behavior, and sensation of pain were the top 3 factors affecting postural tolerance and repetitive movement functional capacity tests. Furthermore, participants reported 28 factors having a median of moderate influence (25%-49%) that could influence the outcome of lifting, postural tolerance, and repetitive movement tests.
Overall, chronic pain behavior, motivation, and sensation of pain are the main factors that can influence functional capacity results. We recommend that scientists and clinicians, respectively, consider the most important factors when planning future studies and when interpreting functional capacity test results.
在国际功能、残疾和健康分类框架内，就影响慢性非特异性肌肉骨骼疼痛患者功能能力结果的最重要的生物心理社会因素达成共识。
三轮、基于互联网的德尔菲调查。
不适用。
对功能能力测试熟悉的科学家、临床医生和患者。根据在同行评议期刊上发表的相关出版物数量，通过有针对性的抽样邀请科学家参加。科学家通过滚雪球抽样招募临床医生和患者。
不适用。
如果至少达到中度影响（25%）且四分位距不超过 1 点，则达成共识。
来自 9 个国家的 33 名科学家、21 名临床医生和 21 名患者参加了研究。参与者就 6 个可能影响举重测试结果的因素达成共识，这些因素具有中度影响（25%-95%）：灾难性思维和恐惧、患者对“医嘱”的依从性、内在和外在动机、肌肉力量、慢性疼痛行为和回避行为。动机、慢性疼痛行为和疼痛感觉是影响姿势耐力和重复运动功能能力测试结果的前 3 个因素。此外，参与者报告了 28 个因素，这些因素具有中度影响（25%-49%），可能影响举重、姿势耐力和重复运动测试的结果。
总体而言，慢性疼痛行为、动机和疼痛感觉是影响功能能力结果的主要因素。我们建议科学家和临床医生在规划未来研究和解释功能能力测试结果时，分别考虑最重要的因素。
