Development and reliability testing of Spanish language and english language versions of the multidimensional task ability profile

Work-Readiness self report lift capacity test short form

BACKGROUND

The Multidimensional Task Ability Profile (MTAP) is a measure of self reported physical work capacity developed for injured workers with musculoskeletal disorders (MSDs) to determine readiness to return to work.

OBJECTIVE

This study compared the concurrent validity of a new short form MTAP (MTAP-SF) comprised of 16 lifting and/or carrying items with the MTAP 55-item version. The hypothesis addressed is whether the validity of a version that imposes less respondent burden (MTAP-SF) would be comparable to the more burdensome instrument (MTAP-55).

METHODS

MTAP scores were compared with demonstrated lift capacity in 1,252 healthy adults. Parallel regression analyses were conducted to examine the explanatory power of both MTAP versions.

RESULTS

Age, gender, body mass and MTAP-SF explained 55% of the variance (p < 0.001) in demonstrated lift capacity, equivalent to MTAP-55.

CONCLUSIONS

Self reported performance in physical work capacity tasks accounts for significant variance in lifting performance. MTAP-SF diminishes respondent burden while maintaining validity and may be useful for managing MSDs by enhancing understanding of the evaluee's psychophysical component in return-to-work rehabilitation planning.

Relationships Between Opioid Dosing, Pain Severity, and Disability in a Community-Based Chronic Pain Population: An Exploratory Retrospective Analysis

OBJECTIVE

To determine the relationship between opioid dose change, pain severity, and function in patients with chronic pain.

DESIGN

Retrospective cohort study.

SETTING

Community interdisciplinary pain management practice.

SUBJECTS

A total of 778 patients with chronic pain prescribed opioids for three or more consecutive months between April 1, 2013, and March 1, 2015.

METHODS

Changes in opioid dose, pain severity rating, modified Roland Morris Disability Questionnaire score, and opioid risk data were extracted from medical records and analyzed for associations.

RESULTS

Two hundred forty-three subjects (31.2%) had an overall dose decrease, 223 (28.7%) had a dose increase, and 312 (40.1%) had no significant change in dose (<20% change). There was a weak negative correlation between change in opioid dose and change in pain severity (r = -0.08, P = 0.04) but no association between change in disability scores and dose change (N = 526, P = 0.13). There was a weak positive correlation between change in pain severity rating and change in disability scores (r = 0.16, P < 0.001).

CONCLUSIONS

The results suggest that escalating opioid doses may not necessarily result in clinically significant improvement of pain or disability. Similarly, significant opioid dose reductions may not necessarily result in worsened pain or disability. This exploratory investigation raised questions of possible subgroups of patients who might demonstrate improvement of pain and disability with opioid dose adjustments, and further research should prospectively explore this potential, given the limitations inherent in retrospective analyses. Prescribers should still consider reduction of opioid doses as recommended by current guidelines, in an effort to mitigate the potential risks associated with high-dose treatment.

Validity of the Multidimensional Task Ability Profile

Background The Multidimensional Task Ability Profile (MTAP) is a patient-reported outcome (PRO) measure that provides a global score linked to the physical demand characteristics of work, but needs to be validated against established measures. Purpose To assess the concurrent validity of the MTAP compared with the Oswestry Disability Index (ODI), Neck Disability Index (NDI), Disabilities of the Arm, Shoulder, and Hand (DASH), Lower Extremity Functional Scale (LEFS), and Short Form 12 Health-Related Quality of Life (SF-12) questionnaires. Methods An observational study was conducted in 157 patients undergoing musculoskeletal rehabilitation. At baseline and after 30 days of treatment, patients completed the MTAP, ODI, NDI, DASH, LEFS, and SF-12 and provided self-reported work status. Results At baseline and after 30 days, convergent validity between the MTAP and DASH, LEFS, NDI, and ODI was good to excellent. Concurrent validity between the MTAP and SF-12 physical component score (PCS) and mental component score (MCS) was moderate or fair, respectively. Sensitivity to change over the 30-day treatment interval was established for the MTAP, SF-12 PCS, SF-12 MCS, and LEFS. Fair to moderate predictive validity for work status was found for the MTAP, ODI, NDI, DASH, and SF-12 PCS. Conclusions The MTAP demonstrated adequate concurrent validity, predictive validity, and sensitivity to change compared to other PROs. For patients with various impairment types, the MTAP may be a useful omnibus measure to supplement specialty instruments such as the DASH, NDI, ODI, or LEFS.