Evaluation of occupational performance and pain intensity: before and after back surgery and rehabilitation

Abstract

Objective: The study had a descriptive, longitudinal design and evaluated occupational performance and pain intensity in daily occupations for patients with low back pain (LBP), assessed preoperatively, and at six and 12 months after surgery and rehabilitation. Methods: Patients were assessed by surgeons and occupational therapists (OTs) to determine whether surgery was required. The OTs used the Assessment of Pain and Occupational Performance (POP) instrument. The POP measures 36 occupations in two dimensions: occupational performance and pain intensity. Patients with specific LBP (n = 97) were included. Results: Preoperatively, 23 occupations showed lower performance and “severe pain”. At six months, 27 occupations were performed “without restriction” (p = n.s. - < 0.001) and without pain or with “mild pain” (p < 0.001). A comparison of preoperative values with those at 12 months showed that 35 occupations were significantly changed on both scales, and 31 occupations were performed “without restriction” (p < 0.01–< 0.001) and “without pain” (p < 0.001). Conclusions: The results indicate significant improvements between baseline, six months, and 12 months. Moreover, when occupational performance and pain intensity were separately identified, it was shown that patients had regained their performance at an ordinary level without pain. This underlines the added value of differentiating between disability and pain.

Key words::

• POP
• outcome measurement
• occupational therapy
• intervention
• instrument
• back pain
• assessment
• activities of daily living

Acknowledgements

This study was supported by funds from the Department of Clinical and Experimental Medicine, Faculty of Health Sciences Linköping University, Sweden.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.