Clinical Effectiveness of a Functional Restoration Program Compared to Conventional Medical Management in Patients With Chronic Pain: A Multicenter, Retrospective Observational Analysis.

OBJECTIVE

The aim of the study was to determine clinical effectiveness of an 8-wk functional restoration program compared with conventional medical management in patients with chronic pain after work-related injury in the workers' compensation system.

DESIGN

This is an observational retrospective chart review of 485 patients treated between January 1, 2020, and December 31, 2022. Included patients with chronic pain after work-related injury who participated in a multidisciplinary evaluation and were considered appropriate for functional restoration program. Outcomes were analyzed for two groups: functional restoration program group completed an 8-wk program, and conventional medical management group did not receive functional restoration program treatment. The ordinary least squares regression model was used to control confounding factors, and an independent t test was performed to assess functional restoration program effectiveness.

RESULTS

Functional restoration program graduates demonstrated improvements in depression, anxiety, self-efficacy, and physical function; Center for Epidemiologic Studies Depression Scale ( P <0.001), Generalized Anxiety Disorder Scale ( P < 0.01), Pain Self-Efficacy Questionnaire ( P < 0.001), Neck Disability Index ( P < 0.001), and Oswestry Low Back Disability Index ( P < 0.001) scores were statistically significant compared to conventional medical management. The Lower Extremity Functional Scale and Quick Disabilities of Arm, Shoulder & Hand scores did not show statistically significant improvement with functional restoration program.

CONCLUSION

Functional restoration program offers a clinically effective treatment option to improve self-efficacy, anxiety, depression, and physical function in patients with chronic pain associated with work-related injury. Prospective, randomized control trials could be key in validating and identifying further variability in outcomes.

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CME

OBJECTIVES

Upon completion of this article, the reader should be able to: ○ Describe the benefits of a functional restoration program (FRP); ○ Provide additional options to improve function for patients with chronic pain associated with work-related injury; and ○ Enhance clinical applications of multidisciplinary treatment for treating delayed recovery from chronic pain in individuals with work-related injuries.

LEVEL: Advanced.

ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.