Preliminary Results of Patient-Defined Success Criteria for Individuals With Musculoskeletal Pain in Outpatient Physical Therapy Settings

Zeppieri G Jr, Lentz TA, Atchison JW, Indelicato PA, Moser MW, Vincent KR, George SZ. Preliminary results of patient-defined success criteria for individuals with musculoskeletal pain in outpatient physical therapy settings. Arch Phys Med Rehabil 2012;93:434-40. Objectives: (1) To investigate patient-defined parameters of treatment success in an outpatient physical therapy setting with musculoskeletal pain, (2) to determine whether patient-defined treatment success was influenced by selected demographic and clinical factors, and (3) to examine whether patient subgroups existed for ratings of importance for each treatment outcome domain. Design: Cross-sectional study. Setting: Outpatient physical therapy clinic. Participants: Consecutive patients (N=110) with complaints of musculoskeletal pain. Interventions: Not applicable. Main Outcome Measure: We reported patient-defined treatment success targets for pain, fatigue, emotional distress, and interference with daily activities using the Patient-Centered Outcomes Questionnaire (PCOQ). We also investigated whether patient subgroups existed based on perceived importance of improvement for these same outcome domains. Results: Patient-defined criteria for treatment success included mean reductions (from baseline scores) in pain of 3.0 points, in fatigue of 2.3 points, in emotional distress of 1.4 points, and in interference with daily activities of 3.4 points. There were no differences in patient-defined criteria for treatment success based on sex, age, postoperative rehabilitation, prior physical therapy, other prior health care interventions, duration of symptoms, and anatomical location of symptoms (P>.01). Cluster analysis of the PCOQ importance ratings indicated a 2-cluster solution. The multifocused subgroup demonstrated higher importance for improvement ratings in each treatment outcome domain when compared with the pain-focused subgroup (P>.05). Conclusions: These data indicate that patient-defined criteria for treatment success required greater reductions in the studied outcome domains to be considered successful. These data suggest the potential existence of patient subgroups that either rate improvement in all outcome domains as important or rate pain relief as the most important outcome.