Outcomes at a glance

1. Outcomes at a glance • This outcome report is based on data from clients who completed a Functional Restoration Programme at the RealHealth Treatment Centre in Coventry between May 2012 and November 2012. • Clients on the Functional Restoration Programme showed an average reduction in pain-related disability of 44% from start to completion of the programme. • The impact of pain on everyday life was reduced on average by 37% from programme start to programme completion. • Clients showed an average improvement in positive psychological outlook of 19% at programme completion compared to initial pre-programme assessments. • Such reductions in perceived disability were mirrored by the functional ability data collected throughout the programme. On average, the functional ability of our clients improved by 44% from programme start to programme completion. • Representative sample based on 21 clients

2. Reducing Pain-Related Disability The Roland & Morris Disability Questionnaire (RMDQ) is a widely used health status measure for low back pain, providing self-ratings of the level of physical disability experienced by the patient as a consequence of the pain. Scores on the RMDQ range from 0-24, with higher scores indicating a greater level of pain related disability. Our data shows that for the clients in the Functional Restoration Programme there was a significant average reduction of 44% in pain related disability scores between admission and discharge from the programme. The Oswestry Disability Index (ODI) is a self –report measure used to assess the extent that back pain affects a patient’s ability to manage everyday life. Total scores are converted to a percentage with 0% representing the highest level of functioning. Scores under 20% are classified as minimal disability while scores of 20-40% are classified as moderate disability. Our clients showed an average reduction in ODI scores of 37% from programme start to programme completion, indicating a significant reduction in the impact of pain on everyday life.

3. Reducing emotional problems The Depression, Anxiety and Positive Outlook Scale is an 11-item scale specifically designed to assess mood and emotional outlook in chronic pain patients. The scale consists of three subscales: Depression (5 items), anxiety (3 items) and positive outlook (3 items). Depression and anxiety scores were reduced by 9% and 6% respectively from start to completion of the Functional Restoration Programme. The improvements seen were small and were not statistically significant, however this is to be expected as almost all of our clients showed very low levels of depression and anxiety at the initial assessments. By far the greatest improvements were seen on the Positive Outlook subscale, with a significant increase in scores of 19% from programme start to programme completion. This suggests significant improvements in mood throughout the Functional Restoration Programme that may not have been picked up in the other two subscales because of the low initial assessment scores.

4. Improving functional ability Functional ability measures were taken to assess any improvements in strength, flexibility, co-ordination and self-confidence in activity over the course of the programme. Three specific functional ability measures were assessed: walking, sit to stand, and stair climb. These measures were taken at the start of the programme and on completion of the programme. The data shows an overall average improvement in functional ability of 44% from pre-programme assessment to programme completion across all three functional measures. This significant improvement in functional ability reflects the reductions in perceived disability reported by our clients in the self-report measures.