Abstract

Chronic pain affects multiple facets of a person’s life. Interdisciplinary programs are effective in treating chronic pain, but approaches used to improve function are different between programs. It is unclear which aspect of rehabilitation is responsible for improving function. In these programs, patients’ allocation to groups and post program assessments are based on subjective and self-report evaluations from the patients. The purpose of this study was to objectively evaluate chronic pain patients’ day and night movement to see the relationship between movement to baseline and final outcomes in pain related fear, function, depression, and pain. Twenty-four patients were diagnosed with chronic pain and wait listed for a chronic pain rehabilitation program (age=48.1±11.8years, weight=76.2±21.2kg, height=164.6±7.3cm). There were two groups at this rehabilitation center, specialized (S) and super-specialized (SP), 12 patients in each group. Patients’ pain related fear, function, depression, and pain was assessed prior to the starting the program and at the completion of the 9-week program. Day movement and night movement were monitored for 7 days prior to starting the program using actigraphy. All pain related fear, function, depression, and pain variables significantly improved upon completion of the program. Movement during the day was significantly related to self-reported function, but not to the 6-minute walk test. Moreover, movement during the day was correlated with depression and pain. In conclusion, day and night movement cannot be used to predict successful completion of the program. Clinicians should use self-reported and objective function measurements to accurately reflect patient ability.