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Sensitivity to Change and Responsiveness of the Global Physiotherapy Examination (GPE-52) in Patients With Long-Lasting Musculoskeletal Pain

A Kvåle, PT, PhD, is Assistant Professor, Section for Physiotherapy Science, Department of Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
JS Skouen, MD, PhD, is Clinical Director, The Outpatient Spine Clinic, Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway, and Assistant Professor, Section for Physiotherapy Science, Department of Public Health and Primary Health Care, Faculty of Medicine, University of Bergen
AE Ljunggren, PT, PhD, is Professor, Section for Physiotherapy Science, Department of Public Health and Primary Health Care, Faculty of Medicine, University of Bergen

Address all correspondence to Dr Kvåle at Section for Physiotherapy Science, Faculty of Medicine, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway (alice.kvale{at}isf.uib.no)

Background and Purpose. The sensitivity to change and the responsiveness of the Global Physiotherapy Examination (GPE-52) were examined in patients with localized and widespread long-lasting musculoskeletal pain. Subjects. All included patients were on sick leave and constituted the treatment group in a randomized controlled study. Two hundred forty-seven patients (64% women; mean age=43.6 years, SD=10.4) were included. At entry, the patients were categorized into 3 groups according to pain localization. Patients who returned fully to work were compared with those who did not. Methods. The GPE-52 has composite scores in 5 main domains—posture (8 tests), respiration (8 tests), movement (16 tests), muscle (12 tests), and skin (8 tests)—and was administered before and after 4 weeks of multidisciplinary outpatient treatment and at a 6-month follow-up examination. The first 61 patients also were re-examined after 18 months. Results. In this study, the GPE-52 and its 5 main domains were demonstrated to be sensitive to change, measured 6 and 18 months after treatment, in different groups of patients with long-lasting musculoskeletal pain. Responsiveness to important change, defined in this study as return to work, was found only for the total GPE-52 score and within the movement and respiration domains. Responsiveness to important change was greater in patients with localized pain than in patients with widespread pain. Discussion and Conclusion. Although the total GPE-52 score was sensitive to change in patients with long-lasting musculoskeletal pain, a shorter test battery including only the respiration and movement domain scores might be appropriate as an outcome measure in intervention studies for patients with long-lasting musculoskeletal pain.

Key Words: Measurement • Movement • Muscle • Posture • Respiration • Responsiveness • Skin • Work status