JANUARY 29, 2025
Physicians treating chronic widespread pain resulting from fibromyalgia often use patient-reported outcome measurements (PROMs) to assess the impact of the condition on functioning.
In an effort to address the limitations of PROMs and better treat patients based on objective data, performance-based tests (PBT) are used. However, data published in The Journal of Pain indicate that there is a lack of evidence supporting the clinical usefulness of many commonly used PBTs.
“We found that there
Physicians treating chronic widespread pain resulting from fibromyalgia often use patient-reported outcome measurements (PROMs) to assess the impact of the condition on functioning.
In an effort to address the limitations of PROMs and better treat patients based on objective data, performance-based tests (PBT) are used. However, data published in The Journal of Pain indicate that there is a lack of evidence supporting the clinical usefulness of many commonly used PBTs.
“We found that there was a need to systematically assess the reliability, validity and responsiveness of the PBTs used in patients with fibromyalgia,” said study author Joaquim Chaler, of the Faculty of Psychology, Education and Sports Sciences at the Universitat Ramon Llull Blanquerna, in Barcelona, Spain.
Researchers found that a six-minute walking test was most often assessed, with moderate quality of evidence for reliability and very good methodological quality for validity.
However, Chaler concluded that most PBTs had concerns regarding the level of evidence which supports their use.
A literature review across four data bases (PubMed, EMBASE, Cochrane Library and Web of Science) identified 22 studies evaluating 26 distinct PBTs. Each test was linked to five International Classification of Functioning disability and health categories: exercise tolerance, muscle power and muscle endurance, and changing basic body position and walking.
After assessing the risk for bias and methodological quality of each PBT, the reliability of most tests was rated as doubtful, with evidence ranging from very low to moderate. None of the studies investigated criterion validity, and construct validity and responsiveness to PBTs were "seldom" determined.
These results led Chaler to conclude that “there is an urgent need to further investigate PBT applied in fibromyalgia.” He hopes that the primary positive outcome of additional research will be that better-validated PBTs will allow physicians to tailor more effective rehabilitation approaches for their patients.
Myles Starr
