A Functional Restoration Program for Active-Duty Service Members With Chronic Pain: Do PTSD Symptoms Moderate Response on Physical Function Assessments?

Chronic pain conditions among active-duty service members (ADSMs) are often accompanied by posttraumatic stress disorder (PTSD) symptoms. Functional restoration programs (FRPs) for ADSMs with chronic pain have resulted in significant improvements in self-reported measures of pain and functioning regardless of co-occurring PTSD. The objective of the current study is to examine whether ADSMs with co-occurring PTSD symptoms demonstrate a differential response to an FRP when measured by objective assessments of physical functioning. Retrospective observational study of data previously collected at Naval Medical Center San Diego (NMCSD) and approved by the NMCSD Institutional Review Board. The study included data from 63 ADSMs who completed an FRP and objective measures of movement patterns, aerobic fitness, functional strength and mobility, and dynamic trunk strength and lifting capacity pre- and post-treatment. Posttraumatic stress disorder status was examined as a moderator of outcomes. Fourteen patients (22.9%) screened positive for PTSD during baseline assessments. Repeated measures analysis of variance showed statistically significant improvement in all measures of physical functioning for the full sample (P < .01). A significant interaction indicated that patients screening positive for PTSD demonstrated less improvement in a measure of aerobic fitness compared to patients screening negative for PTSD (P < .05). No significant interactions with PTSD were demonstrated for changes in movement patterns, functional strength and mobility, and dynamic trunk strength and lifting capacity (all Ps > .42). Active-duty service members with chronic pain demonstrated broad improvements in physical functioning following participation in an FRP. Posttraumatic stress disorder symptoms were not associated with differential response on most objective measures of physical functioning.