ORIGINAL RESEARCH
Stephanie G. Vanterpool, MD, MBA, FASA; Robert E. Heidel, PhD; Kyle Snyder, MD; Tara Keil, MD; Cecilia Contreras, BS; Alexa Hartman, MS; Rebecca Higdon, MPH; Julie Jeter, MD
Corresponding Author: Stephanie G. Vanterpool, MD, MBA, FASA; Department of Anesthesiology - University of Tennessee Graduate School of Medicine.
Email: Svanterpool@utmck.edu
DOI: 10.3122/jabfm.2022.220261R12
Keywords: Chronic Disease, Exercise, Functional Performance, Functional Status, Geriatrics, Health Promotion, Metabolic Equivalent, Surveys and Questionnaires, Tennessee
Dates: Submitted: 07-29-2022; Revised: 10-07-2022; Accepted: 10-11-2022
Ahead of Print: | HTML | | PDF | Final Publication: | HTML | | PDF |
PURPOSE: Functional status is a major contributor to overall health and reflects both daily activity level (performance) and maximum attainable activity level (capacity). Existing assessment tools evaluate only one domain of function and do not provide insight into contributors to functional decline. We addressed these deficiencies by developing the Tennessee Functional Status Questionnaire (TFSQ) which reports activity levels in metabolic equivalents (METs) and evaluates 5 key areas: performance, capacity, activity, pain, and acute care (ED visit, hospitalization, surgery). We validated the activity levels reported by the TFSQ against the Duke Activity Status Index (DASI).
METHODS: In this prospective, observational study 120 patients across 2 clinical sites completed both the TFSQ and the DASI. TFSQ-reported functional performance and capacity was correlated with DASI-calculated METS. The effect of change in activity, pain, and acute care on functional status was also evaluated.
RESULTS: The Pearson correlation between TFSQ-reported capacity and DASI-calculated METs was r=0.69, p<0.001. TFSQ performance and capacity were discordant 53.9% of the time. TFSQ capacity was significantly lower in patients who reported recently decreased activity (p=0.047), pain affecting function (p<0.001), or recent acute care exposure (p=0.017).
CONCLUSIONS: The TFSQ is a brief and efficient assessment of patient function, standardized to METs, and validated against the DASI. Our study suggests that many patients may have the functional reserve to increase their daily physical activity and that factors such as changes in activity, pain, and recent acute care interaction, may lower functional capacity.