Skip to main content
Erschienen in: International Archives of Occupational and Environmental Health 5/2020

03.02.2020 | Original Article

Predictive validity of a customized functional capacity evaluation in patients with musculoskeletal disorders

verfasst von: David Bühne, Torsten Alles, Christian Hetzel, Marco Streibelt, Ingo Froböse, Matthias Bethge

Erschienen in: International Archives of Occupational and Environmental Health | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To examine whether the performance-based work-related functional capacity evaluation (German title: Einschätzung körperlicher Leistungsfähigkeiten bei arbeitsbezogenen Aktivitäten—ELA) can predict return to work (RTW) in patients with musculoskeletal disorders (MSD).

Methods

A multicenter cohort study was conducted on 162 employed or self-employed patients with various injury-related and chronic MSD, recruited from four outpatient rehabilitation clinics. Patient-reported data on health and work ability were collected at discharge. The FCE test was performed subsequently. The overall FCE-based estimation of the ability to cope with the physical demands of work (positive vs. negative) was used to predict RTW. Successful RTW was defined as a combination of (self-)employment at the 3-month follow-up and a low level of sick leave (< 1.5 weeks) due to MSD. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using logistic regression models to evaluate the predictive validity of the adjusted FCE results.

Results

Based on the FCE test, 82% of the patients were estimated as being able to cope with the physical demands of work. 77% of the patients with a positive FCE outcome returned to work (positive predictive value) and 83% with a negative FCE outcome did not (negative predictive value). Patients whose functional capacity was estimated to match the job demands were associated with sixfold higher odds of returning to work after adjusting for patient-reported data on health and work ability. The agreement between the FCE result and RTW differed only on a low to moderate level between the therapists who administered the FCE (72–89%).

Conclusion

The FCE test at discharge predicts RTW among patients with musculoskeletal disorders.
Anhänge
Nur mit Berechtigung zugänglich
Fußnoten
1
A detailed description can be found in the appendix.
 
2
A calculation of the models 1 and 2 based on the 151 participants, that were included in model 3, had only a minor effect on the influence of ELA (OR = 19.4 respectively OR = 18.2). Therefore, it can be assumed that the decline was not caused by the reduction in sample size.
 
Literatur
Zurück zum Zitat Baldwin ML, Butler RJ, Johnson WG, Côte P (2007) Self-reported severity measures as predictors of return-to-work outcomes in occupational back pain. J Occup Rehabil 17(4):683–700 Baldwin ML, Butler RJ, Johnson WG, Côte P (2007) Self-reported severity measures as predictors of return-to-work outcomes in occupational back pain. J Occup Rehabil 17(4):683–700
Zurück zum Zitat Bethge M, Spanier K, Neugebauer T, Mohnberg I, Radoschewski FM (2015) Self-reported poor work ability—an indicator of need for rehabilitation? A cross-sectional study of a sample of German employees. Am J Phys Med Rehabil 94(11):958–966 Bethge M, Spanier K, Neugebauer T, Mohnberg I, Radoschewski FM (2015) Self-reported poor work ability—an indicator of need for rehabilitation? A cross-sectional study of a sample of German employees. Am J Phys Med Rehabil 94(11):958–966
Zurück zum Zitat Bethge M, Markus M, Streibelt M, Gerlich C, Schuler M (2018) Implementing the German model of work-related medical rehabilitation: did the delivered dose of work-related treatment components increase? Arch Phys Med Rehabil 99(12):2465–2471 Bethge M, Markus M, Streibelt M, Gerlich C, Schuler M (2018) Implementing the German model of work-related medical rehabilitation: did the delivered dose of work-related treatment components increase? Arch Phys Med Rehabil 99(12):2465–2471
Zurück zum Zitat Bethge M, Markus M, Streibelt M, Gerlich C, Schuler M (2019) Effects of nationwide implementation of work-related medical rehabilitation in Germany: propensity score matched analysis. Int Arch Occup Environ Health 76(12):913–919. https://doi.org/10.1136/oemed-2019-106065 Bethge M, Markus M, Streibelt M, Gerlich C, Schuler M (2019) Effects of nationwide implementation of work-related medical rehabilitation in Germany: propensity score matched analysis. Int Arch Occup Environ Health 76(12):913–919. https://​doi.​org/​10.​1136/​oemed-2019-106065
Zurück zum Zitat Bieleman HJ, Stewart R, Reneman MF, van Ittersum WM, van der Schans CP, Drossaers-Bakker KW, Oosterveld FGJ (2018) Trajectories of physical work capacity in early symptomatic osteoarthritis of hip and knee: results from the Cohort Hip and Cohort Knee (CHECK) study. J Occup Rehabil. https://doi.org/10.1007/s10926-018-9809-3 Bieleman HJ, Stewart R, Reneman MF, van Ittersum WM, van der Schans CP, Drossaers-Bakker KW, Oosterveld FGJ (2018) Trajectories of physical work capacity in early symptomatic osteoarthritis of hip and knee: results from the Cohort Hip and Cohort Knee (CHECK) study. J Occup Rehabil. https://​doi.​org/​10.​1007/​s10926-018-9809-3
Zurück zum Zitat Bühne D (2018) The prognostic value of functional capacity evaluation in patients with musculoskeletal disorders. Verlag Dr Kovac, Hamburg (German) Bühne D (2018) The prognostic value of functional capacity evaluation in patients with musculoskeletal disorders. Verlag Dr Kovac, Hamburg (German)
Zurück zum Zitat Cutler RB, Fishbain DA, Stelle-Rosomoff R, Rosomoff HL (2003) Relationships between functional capacity measures and baseline psychological measures in chronic pain patients. J Occup Rehabil 13(4):249–258 Cutler RB, Fishbain DA, Stelle-Rosomoff R, Rosomoff HL (2003) Relationships between functional capacity measures and baseline psychological measures in chronic pain patients. J Occup Rehabil 13(4):249–258
Zurück zum Zitat Fishbain DA, Cutler RB, Rosomoff H, Khalil T, Abdel-Moty E, Steele-Rosomoff R (1999) Validity of the dictionary of occupational titles residual functional capacity battery. Clin J Pain 15(2):102–110 Fishbain DA, Cutler RB, Rosomoff H, Khalil T, Abdel-Moty E, Steele-Rosomoff R (1999) Validity of the dictionary of occupational titles residual functional capacity battery. Clin J Pain 15(2):102–110
Zurück zum Zitat Gouttebarge V, Kuijer PP, Wind H, van Duivenbooden C, Sluiter JK, Frings-Dresen MH (2009) Criterion-related validity of functional capacity evaluation lifting tests on future work disability risk and return to work in the construction industry. Occup Environ Med 66(10):657–663. https://doi.org/10.1136/oem.2008.042903 Gouttebarge V, Kuijer PP, Wind H, van Duivenbooden C, Sluiter JK, Frings-Dresen MH (2009) Criterion-related validity of functional capacity evaluation lifting tests on future work disability risk and return to work in the construction industry. Occup Environ Med 66(10):657–663. https://​doi.​org/​10.​1136/​oem.​2008.​042903
Zurück zum Zitat Gross DP, Battié MC (2004) The prognostic value of functional capacity evaluation in patients with chronic low back pain: part 2: sustained recovery. Spine 29(8):920–924 Gross DP, Battié MC (2004) The prognostic value of functional capacity evaluation in patients with chronic low back pain: part 2: sustained recovery. Spine 29(8):920–924
Zurück zum Zitat Gross DP, Battié MC (2005) Functional capacity evaluation performance does not predict sustained return to work in claimants with chronic back pain. J Occup Rehabil 15(3):285–294 Gross DP, Battié MC (2005) Functional capacity evaluation performance does not predict sustained return to work in claimants with chronic back pain. J Occup Rehabil 15(3):285–294
Zurück zum Zitat Gross DP, Battié MC (2006) Does functional capacity evaluation predict recovery in workers’ compensation claimants with upper extremity disorders? Occup Environ Med 63:404–410 Gross DP, Battié MC (2006) Does functional capacity evaluation predict recovery in workers’ compensation claimants with upper extremity disorders? Occup Environ Med 63:404–410
Zurück zum Zitat Gross DP, Battié MC, Cassidy JD (2004) The prognostic value of functional capacity evaluation in patients with chronic low back pain: part 1: timely return to work. Spine 29(8):914–919 Gross DP, Battié MC, Cassidy JD (2004) The prognostic value of functional capacity evaluation in patients with chronic low back pain: part 1: timely return to work. Spine 29(8):914–919
Zurück zum Zitat Hosmer DW, Lemeshow S, Sturdivant RX (2013) Applied logistic regression, 3rd edn. Wiley, New York Hosmer DW, Lemeshow S, Sturdivant RX (2013) Applied logistic regression, 3rd edn. Wiley, New York
Zurück zum Zitat Ilmarinen J, Tuomi K, Klockars M (1997) Changes in the work ability of active employees as measured by the work ability index over an 11-year period. Scand J Work Environ Health 23(1):49–57 Ilmarinen J, Tuomi K, Klockars M (1997) Changes in the work ability of active employees as measured by the work ability index over an 11-year period. Scand J Work Environ Health 23(1):49–57
Zurück zum Zitat King PM, Tuckwell N, Barrett TE (1998) A critical review of functional capacity evaluations. Phys Ther 78:852–866 King PM, Tuckwell N, Barrett TE (1998) A critical review of functional capacity evaluations. Phys Ther 78:852–866
Zurück zum Zitat Kuijer PPFM, Gouttebarge V, Brouwer S, Reneman MF, Fings-Dresen MHW (2012a) Are performance-based measures predictive of work participation in patients with musculoskeletal disorders? A systematic review. Int Arch Occup Environ Health 85:109–123 Kuijer PPFM, Gouttebarge V, Brouwer S, Reneman MF, Fings-Dresen MHW (2012a) Are performance-based measures predictive of work participation in patients with musculoskeletal disorders? A systematic review. Int Arch Occup Environ Health 85:109–123
Zurück zum Zitat Kuijer PPFM, Gouttebarge V, Wind H, van Duivenbooden C, Sluiter JK, Frings-Dresen MHW (2012b) Prognostic value of self-reported work ability and performance-based lifting tests for sustainable return to work among construction workers. Scand J Work Environ Health 38(6):600–603. https://doi.org/10.5271/sjweh.3302 Kuijer PPFM, Gouttebarge V, Wind H, van Duivenbooden C, Sluiter JK, Frings-Dresen MHW (2012b) Prognostic value of self-reported work ability and performance-based lifting tests for sustainable return to work among construction workers. Scand J Work Environ Health 38(6):600–603. https://​doi.​org/​10.​5271/​sjweh.​3302
Zurück zum Zitat Lechner DE, Page JJ, Sheffield G (2008) Predictive validity of a functional capacity evaluation: the physical work performance evaluation. Work 31(1):21–25 Lechner DE, Page JJ, Sheffield G (2008) Predictive validity of a functional capacity evaluation: the physical work performance evaluation. Work 31(1):21–25
Zurück zum Zitat Löffler S, Wolf HD, Gerlich C, Vogel H (2008) Würzburger Screening. Universität Würzburg, Würzburg Löffler S, Wolf HD, Gerlich C, Vogel H (2008) Würzburger Screening. Universität Würzburg, Würzburg
Zurück zum Zitat Matheson LN (2003) The functional capacity evaluation. In: Demeter SL, Andersson GBJ (eds) Disability evaluation. Mosby Yearbook, Chicago, pp 748–768 Matheson LN (2003) The functional capacity evaluation. In: Demeter SL, Andersson GBJ (eds) Disability evaluation. Mosby Yearbook, Chicago, pp 748–768
Zurück zum Zitat Matheson LN, Isernhagen SJ, Hart DL (2002) Relationships among lifting ability, grip force, and return to work. Phys Ther 82:249–256 Matheson LN, Isernhagen SJ, Hart DL (2002) Relationships among lifting ability, grip force, and return to work. Phys Ther 82:249–256
Zurück zum Zitat Vowles KE, Gross RT, Sorrell JT (2004) Predicting work status following interdisciplinary treatment for chronic pain. Eur J Pain 4:351–358 Vowles KE, Gross RT, Sorrell JT (2004) Predicting work status following interdisciplinary treatment for chronic pain. Eur J Pain 4:351–358
Zurück zum Zitat Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Med Care 30(6):473–483 Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Med Care 30(6):473–483
Zurück zum Zitat Wind H, Gouttebarge V, Kuijer PPFM, Sluiter JK, Frings-Dresen MHW (2009) Effect of functional capacity evaluation information on the judgment of physicians about physical work ability in the context of disability claims. Int Arch Occup Environ Health 82(9):1087–1096 Wind H, Gouttebarge V, Kuijer PPFM, Sluiter JK, Frings-Dresen MHW (2009) Effect of functional capacity evaluation information on the judgment of physicians about physical work ability in the context of disability claims. Int Arch Occup Environ Health 82(9):1087–1096
Metadaten
Titel
Predictive validity of a customized functional capacity evaluation in patients with musculoskeletal disorders
verfasst von
David Bühne
Torsten Alles
Christian Hetzel
Marco Streibelt
Ingo Froböse
Matthias Bethge
Publikationsdatum
03.02.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
International Archives of Occupational and Environmental Health / Ausgabe 5/2020
Print ISSN: 0340-0131
Elektronische ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-020-01518-5

Weitere Artikel der Ausgabe 5/2020

International Archives of Occupational and Environmental Health 5/2020 Zur Ausgabe