Background
Performance category | WWS FCE subtests |
---|---|
Weight handling and strength | Lifting low |
Lifting high | |
Short carry | |
Long carry | |
Long carry right-handed | |
Long carry left-handed | |
Pushing static | |
Pulling static | |
Pushing dynamic | |
Pulling dynamic | |
Grip strength right | |
Grip strength left | |
Posture and mobility | Overhead work |
Forward bent standing | |
Forward bent sitting | |
Kneeling | |
Crawling | |
Crouching | |
Dynamic squatting | |
Repetitive rotation standing right/left | |
Repetitive rotation sitting right/left | |
Sitting tolerance | |
Standing tolerance | |
Locomotion | Walking |
Stair climbing | |
Ladder climbing | |
Balance | Balance |
Hand coordination | Hand coordination right |
Hand coordination left |
Methods
Inclusion criteria
Systematic search strategy
Step | Phrase |
---|---|
#1 |
Functional OR physical
|
#2 |
Capacity OR performance
|
#3 |
Evaluation OR assessment
|
#4 | #1 AND #2 AND #3 |
#5 | #4 AND reliability |
Study selection
Assessment of methodological quality
Requirements | Excellent | Good | Fair | Poor | |
---|---|---|---|---|---|
1 | Was the percentage of missing items given? | Percentage of missing items described | Percentage of missing items not described | - | - |
2 | Was there a description of how missing items were handled? | Described how missing items were handled | Not described but it can be deduced how missing items were handled | Not clear how missing items were handled | - |
3 | Was the sample size included in the analysis adequate? | Adequate sample size (≥ 100) | Good sample size (50–99) | Moderate sample size (30–49) | Small sample size (< 30) |
4 | Were the administrations independent? | Independent measurements | Assumable that the measurements were independent | Doubtful whether the measurements were independent | Measurements not independent |
5 | Was the time interval stated? | Time interval stated | - | Time interval not stated | - |
6 | Were patients stable in interim period on the construct to be measured? | Patients were stable (evidence provided) | Assumable that patients were stable | Unclear whether patients were stable | Patients were not stable |
7 | Was the time interval appropriate? | Time interval between test-retest ranges from 3 to 21 days | - | Doubtful whether time interval was appropriate | Time interval between test-retest is less than 3 or more than 21 days |
8 | Were the tests conditions similar for both measurements? e.g., type of administration, environment, and instructions | Test conditions were similar (evidence provided) | Assumable that test conditions were similar | Unclear whether test conditions were similar | Test conditions were not similar |
9 | Were there any important flaws in the design or methods of the study? | No other important methodological flaws in the design or execution of the study | - | Other minor methodological flaws in the design or execution of the study | Other important methodological flaws in the design or execution of the study |
10 | For continuous scores: Was ICC calculated? | ICC calculated and model or formula of the ICC is described | ICC calculated but model or formula of the ICC not described. Pearson or Spearman correlation coefficient calculated with evidence provided that no systematic change has occurred | Pearson or Spearman correlation coefficient calculated without evidence provided that no systematic change has occurred or with evidence that systematic change has occurred | No ICC or Pearson or Spearman correlations calculated |
11 | For dichotomous/ nominal/ordinal scores: Was kappa calculated? | Kappa calculated | - | - | Only percentage agreement calculated |
Synthesis of primary studies
Results
Literature search
Inter-rater reliability | Intra-rater reliability | Test-retest reliability | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Authors | Population | Health status of subjects | Effort levels assessed | Type of monitoring | Expertise of observers | Range of included items | Weight handling and strength | Weight handling and strength | Weight handling and strength | Posture and mobility | Locomotion | Balance |
Smith [19] |
n: 21 subjects (126 taped procedures); Age: 40 years (22–61); Sex: 16 M, 5 F; r: 5 raters; Country: USA | Low back pain | Maximal safe performance | Video monitoring | Trained | Lifting low | POA: 81-82%; κ: 0.62-0.64 | POA: 87%; κ: 0.73 | ||||
Gardener and McKenna [20] |
n: 30 subjects (144 taped procedures); Age: 31 years (20–30); Sex: 10 M, 20 F; r: 5 raters; Country: Australia | Unclear | Maximal safe performance | Video monitoring | Trained | Lifting low | POA: 86-94%; κ: 0.56-0.82 | |||||
Gross and Battie [23] |
n: 28 subjects; Age: 41 years (23–62); Sex: 20 M, 8 F; r: 5 raters; Country: Canada | Low back pain | Maximal safe performance | Direct supervision | Trained | Lifting low, lifting high, short carry two-handed, long carry two-handed, long carry left-handed, long carry right-handed | ICC: 0.95-0.98 | ICC: 0.78-0.94 | ||||
Reneman et al. [24] |
n: 4 subjects (104 taped procedures); Age: 20–30 years; Sex: 2 M, 2 F; r: 5 raters; Country: Netherland | Healthy | Light, moderate, heavy and maximal safe performance | Video monitoring | Trained | Lifting low, lifting high, short carry two-handed, long carry two-handed, long carry left-handed, long carry right-handed | POA: 87-96% | POA: 93-97% | ||||
Reneman et al. [25] |
n: 50 subjects; Age: 38.8 (28–52); Sex: 39 M, 11 F; Country: Netherland | Chronic low back pain | Maximal safe performance | Direct supervision | Trained | Lifting low, lifting high, short carry two-handed | ICC: 0.77-0.87 | |||||
Brouwer et al. [12] |
n: 30 subjects; Age: 40 years; Sex: 24 M, 6 F; Country: Netherland | Chronic low back pain | Maximal safe performance | Direct supervision | Trained | Complete WWS protocol except for grip strength and hand coordination | ICC: 0.75-0.87; POA: 100% | ICC: 0.36-0.96; POA: 78-100%; κ: 0.51-1.00 | ICC: 0.84; POA: 78-85%; κ: 0.25-0.56 | POA: 96% | ||
Reneman et al. [26] |
n: 26 subjects; Age: 34.9 years; Sex: 14 M, 12 F; Country: Netherland | Healthy | Maximal safe performance | Direct supervision | Trained | Complete WWS protocol except for grip strength and hand coordination | ICC: 0.68-0.98; POA: 100% | ICC: 0.54-0.93; POA: 79-100%; κ: 0.57-1.00 | ICC: 0.64; POA: 85-100%; κ: 0.69 | POA: 100% | ||
Reneman et al. [28] |
n: 15 subjects (71 taped procedures); Age: 29.5 years (18–53); Sex: 7 M, 8 F; r: 9 raters; Country: Netherland | Healthy | Light, moderate, heavy and maximal safe performance | Video monitoring | Trained | Lifting low | κ: 0.58 | |||||
n: 16 subjects (63 taped procedures); Age: 39.6 years (27–50); Sex: 12 M, 4 F; r: 9 raters; Country:Netherland | Chronic low back pain | Light, moderate, heavy and maximal safe performance | Video monitoring | Trained | Lifting low | κ: 0.50 | ||||||
Soer et al. [29] |
n: 33 subjects; Age: 29.2 years; Sex: 14 M, 19 F; Country: Netherland | Healthy | Maximal safe performance | Direct supervision | Trained | Lifting high, grip strength right, grip strength left, overhead work | ICC: 0.86-0.92 | ICC: 0.90 | ||||
van Ittersum et al. [30] |
n: 79 subjects; Age: 56.6 years (45–65); Sex: 15% M, 85% F; Country: Netherland | Osteoarthritis (hip and/or knee) | Maximal safe performance | Direct supervision | Trained | Lifting low, lifting high, short carry two-handed | ICC: 0.75-0.88 | |||||
Trippolini et al. [32] |
n: 32 subjects; Age: 36.9 years (18–65); Sex: 21 M, 11 F; Country: Switzerland | Whiplash-associated disorders | Maximal safe performance | Direct supervision | Trained | Lifting low, lifting high, short carry two-handed, long carry left-handed, long carry right-handed, grip strength right, grip strength left, overhead work | ICC: 0.66-0.96 | ICC: 0.83 |
Methodological quality assessment
Authors | Methodological quality by type of reliability | |||
---|---|---|---|---|
Inter-rater | Intra-rater or test-retest | |||
Methodological quality | Worst scores | Methodological quality | Worst scores | |
Smith [19] | Good | 4) Assumable that the measurements were independent | Poor | 7) Time interval not appropriate |
Gardener and McKenna [20] | Good | 8) Assumable that test conditions were similar | ||
Gross and Battie [23] | Poor | 3) Small sample size (< 30) | Poor | 3) Small sample size (< 30) |
7) Time interval not appropriate | ||||
Reneman et al. [24] | Poor | 11) Only percentage agreement calculated | Poor | 7) Time interval not appropriate; |
11) Only percentage agreement calculated | ||||
Reneman et al. [25] | Poor | 7) Time interval not appropriate | ||
Brouwer et al. [12] | Poor | 6) Patients were not stable | ||
Reneman et al. [26] | Poor | 3) Small sample size (< 30) | ||
Reneman et al. [28]a
| Good | 3) Good sample size (50–99)c
| ||
Reneman et al. [28]b
| Good | 3) Good sample size (50–99)c
| ||
Soer et al. [29] | Fair | 3) Moderate sample size (30–49) | ||
van Ittersum et al. [30] | Poor | 7) Time interval not appropriate | ||
Trippolini et al. [32] | Fair | 3) Moderate sample size (30–49) |
Inter-rater reliability
Weight handling and strength
Synthesis of results
Intra-rater reliability
Weight handling and strength
Synthesis of results
Test-retest reliability
Weight handling and strength
Synthesis of results
Posture and mobility
All studies | Level of methodological quality | ||||||||
---|---|---|---|---|---|---|---|---|---|
Poor | Fair to good | ||||||||
Acceptable | Total | % Acceptable | Acceptable | Total | % Acceptable | Acceptable | Total | % Acceptable | |
Inter-rater reliability
| |||||||||
Weight-handling and strength | |||||||||
ICC | 6 | 6 | 100.0% | 6 | 6 | 100.0% | |||
κ | 3 | 6 | 50.0% | 3 | 6 | 50.0% | |||
POA | 16 | 16 | 100.0% | 12 | 12 | 100.0% | 4 | 4 | 100.0% |
Total | 25 | 28 | 89.3% | 18 | 18 | 100.0% | 7 | 10 | 70.0% |
Intra-rater reliability
| |||||||||
Weight-handling and strength | |||||||||
κ | 1 | 1 | 100.0% | 1 | 1 | 100.0% | |||
POA | 7 | 7 | 100.0% | 7 | 7 | 100.0% | |||
Total | 8 | 8 | 100.0% | 8 | 8 | 100.0% | |||
Test-retest reliability
| |||||||||
Weight-handling and strength | |||||||||
ICC | 42 | 44 | 95.5% | 33 | 34 | 97.1% | 9 | 10 | 90.0% |
POA | 4 | 4 | 100.0% | 4 | 4 | 100.0% | |||
Total | 46 | 48 | 95.8% | 37 | 38 | 97.4% | 9 | 10 | 90.0% |
Posture and mobility | |||||||||
ICC | 5 | 17 | 29.4% | 3 | 15 | 20.0% | 2 | 2 | 100.0% |
κ | 10 | 14 | 71.4% | 10 | 14 | 71.4% | |||
POA | 22 | 24 | 91.7% | 22 | 24 | 91.7% | |||
Total | 37 | 55 | 67.3% | 35 | 53 | 66.0% | 2 | 2 | 100.0% |
Locomotion | |||||||||
ICC | 1 | 2 | 50.0% | 1 | 2 | 50.0% | |||
κ | 1 | 3 | 33.3% | 1 | 3 | 33.3% | |||
POA | 3 | 4 | 75.0% | 3 | 4 | 75.0% | |||
Total | 5 | 9 | 55.6% | 5 | 9 | 55.6% | |||
Balance
| |||||||||
POA | 2 | 2 | 100.0% | 2 | 2 | 100.0% | |||
Total | 2 | 2 | 100.0% | 2 | 2 | 100.0% | |||
Total test-retest reliability | 90 | 114 | 78.9% | 79 | 102 | 77.5% | 11 | 12 | 91.7% |
Overall reliability statistics
| 123 | 150 | 82.0% | 105 | 128 | 82.0% | 18 | 22 | 81.8% |