Functional Capacity Evaluation Performance Does Not Predict Sustained Return to Work in Claimants With Chronic Back Pain

Objectives: Functional Capacity Evaluation (FCE) is used to determine return-to-work readiness. We investigated the ability of the Isernhagen Work Systems’ FCE to predict sustained return-to-work and future pain and disability in workers’ compensation claimants with chronic back pain. Methods: Prospective study of 130 claimants undergoing FCE for chronic back problems. FCE indicators included number of failed tasks and floor-to-waist lift weight. Recovery indicators included days to suspension of time-loss benefits and future recurrence. Subjects were contacted after one year to determine pain intensity and disability. Analysis included Cox and logistic regression. Results: Fewer failed tasks (HRR 0.94 (0.91–0.98) and higher floor-to-waist lift (HRR 1.38 (1.17–1.62) were associated with faster return-to-work. FCE was not associated with future recurrence, or reported pain intensity, or disability in subjects reached for follow-up. Conclusions: Better FCE performance was mildly associated with indicators of faster return-to-work. However, FCE is not related to recurrent back problems, future pain intensity, or self-reported disability.

[1]  M. Battié,et al.  Factors influencing results of functional capacity evaluations in workers' compensation claimants with low back pain. , 2005, Physical therapy.

[2]  P M King,et al.  A critical review of functional capacity evaluations. , 1998, Physical therapy.

[3]  J. R. Boston,et al.  Functional capacity assessment: Influence of behavioral and environmental factors. , 1996, Journal of back and musculoskeletal rehabilitation.

[4]  D. Hosmer,et al.  Applied Logistic Regression , 1991 .

[5]  Douglas G. Altman,et al.  Methodological challenges in the evaluation of prognostic factors in breast cancer. , 1998 .

[6]  Robert B. Keller,et al.  Measuring the Impact of Organizational Behaviors on Work Disability Prevention and Management , 2000, Journal of Occupational Rehabilitation.

[7]  M. Battié,et al.  The Prognostic Value of Functional Capacity Evaluation in Patients With Chronic Low Back Pain: Part 2: Sustained Recovery , 2004, Spine.

[8]  L. Gibson,et al.  Assessment of Psychosocial Factors in Functional Capacity Evaluation of Clients with Chronic Back Pain , 1998 .

[9]  J. Lackner,et al.  The relative influence of perceived pain control, anxiety, and functional self efficacy on spinal function among patients with chronic low back pain. , 1999, Spine.

[10]  M. Robinson,et al.  Psychosocial Factors and Functional Capacity Evaluation Among Persons with Chronic Pain , 2003, Journal of Occupational Rehabilitation.

[11]  J. Lackner,et al.  Pain expectancies, pain, and functional self-efficacy expectancies as determinants of disability in patients with chronic low back disorders. , 1996, Journal of consulting and clinical psychology.

[12]  P. V. Rao,et al.  Applied Survival Analysis: Regression Modeling of Time to Event Data , 2000 .

[13]  J. Garrett,et al.  Beyond the Good Prognosis: Examination of an Inception Cohort of Patients With Chronic Low Back Pain , 2000, Spine.

[14]  C. Velozo,et al.  Psychiatric DisorderEffects on Rehabilitation and Ability to Return to Work. , 1991, Work.

[15]  M. Battié,et al.  Construct Validity of a Kinesiophysical Functional Capacity Evaluation Administered Within a Worker's Compensation Environment , 2003, Journal of Occupational Rehabilitation.

[16]  S. Isernhagen.  Functional capacity evaluation: Rationale, procedure, utility of the kinesiophysical approach , 1992, Journal of Occupational Rehabilitation.

[17]  Chris G Maher,et al.  Acute low back pain: systematic review of its prognosis , 2003, BMJ : British Medical Journal.

[18]  G. Pransky,et al.  Methodological Challenges in Studying Recurrence of Low Back Pain , 2003, Journal of Occupational Rehabilitation.

[19]  L Rudolph,et al.  Duration of work disability after low back injury: a comparison of administrative and self-reported outcomes. , 1999, American journal of industrial medicine.

[20]  D. Cole,et al.  Listening to injured workers: how recovery expectations predict outcomes--a prospective study. , 2002, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[21]  S. Hogg-Johnson,et al.  The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplash. , 2001, Journal of clinical epidemiology.

[22]  Douglas P Gross,et al.  Reliability of safe maximum lifting determinations of a functional capacity evaluation. , 2002, Physical therapy.

[23]  P. Dijkstra,et al.  Test–Retest Reliability of the Isernhagen Work Systems Functional Capacity Evaluation in Patients with Chronic Low Back Pain , 2003, Journal of Occupational Rehabilitation.

[24]  S J Isernhagen,et al.  Guidelines for functional capacity evaluation of people with medical conditions. , 1993, The Journal of orthopaedic and sports physical therapy.

[25]  D. Lechner.  Functional Capacity Evaluation , 1998 .

[26]  M. Feuerstein,et al.  Biobehavioral factors affecting pain and disability in low back pain: mechanisms and assessment. , 1995, Physical therapy.

[27]  L.N.H. Göeken,et al.  Test-Retest Reliability of Lifting and Carrying in a 2-day Functional Capacity Evaluation , 2002, Journal of Occupational Rehabilitation.

[28]  M. Battié,et al.  The Prognostic Value of Functional Capacity Evaluation in Patients With Chronic Low Back Pain: Part 1: Timely Return to Work , 2004, Spine.

[29]  R. Brand,et al.  Alternative approaches for measuring duration of work disability after low back injury based on administrative workers' compensation data. , 1999, American journal of industrial medicine.

[30]  Raymond C. Tait,et al.  The Pain Disability Index: psychometric properties , 1990, Pain.

[31]  M. Roland,et al.  The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. , 2000, Spine.

[32]  L. Matheson,et al.  Relationships among lifting ability, grip force, and return to work. , 2002, Physical therapy.

[33]  Stanley Lemeshow,et al.  Applied Logistic Regression, Second Edition , 1989 .

[34]  G. Andersson.  Epidemiological features of chronic low-back pain , 1999, The Lancet.

[35]  D. Kleinbaum,et al.  Survival Analysis: A Self-Learning Text. , 1996 .