J.M.H. Schellekens

Concurrent Validity of Questionnaire and Performance-Based Disability Measurements in Patients with Chronic Nonspecific Low Back Pain

This study aimed to investigate the concurrent validity of two approaches to disability measurement in patients with chronic nonspecific low back pain (CLBP). It was hypothesized that if both are measuring the same construct, the instruments would lead to similar disability results and would correlate strongly (r > 0.75). The study compared the results of self-reported and performance-based measures of disability in 64 consecutive patients with CLBP. Participants mean age was 38.0 years, the mean duration of the current episode of back pain 9.9 months, and 90% were off work due to CLBP. The self-report measures used were: the Roland Disability Questionnaire (Roland); the Oswestry Disability Questionnaire (Oswestry); and the Quebec Back Pain Disability Questionnaire (Quebec). Performance was measured using the Isernhagen Work Systems Functional Capacity Evaluation (FCE). The mean scores from the self-report measure are as follows: Roland 13.5 (scale 0–24), Oswestry 28.2 (scale 0–100), Quebec 37.8 (scale 0–100) consistent with moderate to severe disability. In contrast the results from the performance-based measures suggested that the subjects should be able to work at a physical intensity level of moderate to heavy. Little to moderate correlation was observed between the self-report and performance-based measures (Spearman rank correlations: Roland-FCE (−0.20), p > 0.05; Oswestry-FCE (−0.52), p < 0.01; Quebec-FCE (−0.50), p < 0.01). Results are interpreted to suggest that both performance-based and self-report measures of disability should be used in order to obtain a comprehensive picture of the disability in patients with CLBP.

Matching FCE Activities and Work Demands: An Explorative Study

Objectives: to explore to what extent the standardized Isernhagen Work Systems Functional Capacity Evaluation (IWS FCE) can be matched with observed work demands in workers with chronic low back pain, and, secondly, to explore whether this match can predict sick leave in the year after rehabilitation treatment. Methods: An explorative prognostic cohort study with a one-year follow-up (four, eight and twelve months after baseline) was performed (n = 18). Demographics, back complaints and FCE performance were assessed at baseline. In addition, a workplace assessment (WPA) was performed. Eleven FCE activities were matched with work demands. Sick leave associated with low back pain and physical and psychosocial work demands were assessed during follow-up. Results: Seven activities could be directly matched with WPA data. (Carrying, pushing, pulling, crouching, kneeling, static forward bending, and dynamic bending and rotating.) For some workers, difficulties existed in matching three of the activities (pushing, pulling and crouching). One activity (lifting) could indirectly be matched with WPA data. One activity (walking) could not be matched with WPA data. Two activities (sitting, standing) were excluded from analyses due to practical limitations. No relation was found between FCE performance, work demands, and sick leave during follow-up. Conclusions: Seven FCE activities could be directly matched with work demands. However, not all observed work demands could be matched with IWS FCE activities in the eighteen occupations studied. This quantitative and standardized way of assessing work-related disability is not sufficient to predict work ability and sick leave at the present time.

Prediction of Musculoskeletal Discomfort in a Pick and Place Task (A pilot study)

A pilot study was conducted regarding the effects of working posture, handling frequency, and task duration on musculoskeletal discomfort. Participants rated their discomfort perceived while performing a repetitive task at 8 different combinations of manipulations. Pauses between the work periods lasted 15 min. Discomfort was rated according to Borgs category-ratio scale CR-10 and postures were recorded by an optoelectronic movement registration system. From linear multiple regression analysis equations for predicting discomfort at various body regions were obtained. Coefficients of determination especially point to trunk inclination and handling frequency as major determinants of musculoskeletal discomfort.

Sociaal-medische beoordeling van arbeidsvermogen vanuit een participatiegerichte benadering

SamenvattingIn de sociale zekerheid is een verschuiving gaande van een compensatiemodel naar een participatiemodel. Dit betekent dat de verzorgingsstaat, waarin het uitgangspunt is om mensen die niet in staat zijn aan arbeid deel te nemen, financieel te compenseren, wordt verlaten. Uitgangspunt wordt nu een maatschappij waarin iedereen naar vermogen meedoet, bij voorkeur door het verrichten van betaalde arbeid. Uiteindelijk doel is een stelsel van werk, scholing en inkomen dat werknemers ondersteunt bij het op peil houden en ontwikkelen van hun competenties.