L.N.H. Göeken

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.

Test-retest reliability of the Isernhagen Work Systems Functional Capacity Evaluation in patients with chronic low back pain

The aim of this study was to investigate test–retest reliability of the Isernhagen Work System Functional Capacity Evaluation (IWS FCE) in a sample of patients (n = 30) suffering from Chronic Low Back Pain (CLBP) and selected for rehabilitation treatment. The IWS FCE consists of 28 tests that reflect work-related activities like lifting, carrying, bending, etc. In this study, a slightly modified IWS FCE was used. Patients were included in the study if they were still at work or were less than 1 year out of work because of CLBP. Participants mean age was 40 years, the duration of low back pain ranged between 5 and 10 years. Fifteen patients (50%) were out of work for a mean of 17 weeks, and they all received financial compensation. Two FCE sessions were held with a 2-week interval in between. Means per session, 95% confidence intervals of the mean difference, one-way random Intra Class Correlations (ICC), limits of agreement, Cohens kappa and percentage of absolute agreement were calculated where appropriate. An ICC of 0.75 or more, a kappa value of more than 0.60 and a percentage of absolute agreement of 80% were considered as an acceptable reliability. Tests of the IWC FCE were divided into tests with and tests without an acceptable test–retest reliability on the basis of the kappa values, the percentage of absolute agreement and the ICC values. Fifteen tests (79%) showed an acceptable test–retest reliability based on Kappa values and percentage of absolute agreement. Eleven tests (61%) showed an acceptable test–retest reliability based on ICC values.

Test-Retest Reliability of Lifting and Carrying in a 2-day Functional Capacity Evaluation

The objectives of this study were to establish test-retest reliability of lifting and carrying of a functional capacity evaluation (FCE) on two consecutive days and to verify the need for a 2-day protocol. A cohort of 50 patients (39 men, 11 women) with nonspecific low back pain were evaluated using a 2-day FCE protocol. Intraclass correlation coefficients (ICC) were calculated for weight lifted and carried. Predictive relationschips between test and retest were explored by means of a regression analysis. The results of ICC were lifting low 0.87, lifting overhead 0.87, and carrying 0.77. Performances on day 2 were on an average 6–9% higher. Other than the amount of weight handled on day 1, no variable was found to predict performance on day 2. It was concluded that test-retest reliability of lifting and carrying was good, and the need for a 2-day protocol could not be confirmed.

Measuring maximum holding times and perception of static elevated work and forward bending in healthy young adults.

The objectives of this study were to investigate the maximum holding times (MHT) of two highly stressful postures: standing in a forward bend position and performing elevated work in a standing position. The relationship between perceived exertion and MHT was also studied. Subjects were 44 young adults, age 20–29 years (25 female, 19 male). A test-retest design was used to establish reliability. Mean maximum holding times for forward bending and elevated work were respectively 14.51 and 16.18 min with large interindividual variations. A logarithmic rather than a linear relation between perceived exertion and performance is found. It is not possible to reliably predict MHTs from subjective data. Test-retest correlation is high (n = 19, r = 0.716 and 0.813, p < 0.001), and the scores did not differ significantly (p < 0.005), indicating a reliable procedure. The average holding times of the population studied are higher than expected from literature. Neither generic formulas, curve estimations, or predictions can reliably predict an individuals MHT. An individuals MHTs are best tested through performance based testing.

ONDERZOEK : Test-hertestbetrouwbaarheid van de 'Functionele mogelijkhedenlijst' en de 'Werk & Handicap Vragenlijst' ingevuld door de patiënt

SamenvattingDoel van het onderzoek was om de betrouwbaarheid van de Functionele mogelijkhedenlijst (FML) en de Werk & Handicap Vragenlijst (WHV) ingevuld door patiënten met aspecifieke chronische lage rugpijn binnen de revalidatiegeneeskunde te bepalen.Dertig patiënten (24 mannen, zes vrouwen) vulden de FML en WHV twee keer in met een tussenperiode van twee weken. Kappa’s, percentage absolute overeenstemming en ICC werden gebruikt als betrouwbaarheidsmaten.Vijf van de 26 items (19%) van de FML zijn betrouwbaar. Voor wat betreft de WHV zijn 15 van de 28 items (54%) van het ADL-gedeelte, drie van de 27 items (11%) van vraag 1 van het werkgedeelte en drie van de negen items (33%) van vraag 2 van het werkgedeelte betrouwbaar. Een ICCwaarde van 0,82 werd gevonden voor het ADL-gedeelte, 0,42 en 0,33 voor de werkgedeelten van de WHV. Geconcludeerd wordt dat de FML en de WHV, ingevuld door de patiënt, niet bruikbaar zijn.