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Bieleman HJ, Rijken NHM, Reneman MF, Oosterveld FGJ, Soer R. Changes in kinematics and work physiology during progressive lifting in healthy adults. Appl Ergon 2021; 94:103396. [PMID: 33667899 DOI: 10.1016/j.apergo.2021.103396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE To analyze progression of changes in kinematics and work physiology during progressive lifting in healthy adults. METHODS Healthy participants were recruited. A standardized lifting test from the WorkWell Functional Capacity Evaluation (FCE) was administered, with five progressive lifting low series of five repetitions. The criteria of the WorkWell observation protocol were studied: changes in muscle use (EMG), heart rate (heart rate monitor), base of support, posture and movement pattern (motion capture system). Repeated measures ANOVA's were used to analyze changes during progressive workloads. RESULTS 18 healthy young adults participated (8 men, 10 women; mean age 22 years). Mean maximum weight lifted was 66 (±3.2) and 44 (±7.4) kg for men and women, respectively. With progressive loads, statistically significant (p < 0.01) differences were observed: increase in secondary muscle use at moderate lifting, increase of heart rate, increase of base of support and movement pattern changes were observed; differences in posture were not significant. CONCLUSIONS Changes in 4 out of 5 kinematic and work physiology parameters were objectively quantified using lab technology during progressive lifting in healthy adults. These changes appear in line with existing observation criteria.
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Affiliation(s)
- Hendrik J Bieleman
- Saxion University of Applied Sciences, Faculty of Health and Movement, Enschede, the Netherlands.
| | - Noortje H M Rijken
- Saxion University of Applied Sciences, Faculty of Health and Movement, Enschede, the Netherlands
| | - Michiel F Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Frits G J Oosterveld
- Saxion University of Applied Sciences, Faculty of Health and Movement, Enschede, the Netherlands
| | - Remko Soer
- Saxion University of Applied Sciences, Faculty of Health and Movement, Enschede, the Netherlands; University of Groningen, University Medical Center Groningen, Pain Center, Groningen, the Netherlands
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Swift MC, Townsend R, Edwards D, Loudon JK. Testing to Identify Submaximal Effort: Lifting to a Perceived 50% Effort vs. an Assigned Submaximal Load. J Strength Cond Res 2020; 36:2115-2120. [PMID: 32282531 DOI: 10.1519/jsc.0000000000003586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Swift, MC, Townsend, R, Edwards, D, and Loudon, J. Testing to identify submaximal effort: Lifting to a perceived 50% effort vs. an assigned submaximal load. J Strength Cond Res XX(X): 000-000, 2020-The ability to accurately measure effort during postinjury functional testing allows for the validation of displayed physical limitations by injured workers. The Cross-Reference Testing System (XRTS) has been developed to identify submaximal efforts through distraction-based dynamic material handling testing. The XRTS material handling assessment compares dynamic lifts of weights in a crate and lifts using a lever arm device. The purpose of this study was to determine whether subjects lifting an assigned submaximal load influence test results compared with subjects lifting to but not exceeding a 50% perceived effort. Subjects in group A (n = 35) were assigned the condition to attempt to lift to but not exceed a randomly assigned weight value for both the crate lift and XRTS at 3 lifting heights. Subjects in group B (n = 32) were asked to lift to but not exceed 37.5 lb from the same 3 lifting heights. The reproducibility of effort was measured with current validity criteria for distraction-based material handling testing. Using the percent difference values, a 2 × 3 (group, lifting height) analysis of variance (ANOVA) was performed to test the hypothesis. The alpha level was set at 0.05. The mean percent change between comparative lifts was 31.13%, 95% CI (22.51-39.75) for group A and 29.26% 95% CI (21.91-36.61) for group B. The 2 × 3 ANOVA demonstrated no significant difference (p = 0.751) between groups. The results indicate attempting to lift to a perceived 50% effort was not significantly different from attempting to lift to but not exceed an assigned submaximal load.
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Affiliation(s)
- Marcie C Swift
- Department of Physical Therapy, Rockhurst University, Kansas City, Missouri
| | | | | | - Janice K Loudon
- Department of Physical Therapy, Rockhurst University, Kansas City, Missouri
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van der Laan TMJ, Postema SG, Reneman MF, Bongers RM, van der Sluis CK. Development and reliability of the rating of compensatory movements in upper limb prosthesis wearers during work-related tasks. J Hand Ther 2020; 32:368-374. [PMID: 29439843 DOI: 10.1016/j.jht.2017.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 12/22/2017] [Accepted: 12/27/2017] [Indexed: 02/09/2023]
Abstract
STUDY DESIGN Reliability study. INTRODUCTION Quantifying compensatory movements during work-related tasks may help to prevent musculoskeletal complaints in individuals with upper limb absence. PURPOSE OF THE STUDY (1) To develop a qualitative scoring system for rating compensatory shoulder and trunk movements in upper limb prosthesis wearers during the performance of functional capacity evaluation tests adjusted for use by 1-handed individuals (functional capacity evaluation-one handed [FCE-OH]); (2) to examine the interrater and intrarater reliability of the scoring system; and (3) to assess its feasibility. METHODS Movement patterns of 12 videotaped upper limb prosthesis wearers and 20 controls were analyzed. Compensatory movements were defined for each FCE-OH test, and a scoring system was developed, pilot tested, and adjusted. During reliability testing, 18 raters (12 FCE experts and 6 physiotherapists/gait analysts) scored videotapes of upper limb prosthesis wearers performing 4 FCE-OH tests 2 times (2 weeks apart). Agreement was expressed in % and kappa value. Feasibility (focus area's "acceptability", "demand," and "implementation") was determined by using a questionnaire. RESULTS After 2 rounds of pilot testing and adjusting, reliability of a third version was tested. The interrater reliability for the first and second rating sessions were к = 0.54 (confidence interval [CI]: 0.52-0.57) and к = 0.64 (CI: 0.61-0.66), respectively. The intrarater reliability was к = 0.77 (CI: 0.72-0.82). The feasibility was good but could be improved by a training program. DISCUSSION It seems possible to identify compensatory movements in upper limb prosthesis wearers during the performance of FCE-OH tests reliably by observation using the developed observational scoring system. CONCLUSIONS Interrater reliability was satisfactory in most instances; intrarater reliability was good. Feasibility was established.
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Affiliation(s)
- Tallie M J van der Laan
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Sietke G Postema
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Raoul M Bongers
- University of Groningen, University Medical Center Groningen, Center of Human Movement Sciences, Groningen, The Netherlands
| | - Corry K van der Sluis
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Abstract
RESUMO O objetivo foi estimar a prevalência de incapacidade para realizar tarefas de vida diária e identificar associação com dor e fatores sociodemográficos. Trata-se de um estudo transversal, com amostra de conveniência, composta por indivíduos que buscaram ativamente assistência à saúde em um município de pequeno porte com queixas de dor musculoesquelética e dificuldades na realização de atividades de vida diária. Compuseram a amostra 766 indivíduos. Foram aplicados questionários para avaliar o grau de dificuldade de realização de atividades de vida diária e dor (Questionário Nórdico de Queixas Musculoesqueléticas e Escala Numérica de Dor). Foram estimadas as prevalências de incapacidade e dor, bem como foram construídos cinco modelos de regressão logística para incapacidade considerando sexo, idade, ocupação e presença e características da dor. Os dados encontrados mostraram que a prevalência de alguma dificuldade para realizar atividades de vida diária foi de 87,6%, de muita dificuldade 66,1%; a de dor musculoesquelética foi de 67,5%. Os indivíduos apresentaram incapacidade para realização de 3,6 atividades de vida diária em média. A dor foi o principal fator de associação para explicá-la (OR 9,9; IC95% 5,9-16,5), seguida da idade. A dificuldade na execução de atividades de vida diária foi associada à dor em membros inferiores, com frequência maior que quatro dias na semana, início há mais de cinco anos e intensidade forte ou insuportável nos episódios de crise. As prevalências de incapacidade e dores foram altas. A dor musculoesquelética e a idade impactaram na incapacidade funcional. Este estudo contribui para direcionar a construção de ações de cuidado que visem minimizar e prevenir dificuldades para realizar tarefas do dia a dia.
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Ansuategui Echeita J, Bethge M, van Holland BJ, Gross DP, Kool J, Oesch P, Trippolini MA, Chapman E, Cheng ASK, Sellars R, Spavins M, Streibelt M, van der Wurff P, Reneman MF. Functional Capacity Evaluation in Different Societal Contexts: Results of a Multicountry Study. J Occup Rehabil 2019; 29:222-236. [PMID: 29802582 PMCID: PMC6510856 DOI: 10.1007/s10926-018-9782-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Purpose To examine factors associated with Functional Capacity Evaluation (FCE) results in patients with painful musculoskeletal conditions, with focus on social factors across multiple countries. Methods International cross-sectional study was performed within care as usual. Simple and multiple multilevel linear regression analyses which considered measurement's dependency within clinicians and country were conducted: FCE characteristics and biopsychosocial variables from patients and clinicians as independent variables; and FCE results (floor-to-waist lift, six-minute walk, and handgrip strength) as dependent variables. Results Data were collected for 372 patients, 54 clinicians, 18 facilities and 8 countries. Patients' height and reported pain intensity were consistently associated with every FCE result. Patients' sex, height, reported pain intensity, effort during FCE, social isolation, and disability, clinician's observed physical effort, and whether FCE test was prematurely ended were associated with lift. Patient's height, Body Mass Index, post-test heart-rate, reported pain intensity and effort during FCE, days off work, and whether FCE test was prematurely ended were associated with walk. Patient's age, sex, height, affected body area, reported pain intensity and catastrophizing, and physical work demands were associated with handgrip. Final regression models explained 38‒65% of total variance. Clinician and country random effects composed 1-39% of total residual variance in these models. Conclusion Biopsychosocial factors were associated with every FCE result across multiple countries; specifically, patients' height, reported pain intensity, clinician, and measurement country. Social factors, which had been under-researched, were consistently associated with FCE performances. Patients' FCE results should be considered from a biopsychosocial perspective, including different social contexts.
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Affiliation(s)
- Jone Ansuategui Echeita
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.002, 9750 RA, Haren, Groningen, The Netherlands.
| | - Matthias Bethge
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Berry J van Holland
- Institute for Sports Studies, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada
| | - Jan Kool
- Rehabilitation Centre Valens, Valens, Switzerland
| | - Peter Oesch
- Rehabilitation Centre Valens, Valens, Switzerland
| | - Maurizio A Trippolini
- Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, Boston, USA
- PhD in Rehabilitation Sciences Program, Institute for Health Professions, Massachusetts General Hospital (MGH), Charlestown, Boston, USA
- Department of Work Rehabilitation, Rehaklinik Bellikon, Suva Care, Bellikon, Switzerland
| | | | - Andy S K Cheng
- Ergonomics and Human Performance Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | | | | | - Marco Streibelt
- Department of Rehabilitation, German Federal Pension Insurance, Berlin, Germany
| | - Peter van der Wurff
- Research & Development, Military Rehabilitation Center Aardenburg, Doorn, The Netherlands
- Institute for Human Movement Studies, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.002, 9750 RA, Haren, Groningen, The Netherlands
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Abstract
Purpose: This work generates a comprehensive description of upper extremity and torso kinematics of a healthy population during reaching and dexterity Functional Capacity Evaluation (FCE) tasks. Methods: Upper limb and torso kinematic data were collected from 30 young, healthy participants as they performed three common FCE tasks: repetitive reaching, fingertip dexterity, and hand and forearm dexterity. Kinematic profiles were created for all clinically relevant angles of the torso, shoulder, elbow, and wrist. Results: These provocative tasks require large ranges of motion and create high demand postures for the upper limb, specifically at the shoulder. Arm elevation was up to 90°, while humeral internal rotation of 25° was observed. Torso angles were typically below 30° from neutral and elbow flexion remained within 90°–120° for nearly all tasks. Wrist ulnar deviation ranged from 0° to 26° for both wrists. Conclusion: The normative data created in this investigation provide a description of healthy motion during reaching and dexterity tasks. These normative curves are the initial step towards understanding movement that would contraindicate return to work during an FCE. This work supports a future clinical goal of being able to identify persons at risk of further injury or disability if returned to work too early.
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Affiliation(s)
- Angelica E. Lang
- Department of Health Science, University of Saskatchewan, Saskatoon, Canada
| | - Clark R. Dickerson
- Faculty of Applied Health Sciences, Department of Kinesiology, University of Waterloo, Waterloo, Canada
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Lang AE, Dickerson CR. Task intensity influences upper limb and torso kinematics during two common overhead Functional Capacity Evaluation tasks. Work 2017; 58:121-134. [DOI: 10.3233/wor-172614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Angelica E. Lang
- Department of Health Sciences, University of Saskatchewan, Saskatoon, SK, Canada
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Abstract
BACKGROUND In Canada, functional capacity evaluations (FCEs) are commonly administered by several health care professions including kinesiologists. Kinesiologists have been recently regulated as health care professionals in Ontario and we know little about their demographics, the frequency of FCE administration, or the types of FCEs used by this group. OBJECTIVE The purposes of this study were to identify: 1) the demographic characteristics and FCE education of kinesiology FCE practitioners; 2) the FCE systems most used by these practitioners and 3) the constructs from assessments used to determine functional capacity. METHODS A survey was distributed to members of the Canadian Kinesiology Alliance. Descriptive statistics and frequency distributions were calculated from the survey responses (n = 77). RESULTS FCE practitioners were represented by kinesiologists (79%) practicing more than 15 years and 1-5 years, who received FCE training from a certification course. ARCON (23%) was the most common FCE system used. Low-level lifting (43%), mid-lift (38%), pulling (38%) and walking (38%) are the most common FCE task components used to assess functional capacity. Although kinesiologists consider multiple factors when making decisions about task component endpoints, biomechanical observations/body mechanics are the primary methods used. CONCLUSIONS Kinesiologists are conducting FCEs for the primary purpose of preparing return-to-work or workplace accommodation recommendations. Although functional capacity is determined using multiple factors, there is an emphasis on biomechanics and body mechanics. Focusing FCE training and research on these constructs may provide opportunities to further strengthen the reliability and validity of FCE outcomes.
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Affiliation(s)
- Kathryn E Sinden
- School of Kinesiology, Lakehead University, Thunder Bay, ON, Canada
| | | | | | - Steven L Fischer
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
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Turk DC, Fillingim RB, Ohrbach R, Patel KV. Assessment of Psychosocial and Functional Impact of Chronic Pain. The Journal of Pain 2016; 17:T21-49. [DOI: 10.1016/j.jpain.2016.02.006] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/08/2016] [Accepted: 02/16/2016] [Indexed: 12/20/2022]
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Meyer K, Klipstein A, Oesch P, Jansen B, Kool J, Niedermann K. Development and Validation of a Pain Behavior Assessment in Patients with Chronic Low Back Pain. J Occup Rehabil 2016; 26:103-113. [PMID: 26149617 DOI: 10.1007/s10926-015-9593-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE High levels of pain behavior adversely affect the success of multidisciplinary rehabilitation of patients with chronic nonspecific low back pain (CNSLBP). Functional capacity evaluation (FCE) assessment should detect high levels of pain behavior to prevent the inclusion of unsuitable patients to functional rehabilitation programs. The aim of this study was to develop a Pain Behavior Assessment (PBA) and to evaluate its construct validity. METHODS The PBA was developed by experts in the field and is literature-based. Inclusion criteria for participants of the validation study were: CNSLBP, age 20-60 years, referral for fitness-for-work evaluation. The PBA was applied by physiotherapists during FCE. Rasch analysis was performed to evaluate the construct validity of the PBA. Internal consistency was indicated by the person separation index (PSI), which corresponds to Cronbach's alpha. RESULTS 145 male (72.5%) and 55 female patients were included. Rasch analysis removed 11 items due to misfit and redundancy, resulting in a final PBA of 41 items. Item mean fit residual was -0.33 (SD 1.06) and total item Chi square 100.39 (df = 82, p = 0.08). The PSI value was 0.83. DIF analysis for age and gender revealed no bias. CONCLUSIONS The PBA is a valid assessment tool to describe pain behavior in CNSLBP patients. The high PSI-value justifies the use of the PBA in individuals. The PBA may help to screen patients for high levels of pain behavior.
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Affiliation(s)
- Katharina Meyer
- Physiotherapy and Occupational Therapy, University Hospital Zurich, U OST 153, Gloriastr. 25, 8091, Zurich, Switzerland.
| | - Andreas Klipstein
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland.
- Center of Occupational Health, Militärstrasse 76, 8004, Zurich, Switzerland.
| | - Peter Oesch
- Research Department and Department of Rheumatology, Rehabilitation Centre Valens, 7317, Valens, Switzerland.
| | - Beatrice Jansen
- Department of Work Rehabilitation, Rehaklinik Bellikon, Suva Care, 5454, Bellikon, Switzerland.
| | - Jan Kool
- Research Department and Department of Rheumatology, Rehabilitation Centre Valens, 7317, Valens, Switzerland.
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, 8400, Winterthur, Switzerland.
| | - Karin Niedermann
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, 8400, Winterthur, Switzerland.
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James CL, Reneman MF, Gross DP. Functional Capacity Evaluation Research: Report from the Second International Functional Capacity Evaluation Research Meeting. J Occup Rehabil 2016; 26:80-83. [PMID: 26108156 DOI: 10.1007/s10926-015-9589-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Functional capacity evaluations are an important component of many occupational rehabilitation programs and can play a role in facilitating reintegration to work thus improving health and disability outcomes. The field of functional capacity evaluation (FCE) research has continued to develop over recent years, with growing evidence on the reliability, validity and clinical utility of FCE within different patient and healthy worker groups. The second International FCE Research Conference was held in Toronto, Canada on October 2nd 2014 adjacent to the 2014 Work Disability Prevention Integration conference. This paper describes the outcomes of the conference. REPORT Fifty-four participants from nine countries attended the conference where eleven research projects and three workshops were presented. The conference provided an opportunity to discuss FCE practice, present new research and provide a forum for discourse around the issues pertinent to FCE use. Conference presentations covered aspects of FCE use including the ICF-FCE interface, aspects of reliability and validity, consideration of specific injury populations, comparisons of FCE components and a lively debate on the merits of 'Man versus Machine' in FCE's. FUTURE DIRECTIONS Researchers, clinicians, and other professionals in the FCE area have a common desire to improve the content and quality of FCE research and to collaborate to further develop research across systems, cultures and countries.
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Affiliation(s)
- C L James
- School of Health Sciences, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - M F Reneman
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - D P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada
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Trippolini MA, Dijkstra PU, Côté P, Scholz-Odermatt SM, Geertzen JH, Reneman MF. Can Functional Capacity Tests Predict Future Work Capacity in Patients With Whiplash-Associated Disorders? Arch Phys Med Rehabil 2014; 95:2357-66. [DOI: 10.1016/j.apmr.2014.07.406] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 06/30/2014] [Accepted: 07/16/2014] [Indexed: 11/17/2022]
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Bieniek S, Bethge M. The reliability of WorkWell Systems Functional Capacity Evaluation: a systematic review. BMC Musculoskelet Disord 2014; 15:106. [PMID: 24674029 DOI: 10.1186/1471-2474-15-106] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 03/19/2014] [Indexed: 11/23/2022] Open
Abstract
Background Functional capacity evaluation (FCE) determines a person’s ability to perform work-related tasks and is a major component of the rehabilitation process. The WorkWell Systems (WWS) FCE (formerly known as Isernhagen Work Systems FCE) is currently the most commonly used FCE tool in German rehabilitation centres. Our systematic review investigated the inter-rater, intra-rater and test-retest reliability of the WWS FCE. Methods We performed a systematic literature search of studies on the reliability of the WWS FCE and extracted item-specific measures of inter-rater, intra-rater and test-retest reliability from the identified studies. Intraclass correlation coefficients ≥ 0.75, percentages of agreement ≥ 80%, and kappa coefficients ≥ 0.60 were categorised as acceptable, otherwise they were considered non-acceptable. The extracted values were summarised for the five performance categories of the WWS FCE, and the results were classified as either consistent or inconsistent. Results From 11 identified studies, 150 item-specific reliability measures were extracted. 89% of the extracted inter-rater reliability measures, all of the intra-rater reliability measures and 96% of the test-retest reliability measures of the weight handling and strength tests had an acceptable level of reliability, compared to only 67% of the test-retest reliability measures of the posture/mobility tests and 56% of the test-retest reliability measures of the locomotion tests. Both of the extracted test-retest reliability measures of the balance test were acceptable. Conclusions Weight handling and strength tests were found to have consistently acceptable reliability. Further research is needed to explore the reliability of the other tests as inconsistent findings or a lack of data prevented definitive conclusions.
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