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Symptom Increase Following a Functional Capacity Evaluation in Patients with Chronic Low Back Pain: An Explorative Study of Safety

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Abstract

Introduction: This study was performed to study intensity and duration of symptom increase following an FCE and to explore safety of an FCE. Methods: Included were 92 patients with chronic low back pain (CLBP), mean age 38.5 years, mean self-reported disability 12.5 (Roland Morris Disability Questionnaire). All patients underwent an FCE. Symptom increase was measured with a 2-item questionnaire. Operational definition for safety: no formal complaint filed and symptom increase to occur only temporarily. Results: No formal complaints were filed (n=92). In total, 54 patients returned the questionnaire (59%; ‘responders’). Of the responders, 76% reported increased symptom intensity after an FCE, ranging from ‘little increase’ to ‘severe increase’. Symptoms of all responders returned to pre-FCE level. Duration of symptom increase of the responders ranged from 1 day to 3 weeks. Symptom increase resided to pre-FCE level within 1 week in 93% of the responders. Symptom increase was weakly related to self-reported disability (r=0.38, p<0.05). Except for gender, differences between responders and non-responders were non-significant. Conclusion: A temporary increase in symptom intensity following an FCE is common. Within the operational definitions of safety used in this study, assessment of functional capacity of patients with CLBP appears safe.

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Notes

  1. Isernhagen WorkWell Systems Inc., Duluth, Minnesota, USA.

References

  1. Hart DL, Isernhagen SJ, Matheson LN. Clinical commentary: guidelines for functional capacity evaluation of people with medical conditions. JOSPT 1993;18:682–6.

    PubMed  CAS  Google Scholar 

  2. Brouwer S, Reneman MF, Dijkstra PU, Groothoff JW, Schellekens JMH, Göeken LNH. Test-retest reliability of the Isernhagen Work Systems functional capacity evaluation in patients with chronic low back pain. J Occup Rehabil 2003;13:207–18.

    Article  PubMed  CAS  Google Scholar 

  3. Reneman MF, Brouwer S, Speelman-Meinema A, Dijkstra PU, Geertzen JHB, Groothoff JW. Test-retest reliability of the Isernhagen Work Systems functional capacity evaluation in healthy adults. J Occup Rehabil 2004;14:295–305.

    Article  PubMed  CAS  Google Scholar 

  4. Reneman MF, Dijkstra PU, Westmaas M, Göeken LNH. Test-retest reliability of lifting and carrying in a 2-day functional capacity evaluation. J Occup Rehabil 2002;12:269–76.

    Article  PubMed  CAS  Google Scholar 

  5. Gross DP, Battie MC. Reliability of safe maximum lifting determinations of a functional capacity evaluation. Phys Ther 2002;82:364–71.

    PubMed  Google Scholar 

  6. Reneman MF, Jorritsma W, Dijkstra SJ, Dijkstra PU. The relationship between kinesiophobia and performance in a Functional Capacity Evaluation. J Occup Rehabil 2003;13:277–85.

    Article  PubMed  Google Scholar 

  7. Reneman MF, Jorritsma W, Schellekens JMH, Göeken LNH. Concurrent validity of questionnaire and performance-based disability measurements in patients with chronic non-specific low back pain. J Occup Rehabil 2002;12:119–30.

    Article  PubMed  Google Scholar 

  8. Gross DP, Battie MC. The construct validity of a kinesiophysical functional capacity evaluation administered within a workers’ compensation environment. J Occup Rehabil 2003;13:287–95.

    Article  PubMed  Google Scholar 

  9. Smith RL. Therapists’ ability to identify safe maximum lifting in low back pain patients during functional capacity evaluation. JOSPT 1994;19:277–81.

    PubMed  CAS  Google Scholar 

  10. Gardener L, McKenna K. Reliability of occupational therapists in determining safe, maximal lifting capacity. Aus Occup Ther J 1999;46:110–9.

    Article  Google Scholar 

  11. Isernhagen SJ, Hart DL, Matheson LM. Reliability of independent observer judgements of level of lift effort in a kinesiophysical Functional Capacity Evaluation. WORK 1999;12:145–50.

    PubMed  Google Scholar 

  12. Reneman MF, Jaegers SMHJ, Westmaas M, Göeken LNH. The reliability of determining effort level of lifting and carrying in a functional capacity evaluation. WORK 2002;18:23–7.

    PubMed  CAS  Google Scholar 

  13. Gibson L, Strong J. Safety issues in functional capacity evaluation: findings from a trial of a new approach for evaluating clients with chronic back pain. J Occup Rehabil 2005;15:237–51.

    Article  PubMed  Google Scholar 

  14. Hart DL, Berlin S, Brager PE, Caruso M, Hejduk JF, Howar JM, Snyder KP, Susi JL, Wah MD. Development of clinical standards in industrial rehabilitation. JOSPT 1994;19:232–41.

    PubMed  CAS  Google Scholar 

  15. Hoogendoorn WE, van Poppel MNM, Bongers PM, Koes BW, Bouter LM. Physical load during work and leisure time as risk factors for low back pain: a systematic review. Scand Work Environ Health 1999;25:387–403.

    CAS  Google Scholar 

  16. Hoogendoorn WE, Bongers PM, de Vet HCW, Douwes M, Koes BW, Miedema MC, Ariens GA, Bouter LM. Flexion and rotation of the trunk and lifting at work are risk factors for low back pain: results of a prospective cohort study. Spine 2000;25:3087–92.

    Article  PubMed  CAS  Google Scholar 

  17. Gross DP, Battie MC. The prognostic value of functional capacity evaluation in patients with chronic low back pain: part 1. Timely return to work. Spine 2004;14:914–9.

    Article  Google Scholar 

  18. Matheson LN, Mooney V, Grant JE, Affleck M, Hall H, Melles T, Lichter RL, Mclntosh G. A test to measure lift capacity of physically impaired adults; Part I: development and reliability testing. Spine 1995;19:2119–29.

    Google Scholar 

  19. Kuijer W, Brouwer S, Schiphorst Preuper HR, Dijkstra PU, Groothoff JW, Geertzen JHB. Work status and chronic low back pain. Exploring the international classification of functioning, disability and health. Disabil Rehabil 2005 (in press);27.

  20. Nachemson A, Vingard E. Assessment of patients with back and neck pain: a best-evidence synthesis. In: Nachemson A, Jonsson E, editors. Neck and back pain: the scientific evidence of causes, diagnostics, and treatment. Philadelphia: Lippincott Williams & Wilkins; 2000. pp. 57–79.

    Google Scholar 

  21. Roland M, Morris R. A study of the natural history of back pain. Part 1: development of a reliable and sensitive measure of disability in low-back pain. Spine 1983;8:141–4.

    Article  PubMed  CAS  Google Scholar 

  22. Brouwer S, Kuijer W, Dijkstra PU, Göeken LNH, Groothoff JW, Geertzen JHB. Reliability and stability of the Roland Morris Disability Questionnaire: intra class correlation and limits of agreement. Disabil Rehabil 2004;26:162–5.

    Article  PubMed  CAS  Google Scholar 

  23. van Dieen JH, Hoozemans MJ, Toussaint HM. Stoop or squat: a review of biomechanical studies on lifting technique. Clin Biomech 1999;14:685–96.

    Article  CAS  Google Scholar 

  24. Munro BH, Visintainer MA, Batten Page E. Statistical methods for healthcare research. Philadelphia: JB Lippencott Company; 1986.

    Google Scholar 

  25. King PM, Tuckwell N, Barrett TE. A critical review of Functional Capacity Evaluations. Phys Therapy 1998;78:852–66.

    CAS  Google Scholar 

  26. Newton M, Waddell G. Trunk strength testing with iso-machines. Part 1: review of a decade of scientific evidence. Spine 1993;18:801–11.

    Article  PubMed  CAS  Google Scholar 

  27. Fordyce WE. Back pain in the workplace; management of disability in non-specific conditions. USA: IASP Press; 1995.

    Google Scholar 

  28. Powers SK, Howley ET. Exercise physiology. Theory and application to fitness and performance. 4th ed. New York: McGraw-Hill; 2001.

    Google Scholar 

  29. Coudreuse JM, Dupont P, Nicol C. Delayed post effort muscle soreness. Ann Readapt Med Phys 2004;47:290–8.

    PubMed  CAS  Google Scholar 

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Acknowledgement

The data of this study were collected as part of the low back pain disability (LOBADIS) research program, supported by Zorgonderzoek Nederland (ZON) grant number 96-06-006. The authors wish to acknowledge the support of the physiatrists during this study.

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Authors and Affiliations

  1. Center for Rehabilitation, University Medical Center Groningen, University of Groningen, P.O. Box 30.002, 9750, RA, The Netherlands

    Michiel F. Reneman, Wietske Kuijer, Sandra Brouwer, H. R. Schiphorst Preuper, Jan H. B. Geertzen & Pieter U. Dijkstra

  2. Center for Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Michiel F. Reneman & Johan W. Groothoff

  3. Northern Center for Health Care Research, University of Groningen, Groningen, The Netherlands

    Michiel F. Reneman, Wietske Kuijer, Sandra Brouwer, H. R. Schiphorst Preuper, Johan W. Groothoff, Jan H. B. Geertzen & Pieter U. Dijkstra

  4. Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Pieter U. Dijkstra

Authors
  1. Michiel F. Reneman
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  2. Wietske Kuijer
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  3. Sandra Brouwer
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  4. H. R. Schiphorst Preuper
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  5. Johan W. Groothoff
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  6. Jan H. B. Geertzen
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  7. Pieter U. Dijkstra
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Correspondence to Michiel F. Reneman.

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Reneman, M.F., Kuijer, W., Brouwer, S. et al. Symptom Increase Following a Functional Capacity Evaluation in Patients with Chronic Low Back Pain: An Explorative Study of Safety. J Occup Rehabil 16, 192–200 (2006). https://doi.org/10.1007/s10926-006-9023-6

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  • DOI: https://doi.org/10.1007/s10926-006-9023-6

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