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Predictive validity of a customized functional capacity evaluation in patients with musculoskeletal disorders

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Abstract

Purpose

To examine whether the performance-based work-related functional capacity evaluation (German title: Einschätzung körperlicher Leistungsfähigkeiten bei arbeitsbezogenen Aktivitäten—ELA) can predict return to work (RTW) in patients with musculoskeletal disorders (MSD).

Methods

A multicenter cohort study was conducted on 162 employed or self-employed patients with various injury-related and chronic MSD, recruited from four outpatient rehabilitation clinics. Patient-reported data on health and work ability were collected at discharge. The FCE test was performed subsequently. The overall FCE-based estimation of the ability to cope with the physical demands of work (positive vs. negative) was used to predict RTW. Successful RTW was defined as a combination of (self-)employment at the 3-month follow-up and a low level of sick leave (< 1.5 weeks) due to MSD. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using logistic regression models to evaluate the predictive validity of the adjusted FCE results.

Results

Based on the FCE test, 82% of the patients were estimated as being able to cope with the physical demands of work. 77% of the patients with a positive FCE outcome returned to work (positive predictive value) and 83% with a negative FCE outcome did not (negative predictive value). Patients whose functional capacity was estimated to match the job demands were associated with sixfold higher odds of returning to work after adjusting for patient-reported data on health and work ability. The agreement between the FCE result and RTW differed only on a low to moderate level between the therapists who administered the FCE (72–89%).

Conclusion

The FCE test at discharge predicts RTW among patients with musculoskeletal disorders.

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Notes

  1. A detailed description can be found in the appendix.

  2. A calculation of the models 1 and 2 based on the 151 participants, that were included in model 3, had only a minor effect on the influence of ELA (OR = 19.4 respectively OR = 18.2). Therefore, it can be assumed that the decline was not caused by the reduction in sample size.

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Acknowledgements

We would like to thank the following institutions for assistance with data collection and study implementation: ASR Rehabilitationszentren (location: Cologne), Regio-RehaTagesklinik Freiburg, medicoreha Welsink Rehabilitation (location: Neuss) and Reha Viersen.

Funding

There was no funding for the study.

Author information

Authors and Affiliations

  1. Institute for Quality Assurance in Prevention and Rehabilitation, German Sport University Cologne (IQPR), Eupener Str. 70, 50933, Cologne, Germany

    David Bühne, Torsten Alles & Christian Hetzel

  2. Department of Rehabilitation, German Federal Pension Insurance, Hohenzollerndamm 47, 10704, Berlin, Germany

    Marco Streibelt

  3. Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany

    Ingo Froböse

  4. Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany

    Matthias Bethge

Authors
  1. David Bühne
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  2. Torsten Alles
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  3. Christian Hetzel
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  4. Marco Streibelt
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  5. Ingo Froböse
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  6. Matthias Bethge
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Corresponding author

Correspondence to David Bühne.

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Conflict of interest

Some authors are employees of the Institute for Quality Assurance in Prevention and Rehabilitation at the German Sport University Cologne, which is responsible for the development and training of ELA. The other authors declare that they have no conflict of interest.

Ethical approval

All subjects gave their informed written consent and the study was approved by the Ethics Committee of the German Sport University Cologne.

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Bühne, D., Alles, T., Hetzel, C. et al. Predictive validity of a customized functional capacity evaluation in patients with musculoskeletal disorders. Int Arch Occup Environ Health 93, 635–643 (2020). https://doi.org/10.1007/s00420-020-01518-5

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  • DOI: https://doi.org/10.1007/s00420-020-01518-5

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