Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
Int Arch Occup Environ Health. 2012 Feb;85(2):109-23. doi: 10.1007/s00420-011-0659-y. Epub 2011 Jun 10.
Assessments of whether patients with musculoskeletal disorders (MSDs) can participate in work mainly consist of case history, physical examinations, and self-reports. Performance-based measures might add value in these assessments. This study answers the question: how well do performance-based measures predict work participation in patients with MSDs?
A systematic literature search was performed to obtain longitudinal studies that used reliable performance-based measures to predict work participation in patients with MSDs. The following five sources of information were used to retrieve relevant studies: PubMed, Embase, AMA Guide to the Evaluation of Functional Ability, references of the included papers, and the expertise and personal file of the authors. A quality assessment specific for prognostic studies and an evidence synthesis were performed.
Of the 1,230 retrieved studies, eighteen fulfilled the inclusion criteria. The studies included 4,113 patients, and the median follow-up period was 12 months. Twelve studies took possible confounders into account. Five studies were of good quality and thirteen of moderate quality. Two good-quality and all thirteen moderate-quality studies (83%) reported that performance-based measures were predictive of work participation. Two good-quality studies (11%) reported both an association and no association between performance-based measures and work participation. One good-quality study (6%) found no effect. A performance-based lifting test was used in fourteen studies and appeared to be predictive of work participation in thirteen studies.
Strong evidence exists that a number of performance-based measures are predictive of work participation in patients with MSDs, especially lifting tests. Overall, the explained variance was modest.
评估患有肌肉骨骼疾病（MSD）的患者是否能够参与工作主要包括病史、体格检查和自我报告。基于表现的测量可能会在这些评估中增加价值。本研究回答了以下问题：基于表现的测量在多大程度上可以预测 MSD 患者的工作参与度？
进行了系统的文献检索，以获取使用可靠的基于表现的测量来预测 MSD 患者工作参与度的纵向研究。使用以下五个信息来源检索相关研究：PubMed、Embase、AMA 功能能力评估指南、纳入文献的参考文献以及作者的专业知识和个人档案。对特定于预后研究的质量评估和证据综合进行了评估。
在检索到的 1230 篇研究中，有 18 篇符合纳入标准。这些研究共纳入了 4113 名患者，中位随访时间为 12 个月。12 项研究考虑了可能的混杂因素。其中 5 项研究的质量较好，13 项研究的质量中等。2 项质量较好的研究（11%）和所有 13 项质量中等的研究（83%）报告了基于表现的测量与工作参与之间的预测关系。2 项质量较好的研究（11%）报告了基于表现的测量与工作参与之间的关联和无关联。1 项质量较好的研究（6%）则没有发现效果。14 项研究使用了基于表现的举重测试，其中 13 项研究表明该测试可以预测工作参与度。
有强有力的证据表明，许多基于表现的测量可以预测 MSD 患者的工作参与度，尤其是举重测试。总体而言，解释的方差较小。
