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患有慢性非特异性肌肉骨骼疼痛且有/无病假的工人与健康工人相比,其功能能力是否较低?

Do workers with chronic nonspecific musculoskeletal pain, with and without sick leave, have lower functional capacity compared with healthy workers?

机构信息

Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

出版信息

Arch Phys Med Rehabil. 2012 Dec;93(12):2216-22. doi: 10.1016/j.apmr.2012.06.023. Epub 2012 Jul 5.

DOI:10.1016/j.apmr.2012.06.023
PMID:22772082
Abstract

OBJECTIVES

(1) To analyze whether functional capacity (FC) of sick listed workers with chronic nonspecific musculoskeletal pain (CMP) referred for rehabilitation (SL-Rehab group) and workers with CMP who stay at work (SAW group) differ from the FC of healthy workers (HW group). (2) To analyze if FC of workers with CMP is insufficient to meet work demands, and to assess factors associated with insufficient FC.

DESIGN

A 3-group cross-sectional comparison.

SETTING

Rehabilitation center.

PARTICIPANTS

Workers (N=942) were included (SL-Rehab group: n=122, SAW group: n=119, and HW group: n=701).

INTERVENTIONS

All subjects performed a short Functional Capacity Evaluation (FCE) and completed questionnaires assessing demographics, personal, and work characteristics.

MAIN OUTCOME MEASURE

FCE performances. Participants' FC was insufficient to meet their work demands when their FC was lower than the 5th percentile of the HW group's FC.

RESULTS

Both the SL-Rehab and SAW groups had significantly lower FC compared with the HW group; 15% to 71% demonstrated insufficient FC. Insufficient FC was associated with group status (SL Rehab group: odds ratio [OR]=6.5; SAW group: OR=7.2), having physically high demanding work (OR=35.1), being a woman (OR=35.7), higher age (OR=1.2), and lower effort level during FCE (OR=1.9). Among subjects with CMP, kinesiophobia, physical health, and perceived disability were associated with having an insufficient FC for work.

CONCLUSIONS

Workers in the SL-Rehab group have lower FC than their working counterparts. Many workers in both groups with CMP demonstrated insufficient FC. Not the pain itself, but personal and work-related factors are related to insufficient FC.

摘要

目的

(1)分析慢性非特异性肌肉骨骼疼痛(CMP)就诊康复(SL-Rehab 组)和继续工作(SAW 组)的 Sick-Listed 工人与健康工人(HW 组)的功能能力(FC)是否存在差异。(2)分析 CMP 工人的 FC 是否不足以满足工作需求,并评估与 FC 不足相关的因素。

设计

3 组横断面比较。

地点

康复中心。

参与者

共纳入 942 名工人(SL-Rehab 组:n=122,SAW 组:n=119,HW 组:n=701)。

干预措施

所有受试者均进行了简短的功能能力评估(FCE),并填写了调查问卷,内容包括人口统计学、个人和工作特征。

主要观察指标

FCE 表现。当工人的 FC 低于 HW 组 FC 的第 5 百分位时,认为其 FC 不足以满足工作需求。

结果

SL-Rehab 组和 SAW 组的 FC 均显著低于 HW 组,15%至 71%的工人 FC 不足。FC 不足与组间状态(SL Rehab 组:优势比[OR]=6.5;SAW 组:OR=7.2)、工作物理需求高(OR=35.1)、女性(OR=35.7)、年龄较大(OR=1.2)和 FCE 期间的努力水平较低(OR=1.9)相关。在 CMP 患者中,运动恐惧、身体健康和感知残疾与工作 FC 不足有关。

结论

SL-Rehab 组的工人 FC 低于工作对照组。两组中有许多 CMP 工人 FC 不足。与 FC 不足相关的不是疼痛本身,而是个人和工作相关的因素。

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