Trippolini M A, Dijkstra P U, Geertzen J H B, Reneman M F
Department of Work Rehabilitation, Rehaklinik Bellikon, Suva Care, 5454, Bellikon, Switzerland,
J Occup Rehabil. 2015 Sep;25(3):481-92. doi: 10.1007/s10926-014-9555-0.
The construct validity of functional capacity evaluations (FCE) in whiplash-associated disorders (WAD) is unknown. The aim of this study was to analyse the validity of FCE in patients with WAD with cultural differences within a workers' compensation setting.
314 participants (42% females, mean age 36.7 years) with WAD (grade I and II) were referred for an interdisciplinary assessment that included FCE tests. Four FCE tests (hand grip strength, lifting waist to overhead, overhead working, and repetitive reaching) and a number of concurrent variables such as self-reported pain, capacity, disability, and psychological distress were measured. To test construct validity, 29 a priori formulated hypotheses were tested, 4 related to gender differences, 20 related associations with other constructs, 5 related to cultural differences.
Men had significantly more hand grip strength (+17.5 kg) and lifted more weight (+3.7 kg): two out of four gender-related hypotheses were confirmed. Correlation between FCE and pain ranged from -0.39 to 0.31; FCE and self-reported capacity from -0.42 to 0.61; FCE and disability from -0.45 to 0.34; FCE and anxiety from -0.36 to 0.27; and FCE and depression from -0.41 to 0.34: 16 of 20 hypotheses regarding FCE and other constructs were confirmed. FCE test results between the cultural groups differed significantly (4 hypotheses confirmed) and effect size (ES) between correlations were small (1 hypothesis confirmed). In total 23 out of 29 hypotheses were confirmed (79%).
The construct validity for testing functional capacity was confirmed for the majority of FCE tests in patients with WAD with cultural differences and in a workers' compensation setting. Additional validation studies in other settings are needed for verification.
鞭打相关疾病（WAD）中功能能力评估（FCE）的结构效度尚不清楚。本研究的目的是在工伤赔偿环境中分析具有文化差异的WAD患者中FCE的效度。
314名患有WAD（I级和II级）的参与者（42%为女性，平均年龄36.7岁）被转介进行包括FCE测试在内的多学科评估。测量了四项FCE测试（握力、从腰部举到头顶、头顶作业和重复伸手）以及一些同时存在的变量，如自我报告的疼痛、能力、残疾和心理困扰。为了测试结构效度，对29个预先制定的假设进行了测试，其中4个与性别差异有关，20个与其他结构的关联有关，5个与文化差异有关。
男性的握力明显更强（+17.5千克），举起的重量更大（+3.7千克）：四个与性别相关的假设中有两个得到证实。FCE与疼痛之间的相关性在-0.39至0.31之间；FCE与自我报告的能力之间的相关性在-0.42至0.61之间；FCE与残疾之间的相关性在-0.45至0.34之间；FCE与焦虑之间的相关性在-0.36至0.27之间；FCE与抑郁之间的相关性在-0.41至0.34之间：关于FCE与其他结构的20个假设中有16个得到证实。文化组之间的FCE测试结果有显著差异（4个假设得到证实），相关性之间的效应大小（ES）较小（1个假设得到证实）。29个假设中共有23个得到证实（79%）。
在具有文化差异的WAD患者和工伤赔偿环境中，大多数FCE测试的功能能力测试的结构效度得到了证实。需要在其他环境中进行额外的验证研究以进行核实。
