Institute for Quality Assurance in Prevention and Rehabilitation, German Sport University Cologne (IQPR), Eupener Str. 70, 50933, Cologne, Germany.
Department of Rehabilitation, German Federal Pension Insurance, Hohenzollerndamm 47, 10704, Berlin, Germany.
Int Arch Occup Environ Health. 2020 Jul;93(5):635-643. doi: 10.1007/s00420-020-01518-5. Epub 2020 Feb 3.
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).
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.
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%).
The FCE test at discharge predicts RTW among patients with musculoskeletal disorders.
考察基于绩效的与工作相关的身体功能能力评估（德语：Einschätzung körperlicher Leistungsfähigkeiten bei arbeitsbezogenen Aktivitäten-ELA）是否可预测肌肉骨骼疾病（MSD）患者的工作回归（RTW）。
对来自四家门诊康复诊所的 162 名患有各种与损伤相关和慢性 MSD 的在职或自雇患者进行了一项多中心队列研究。在出院时收集了患者的健康和工作能力报告数据。随后进行了 FCE 测试。整体 FCE 对工作体力需求的适应能力（阳性与阴性）的评估用于预测 RTW。成功的 RTW 定义为在 3 个月随访时（自我）就业和因 MSD 导致的病假（<1.5 周）低水平的组合。使用逻辑回归模型计算了比值比（OR）和 95％置信区间（CI），以评估调整后的 FCE 结果的预测有效性。
根据 FCE 测试，82％的患者被评估为能够适应工作的体力需求。82％的 FCE 结果为阳性的患者（阳性预测值）返回工作，而 77％的 FCE 结果为阴性的患者（阴性预测值）未返回工作。在调整了患者的健康和工作能力报告数据后，其功能能力被评估为与工作需求相匹配的患者，其返回工作的可能性是六倍。在对进行 FCE 的治疗师之间，FCE 结果与 RTW 之间的一致性仅处于低到中度水平（72-89％）。
在出院时进行的 FCE 测试可预测 MSD 患者的 RTW。
