Affiliations: Department of Ergonomics and Research, Rehabilitation
Centre Valens, 7317 Valens, Switzerland | EIHMS, University of Surrey, Guildford, Surrey, GU2
7TE, UK
Note: [] Address for correspondence: Peter R. Oesch, Department of
Ergonomics and Research, Klinik Valens, 7317 Valens, Switzerland. Tel.: +41 81
303 14 51; Fax: +41 81 303 11 00; E-mail: [email protected]
Abstract: Background: Comprehensive medical assessments in the majority of
patients with chronic low back pain (CLBP) have failed to assess working
capacity. Functional Capacity Evaluation (FCE) has become increasingly popular
in the evaluation of working capacity in CLBP patients. This study investigates
the influence of functional testing on decision making concerning medical
fitness assessments for work. Methods: A randomized clinical trial comparing the effect of a
function-centred (FCT) versus a pain-centred treatment (PCT) in patients with
CLBP was performed. According to the legal requirements physicians issued
Fitness for Work Certificates (FWCs) after rehabilitation. In the FCT group
physicians were in possession of the results of FCE while this was not the case
in the PCT group. Three experts assessed the FWCs and rated the quality and the
information provided regarding working capacity in the previous work. Results: Rating of the issued FWCs proved reliable
(ICC=0.77–0.92). Quality of FWCs and information regarding working
capacity in the previous work differed significantly between the two groups
(chi-square, p=0.03, resp. =0.008). There was a trend towards a higher attested
work capacity in the FCT group (Mann-Whitney, p=0.071). Conclusions: Functional Capacity Evaluation positively
influences quality and information regarding working capacity of medical
Fitness for Work Certificates in patients with chronic low back pain.
Keywords: Randomized controlled trial, assessment, work capacity, quality
