Functional Capacity Evaluation: Performance of Patients with Chronic Non-specific Low Back Pain Without Waddell Signs

Oesch, Peter; Meyer, Kathrin; Jansen, B.; Kool, Jan

doi:10.1007/s10926-014-9533-6

Cited by 17 publications

(18 citation statements)

References 29 publications

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“…Women, higher scores in CSI-A and in Waddell NOS, and older age were found to be significantly associated to lower lifting capacity. While for the Waddell NOS, the current results reinforce the previously described correlations with lifting capacity and return to work in patients with CBP [6,7]; for the CSI-A, to the authors' best knowledge, the results of an association with lifting capacity in patients with CBP has never been reported before. Furthermore, until now the study with the most variance explained in lifting capacity with patients was able to explain 42% of the total variance including eight biopsychosocial variables [5].…”

Section: Discussionsupporting

confidence: 89%

“…The descriptive statistics of patients' collected variables were calculated and presented as means and standard deviations for continuous variables (m and SD) or as counts and percentages for categorical variables (n and %). As large differences exist in lifting capacity between men and women [5][6][7], all correlations and regression analyses were performed controlling for sex.…”

Section: Data Analysesmentioning

confidence: 99%

“…One of the main goals of VR is to improve functional capacity for a successful return to work. Functional capacity evaluations (FCEs) are batteries of tests that may be used to predict return to work, determine aspects of disability, and guide suitable intervention approaches [3][4][5][6][7][8][9][10][11], reasons for which they are used in VR. One of the best FCE tests to predict return to work is a lifting capacity test [3].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies suggested that non-organic signs (NOS) should be part of routine screening in chronic pain rehabilitation, to help identify patients who require thorough psychosocial evaluation and to distinguish from conditions mainly determined by biological factors [6,12]. The NOS, introduced in 1980 by Dr. Gordon Waddell [12], consist of eight simple physical tests which reflect "non-organic" behavior, providing an opening for a biopsychosocial approach.…”

Section: Introductionmentioning

confidence: 99%

“…The most recent and most comprehensive study on FCE revealed an explained variance for lifting capacity of 42%, with a mix of biological, psychological, and social factors as independent predictors [5]. While this was the most comprehensive study and it had the highest explained variance; there was still a large proportion unexplained, and a known confounder (NOS [6]) and potential new confounder (CS) were not included. The value of CS over known variables such as NOS, pain-related disability, pain intensity, psychosocial variables, and patient characteristics to predict lifting capacity in patients with CBP is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Lifting capacity is associated with central sensitization and non-organic signs in patients with chronic back pain

Echeita

Wurff

Killen

et al. 2020

Disability and Rehabilitation

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Purpose: To analyze the associations between lifting capacity, and central sensitization (CS) and nonorganic signs (NOS) in patients with chronic back pain (CBP) attending vocational rehabilitation. Materials and methods: Cross-sectional observational multicenter study among patients with CBP undergoing a return to work assessment within care as usual. Main analyses: step 1: partial correlation between lifting capacity, and CS, NOS, and additional variables; step 2: multiple regression in stepwise forward method for dependent variable lifting capacity, and for independent variables CS and NOS, and additional variables significant (p < 0.05) at step 1. All analyses were controlled for sex. Results: Fifty-six patients of mean age 42.5 years and 59% women participated in the study. Correlations between lifting capacity and CS and NOS were r ¼ -0.53 and r ¼ -0.50, respectively. CS and NOS, as well as age and sex, contributed significantly to the final regression model, which explained 57.6% of variance. Conclusions: After controlling for confounders, CS and NOS were negatively associated with lifting capacity in patients with CBP. Explained variance was substantially higher than previously reported studies. ä IMPLICATIONS FOR REHABILITATION The identification of central sensitization and non-organic signs (NOS) in patients with chronic back pain can alert clinicians about central nervous system being in a hypersensitive state and about pain behavior. Central sensitization and NOS are relevant determinants of lifting capacity. Better understanding of the factors affecting lifting capacity lead to better design and tailoring of interventions, resulting in optimized vocational rehabilitation programs and faster return to work. ARTICLE HISTORY

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Section: Discussionsupporting

confidence: 89%

Section: Data Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lifting capacity is associated with central sensitization and non-organic signs in patients with chronic back pain

Echeita

Wurff

Killen

et al. 2020

Disability and Rehabilitation

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Are biomarkers associated with sensitivity to physical activity?

Flegg,

Lima,

Woznowski‐Vu

et al. 2023

European Journal of Pain

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BackgroundActivity‐based treatments play an integral role in managing musculoskeletal conditions including low back pain. However, while therapeutic exercise has been shown to reduce pain in such conditions, certain individuals experience a paradoxical pain increase in response to exercise. The physiological processes underlying this sensitivity to physical activity (SPA) are not fully understood, however stress and inflammation have been shown to contribute to SPA. The present cross‐sectional study investigated whether physiological indicators of stress (cortisol) and inflammation (IL‐6) help explain SPA.MethodsTwenty‐seven patients with chronic low back pain and 21 healthy controls completed a 1‐h exercise session of standardized physical tasks. SPA was calculated from the difference between post‐ and pre‐exercise pain levels. Participant's saliva was collected at several timepoints for cortisol and IL‐6 levels quantification. Their waking cortisol response was calculated to reflect their cortisol regulation. Reactivity of IL‐6 and cortisol was calculated to reflect changes in these measures during exercise.ResultsIL‐6 reactivity was significantly and positively correlated with SPA among participants with low back pain. In contrast, neither cortisol waking response nor cortisol reactivity was significantly correlated within the low back pain group. No significant differences in IL‐6 reactivity, cortisol reactivity or cortisol waking response were observed.ConclusionThese findings are the first to link SPA to an objective biomarker among people with low back pain. These findings help describe the physiological mechanisms of SPA and can support new clinical research that targets the inflammatory response of patients with chronic low‐back pain and elevated SPA.SignificanceThis study reveals a correlation between SPA and an objective salivary biomarker of IL‐6 in people with low back pain, improving our understanding of this clinically relevant subjective experience.

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Konzeptentwicklung

Mohokum¹

2018

Betriebliche Gesundheitsförderung

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Functional Capacity Evaluation: Performance of Patients with Chronic Non-specific Low Back Pain Without Waddell Signs

Abstract: WS should be assessed for interpretation of FCE results. Despite long work absence, patients with CNSLBP with negative WS demonstrated a physical capacity corresponding to substantial physical work demands.

Cited by 17 publications

References 29 publications

Lifting capacity is associated with central sensitization and non-organic signs in patients with chronic back pain

Lifting capacity is associated with central sensitization and non-organic signs in patients with chronic back pain

Are biomarkers associated with sensitivity to physical activity?

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