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The influence of a Functional Capacity Evaluation on fitness for work certificates in patients with non-specific chronic low back pain.

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.

Adult↗

The role of the occupational therapist-work evaluator.

This paper presents the role of the occupational therapist as that of a work evaluator who provides services to injured workers. Therapists, by virtue of their professional knowledge, have a frame of reference for work evaluation and understand the factors that interrupt the work process. In work evaluation, the therapist assists the injured worker to develop work readiness and the physical capacities necessary for working productively. This development takes place in a therapeutic milieu where the "worker" role is regained. The role of the occupational therapist-work evaluator includes work-oriented treatment in the acute care setting, job analysis, work tolerance screening, work capacity evaluation, work hardening, and job market reentry management in the work evaluation and community settings.

Adaptation, Psychological↗

[Tolerance of physical stress and evaluation of work capacity of persons with functional diseases of the heart].

The examination of 112 patients with functional cardiopathies demonstrated that bicycle ergometry permits to differentiate them from ischaemic heart disease. These patients exhibit a reduced capacity for physical labour caused by several factors (among them such as lack of habit of physical labour, nervous regulation disorders, latent circulation insufficiency). Ergometry proves to be a good objective test for the efficiency of therapy of functional cardiopathies.

Adolescent↗

[Possible methods of evaluating the work capacity of ship operators].

By identifying correlation between physiological changes that develop in work and professional errors of ship operators the complex of informative parameters to be used in assaying ther performance has been determined. The complex includes: latent period of a complex sensorimotor response with a choice, critical frequence of fusion of light oscillations, heart rate, tolerance to static force, pulse arterial pressure and index of a two-minute step-test. With the aid of the complex of clinical, physiological and psychophysiological methods it has been shown that indirect indices of performance of operators in long voyages deteriorate two or three weeks earlier than its direct signs. It has been found that the operator's performance can in principle be quantified. It can be done by taking into consideration changes in the informative indices during a specific operation and contribution of each of them to the integrative evaluation of the operator's performance.

Adaptation, Physiological↗

[Evaluation of work capacity in cases of discopathy of the lumbosacral segment of the spine].

The ability to resume occupational work in cases of lumbar discopathy was assessed in an analysis of 1104 cases treated in a period of 25 years. The assessment was analysed in relation to the following factors: 1. disease duration, 2. discopathy type, 3. patient's age, 4. occupation type, 5. treatment. The paper contains a number of observations concerning the management of lumbar discopathy, and suggestions related to working ability expertise in such cases.

Adult↗