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.