Longitudinal determinants of employment status in people with relapsing-remitting multiple sclerosis.

Purpose: To investigate longitudinal relationships between employment status and disease-related, (neuro)psychological, and work-related factors in people with multiple sclerosis (MS). Methods: 170 employed people with MS underwent yearly neurological and neuropsychological examinations to assess MS-related disability and cognitive functioning. Additionally, they completed yearly questionnaires assessing depression, anxiety, fatigue, cognitive complaints, workplace support and coping. Multilevel models for change were fitted to examine progression of these factors over three years, and to assess possible relationships with change in employment status. Results: People with a deteriorated employment status after three years reported more depression (p=0.009), a higher impact of fatigue (p<0.001), more cognitive complaints (p<0.001) and less workplace support (p=0.001) at baseline than people with a stable employment status. There were no differences in progression over time of the examined variables between people with a stable or deteriorated employment status. Conclusion: More depression, a higher impact of fatigue, more cognitive complaints and less workplace support are predictive of a deteriorated employment status after three years in individuals with MS. How these factors progress over time is not different between those with a stable or deteriorated employment. MS-related disability, anxiety, objective cognition and coping were not related to a deterioration in employment status.

Insufficient Evidence for Load as the Primary Cause of Nonspecific (Chronic) Low Back Pain. A Scoping Review.

OBJECTIVE: To assess the causal role of the relationship between loading and the onset of nonspecific low back pain (NSLBP) and persistence of NSLBP (chronic low back pain [CLBP]). DESIGN: Scoping review. LITERATURE SEARCH: We searched the literature from 2010 until May 2021 using a combination of terms related to (spinal) load and the Bradford-Hill (BH) criteria. STUDY SELECTION CRITERIA: Operational definitions were developed for every criterion of the BH framework for causality. Study selection was based on the causal role of load in the onset of NSLBP and persistence of chronic low back pain. DATA SYNTHESIS: The BH criteria were operationalized, and causation was considered established when evidence supported the BH criteria strength, temporality, biological gradient, experiment, and biological plausibility. RESULTS: Twenty-two studies were included. There was no consistent support for an association between load and the incidence of NSLBP, or that more load increased the risk of NSLBP/CLBP. Half of the studies did not support specific load exposures to increase incidence of or increase pain in NSLBP/CLBP. Half of studies did not support load preceding NSLBP. No study supported plausible biological explanations to influence the relationship between load and NSLBP/CLBP, or that similar causes have similar effects on NSLBP. Nine of 10 experimental studies did not support that load results in NSLBP or that relieving load reduces NSLBP/CLBP. CONCLUSION: There was insufficient evidence to support a causal relationship between loading and the onset and persistence of NSLBP/CLBP based on the BH criteria. These results question the role of load management as the only/primary strategy to prevent onset and persistence of NSLBP/CLBP. J Orthop Sports Phys Ther 2024;54(3):1-15. Epub 25 January 2024. doi:10.2519/jospt.2024.11314.

Side-effects and adverse events of a shoulder- and back-support exoskeleton in workers: A systematic review.

INTRODUCTION: While the biomechanical effects of exoskeletons are well studied, research about potential side-effects and adverse events are limited. The aim of this systematic review was to provide an overview of the side-effects and adverse events on shoulder- and back-support exoskeletons during work tasks. METHODS: Four in-field studies and 32 laboratory studies were included in this review, reporting on n = 18 shoulder exoskeletons, n = 9 back exoskeletons, n = 1 full body with a supernumerary arm, and n = 1 combination of shoulder and back exoskeleton. RESULTS: The most frequent side-effect reported is discomfort (n = 30), followed by a limited usability of the exoskeleton (n = 16). Other identified side-effects and adverse events were changes in muscle activity, mobility, task performance, balance and posture, neurovascular supply, gait parameters and precision. An incorrect fit of the exoskeleton and the decreased degrees of freedom are most often reported as causes of these side-effects. Two studies did not find any side-effects. This review also showed that there are differences in the occurrence of side-effects in gender, age, and physical fitness. Most studies (89%) were conducted in a laboratory setting. Most studies (97%) measured short-term effects only. Psychological and social side-effects or adverse events were not reported. Side-effects and adverse events for active exoskeletons were understudied (n = 4). CONCLUSION: It was concluded that the evidence for side-effects and adverse events is limited. If available, it mainly consists of reports of mild discomfort and limited usability. Generalisation is limited because studies were conducted in lab settings and measured short term only, and most participants were young male workers.

Personality traits are not associated with changes in employment status over 3 years in persons with multiple sclerosis.

Previous research discovered a protective effect of higher conscientiousness against a 3-year deterioration in employment status in persons with multiple sclerosis (pwMS). To replicate these findings, we used data from a multicentre prospective cohort study where 145 employed pwMS completed questionnaires, neurological and neuropsychological examinations at baseline and after 3 years. A 3-year deterioration in employment status was reported in 31.0%. We observed no differences in personality, demographics or clinical characteristics between pwMS with deteriorated or stable employment status. These null findings may be partly explained by the classification of deteriorated employment status, which does not reflect Dutch labour conditions.

Subjective cognitive impairment is related to work status in people with multiple sclerosis.

Background: Unemployment is common among people with multiple sclerosis (pwMS) and has been associated with subjective cognitive difficulties, specifically in memory, attention, and executive functioning. However, longitudinal research on subjective cognitive difficulties and employment is scarce. Objective: We investigated whether subjective cognitive impairment (SCI), based on the clinical cut-off score of the MS Neuropsychological Screening Questionnaire (MSNQ), was associated with work status and negative work events (NWE) at baseline and after 2 years. Moreover, we investigated whether four MSNQ subdomains were related to work status and NWE. Methods: 287 participants (77.4% female, median age = 42 years) completed questionnaires on subjective cognitive functioning, depression, anxiety, and fatigue, and completed the Symbol Digit Modalities Test (SDMT). After baseline comparisons, logistic regression analyses were performed, with work status and NWE at baseline, and employment change and NWE change within 2 years after baseline as dependent variables. Independent variables included SCI and the MSNQ domains. Covariates anxiety, depression, fatigue, and SDMT were added. Results: SCI, depression and anxiety were associated with work status (Nagelkerke R 2 = .286), but only SCI was associated with employment change (Nagelkerke R 2 = .164). No predictors were associated with NWE at baseline or follow-up. In addition, no MSNQ subdomain was related to work status, employment change or NWE. Conclusion: Unemployed pwMS and pwMS with a deteriorated work status reported more cognitive difficulties after 2 years than employed pwMS or pwMS with a stable work status. In addition, depression, and anxiety were associated with work status.

Work difficulties in people with multiple sclerosis: The role of anxiety, depression and coping.

Background: Symptoms of anxiety and depression affect the daily life of people with multiple sclerosis (MS). This study examined work difficulties and their relationship with anxiety, depression and coping style in people with MS. Methods: 219 employed people with MS (median age = 43 years, 79% female) completed questionnaires on anxiety, depression, coping style, demographics and work difficulties, and underwent a neurological examination. Two regression analyses were performed with work difficulties as the dependent variable and either anxiety or depression as continuous independent variables. Coping style, age, gender, educational level, MS-related disability and disease duration were added as additional predictors, as well as interaction terms between coping style and either symptoms of depression or anxiety. Results: A significant model was found (F (10,205) = 13.14, p < 0.001, R 2 = 0.39) in which anxiety, emotion- and avoidance-oriented coping and MS-related disability were positively related to work difficulties. The analysis of depression resulted in a significant model (F (10,205) = 14.98, p < 0.001, R 2 = 0.42) in which depression, emotion- and avoidance-oriented coping and MS-related disability were positively related to work difficulties. None of the interaction effects were significant. Conclusions: Work difficulties were positively related to anxiety, depression, emotion- and avoidance-oriented coping and MS-related disability in workers with MS.

Measurement Properties of the Work Ability Score in Sick-Listed Workers with Chronic Musculoskeletal Pain.

Purpose Chronic musculoskeletal pain can have a major impact on ability to work. The work ability score is a commonly used single-item question to assess work ability but has not been fully validated yet. The aim of the present study was to evaluate test-retest reliability, agreement, construct validity, and responsiveness of the work ability score among sick-listed workers with chronic musculoskeletal pain. Methods Data of sick-listed workers with chronic musculoskeletal pain was routinely collected at seven rehabilitation centres in the Netherlands. Assessments included a set of questionnaires, administered at admission and discharge from a fifteen-week vocational rehabilitation program. Test-retest reliability was determined with the intraclass correlation coefficient. For agreement, the standard error of measurement and smallest detectable changes were calculated. Construct validity was assessed by testing hypotheses regarding Spearman rank correlation coefficient. Area under the curve obtained from the receiver operating characteristic curve and minimal clinically important change were determined for the total sample and work ability score baseline tertile groups to assess responsiveness. Results In total, 34 workers were analyzed for reliability and agreement, 1291 workers for construct validity, and 590 responded to the responsiveness questionnaire. Reliability reached an intraclass correlation coefficient of 0.89; 95% CI 0.77-0.94, a standard error of measurement of 0.69 points, and the smallest detectable change of 1.92 points. For construct validity, six of the seven predefined hypotheses were not refuted. The area under the curve was 0.76 (95% CI 0.71-0.81) allowing for discrimination between stable and improved workers, with a minimal clinically important change of 2.0 points for the total sample. Conclusion The work ability score showed good measurement properties among sick-listed workers with chronic musculoskeletal pain.

Self-regulation as rehabilitation outcome: what is important according to former patients?

PURPOSE: Self-regulation refers to self-management and self-control, with or without disability. Outcomes of rehabilitation with respect to self-regulation are unclear. This study aims to identify elements of self-regulation that former patients consider important in the context of medical rehabilitation. MATERIALS AND METHODS: Qualitative exploration based on focus group discussions (FGDs). Transcripts were analysed using thematic analysis as well as open coding. Forty individuals participated in seven diagnosis-related FGDs. RESULTS: Six subthemes were raised in the FGDs which could be merged into three main themes. Two main themes are conditional for regaining self-regulation: 1) having insight into one's condition and abilities (i.e., insight into impairments. consequences of impairments. abilities); 2) to know how to cope with the consequences of the condition (be able to communicate limitations; have to trust in body and functioning). The subject of the last theme 3) is how to apply self-regulation in one's own life (to make use of abilities and optimize functioning). CONCLUSIONS: Three main themes of self-regulation in the context of medical rehabilitation were identified by former patients, partly relating to the ability to self-regulate and partly to the execution of self-regulation. This knowledge can be used to define specific rehabilitation goals and further develop rehabilitation outcome measurement.IMPLICATIONS FOR REHABILITATIONAwareness of the fundamental subthemes of self-regulation in rehabilitation will positively contribute to theory building and improve clinical practice (e.g., goal setting).Paying explicit attention to the six subthemes as standard elements of rehabilitation will help to provide a comprehensive view concerning self-regulation.The conceptual model of self-regulation, based on patient perspectives, can contribute to the measurement of rehabilitation outcomes.

Self-reported occupational functioning in persons with relapsing-remitting multiple sclerosis: Does personality matter?

BACKGROUND: Multiple sclerosis (MS) poses a major threat to sustainable employability. Identifying conditions and factors that promote work participation is of great importance. Our objective was to explore the contribution of personality traits in explaining occupational functioning in MS. METHODS: 241 participants with relapsing-remitting MS (78% female, median age: 42.0 years, median EDSS: 2.0) and 60 healthy controls (70% female, median age: 45.0 years) underwent neuropsychological and neurological examinations and completed questionnaires. Multivariate logistic and linear regression analyses were conducted to examine relations between personality traits and self-reported occupational functioning, while accounting for known correlates. RESULTS: Personality traits were not associated with self-reported occupational functioning when correcting for known correlates. A higher impact of fatigue (B = -0.05, p = .005 and B = -0.04, p = .009) and depression (B = -0.22, p = .008 and B = -0.21, p = .01) were associated with no paid job (R2 = 0.13) and considering to reduce work hours (R2 = 0.12). A higher impact of fatigue (B = -0.05, p = .008, ß = 0.46, p = .001 and ß = -0.36, p = .001) was associated with absenteeism from work (R2 = 0.15), more presenteeism (R2 = 0.35) and lower work ability (R2 = 0.25). A higher impact of fatigue (ß = 0.46, p = .001) and anxiety (ß = 0.25, p = .001) were associated with more work difficulties (R2 = 0.54). CONCLUSION: Personality traits did not explain additional variance in self-reported occupational functioning in persons with relapsing-remitting MS with mild disability. The impact of fatigue was the main and most consistent correlate of occupational functioning, often combined with depression or anxiety. Total explained variance of the models was limited, emphasizing the need to additionally examine other (contextual) factors when considering occupational challenges in MS.

Can breathing gases be analyzed without a mouth mask? Proof-of-concept and concurrent validity of a newly developed design with a mask-less headset.

A portable headset has been developed to analyze breathing gases and establish the energetic workload of physically active workers. This proof-of-concept study aimed to investigate the following: (1) the validity of the headset compared to indirect calorimetry using a mouth mask; (2) the validity of the headset compared to the validity of oxygen consumption (V̇O2) estimated on the basis of heart rate; (3) the influence of wind on validity; and (4) user experiences of the headset. Fifteen subjects performed a submaximal cycling test twice, once with the headset, and once with a mouth mask and heartrate monitor. Concurrent validity of the headset was analyzed using an intraclass correlation coefficient (ICC). Across all phases, a good correlation between the headset and mouth mask was observed for V̇O2, carbon dioxide production (V̇CO2) and exhaled volume (V̇E) (ICC≥0.72). The headset tended to underestimate V̇O2, V̇CO2 and V̇E at low intensities and to overestimate it at higher intensities. The headset was more valid for estimating V̇O2 (ICC = 0.39) than estimates based on heart rate (ICC = 0.11) (n = 7). Wind flow caused an overestimation (md ≥ 18.4 ± 16.9%) and lowered the correlation of V̇O2 between the headset and the mouth mask to a moderate level (ICC = 0.48). The subjects preferred the headset over the mouth mask because it was more comfortable, did not hinder communication and had lower breathing resistance. The headset appears to be useable for monitoring development of the energetic workloads of physically active workers, being more valid than heart rate monitoring and more practical than indirect calorimetry with a mouth mask. Proof-of-concept was confirmed. Another design step and further validation studies are needed before implementation in the workplace.

Functional Capacity Evaluation Research: Report from the Fourth International Functional Capacity Evaluation Research Meeting.

Purpose To summarize progress of functional capacity evaluation (FCE) research based on the proceedings of the Fourth International FCE Research Conference held in Switzerland on September 21 and 22, 2018. Methods A scientific committee identified key issues in FCE research and developed the program including key note presentations, a call for abstracts, and round table discussions over 2 days. Highlights of the presentations and discussions are summarized in this article. Results Seventy-nine participants from 11 countries attended the conference where 10 keynote lectures and 21 abstracts were presented. There was also an open discussion regarding the need for an International FCE clinical practice guideline (CPG), methods for developing such a guideline, and practical next steps. Full program details and abstracts from this Fourth International FCE Research Conference are available from https://www.sar-reha.ch/interessengemeinschaften/ig-ergonomie.html . Conclusions Researchers and clinicians continue to increase the body of knowledge in the FCE field. A major finding of this conference is the diversity across the different FCE protocols and research groups as well as of the different uses of FCE across cultural and social economic systems. Next steps will include exploring the development of an international, interdisciplinary, evidence-based FCE clinical practice guideline by a committee formed at the conference.

Monitoring core temperature of firefighters to validate a wearable non-invasive core thermometer in different types of protective clothing: Concurrent in-vivo validation.

This study aims (1) to test the validity of a new non-invasive core thermometer, Cosinuss°, in rest and (2) during firefighting simulation tasks, against invasive temperature pill and inner-ear temperature and (3) to compare the change in core temperature of firefighters when working in two types of protective clothing (traditional turnout gear versus new concept). 11 active firefighters performed twice a selection of tasks during their periodic preventive medical examination and a fire-extinguishing task. Without correction no correlation between the Cosinuss° and thermometer pill (ICC≤0.09, p ≥ 0.154, LoA≥1.37) and a moderate correlation between Cosinuss° and inner-ear infrared (ICC = 0.40, p = 0.044, LoA±1.20) was observed. With individual correction both correlations were excellent (ICC≥0.84, p = 0.000, LoA≤0.30). However, during and after working all correlations were poor and non-significant (ICC≤0.38, p ≥ 0.091, LoA≥1.71). During firefighting tasks, the Cosinuss° is invalid for measuring the core temperature. No differences in heat development in the two types of protective clothing was proven.

Trajectories of Physical Work Capacity in Early Symptomatic Osteoarthritis of Hip and Knee: Results from the Cohort Hip and Cohort Knee (CHECK) Study.

Purpose To evaluate the 5-year course of physical work capacity of participants with early symptomatic osteoarthritis (OA) of the hip and/or the knee; to identify trajectories and explore the relationship between trajectories and covariates. Methods In a prospective cohort study, physical work capacity was measured at baseline, using a test protocol (functional capacity evaluation) consisting of work-related physical activities. Participants were invited to participate in 1, 2 and 5 year follow-up measurements. Multilevel analysis and latent classes analysis were performed, in models with test performances as dependent variables and age, sex, work status, self-reported function (Western Ontario McMasters Arthritis Scale-WOMAC), body mass index (BMI) and time as independent variables. Multiple imputation was used to control for the influence of missing data. Results At baseline and after 1, 2 and 5 years there were 96, 64, 61 and 35 participants. Mean (SD) age at baseline was 56 (4.9) years, 84% were females. There was no statistically significant change in test performances (lifting low and high, carrying, static overhead work, repetitive bending, repetitive rotations) between the 4 measurements. Male sex, younger age and better self-reported function were statistically significant (p < 0.05) determinants of higher performance on most of the tests; having a paid job, BMI and progression of time were not. Three trajectories were identified: 'weak giving way', 'stable and able', and 'strong with decline'. Discussion In subgroups of participants with early symptomatic OA, determined by age, sex and self-reported function, physical work capacity seems to be a stable characteristic over 5 years.

The capability set for work - correlates of sustainable employability in workers with multiple sclerosis.

BACKGROUND: The aim of this study was to examine whether work capabilities differ between workers with Multiple Sclerosis (MS) and workers from the general population. The second aim was to investigate whether the capability set was related to work and health outcomes. METHODS: A total of 163 workers with MS from the MS@Work study and 163 workers from the general population were matched for gender, age, educational level and working hours. All participants completed online questionnaires on demographics, health and work functioning. The Capability Set for Work Questionnaire was used to explore whether a set of seven work values is considered valuable (A), is enabled in the work context (B), and can be achieved by the individual (C). When all three criteria are met a work value can be considered part of the individual's 'capability set'. RESULTS: Group differences and relationships with work and health outcomes were examined. Despite lower physical work functioning (U = 4250, p = 0.001), lower work ability (U = 10591, p = 0.006) and worse self-reported health (U = 9091, p ≤ 0.001) workers with MS had a larger capability set (U = 9649, p ≤ 0.001) than the general population. In workers with MS, a larger capability set was associated with better flexible work functioning (r = 0.30), work ability (r = 0.25), self-rated health (r = 0.25); and with less absenteeism (r = - 0.26), presenteeism (r = - 0.31), cognitive/neuropsychiatric impairment (r = - 0.35), depression (r = - 0.43), anxiety (r = - 0.31) and fatigue (r = - 0.34). CONCLUSIONS: Workers with MS have a larger capability set than workers from the general population. In workers with MS a larger capability set was associated with better work and health outcomes. TRIAL REGISTRATION: This observational study is registered under NL43098.008.12: 'Voorspellers van arbeidsparticipatie bij mensen met relapsing-remitting Multiple Sclerose'. The study is registered at the Dutch CCMO register ( https://www.toetsingonline.nl ). This study is approved by the METC Brabant, 12 February 2014. First participants are enrolled 1st of March 2014.

Functional Capacity Evaluation Research: Report from the Third International Functional Capacity Evaluation Research Meeting.

Purpose Based on the success of the first two conferences the Third International FCE Research Conference was held in The Netherlands on September 29, 2016. The aim was to provide ongoing opportunity to share and recent FCE research and discuss its implications. Methods Invitations and call for abstracts were sent to previous attendees, researchers, practicing FCE clinicians and professionals. Fifteen abstracts were selected for presentation. The FCE research conference contained two keynote lectures. Results 54 participants from 12 countries attended the conference where 15 research projects and 2 keynote lectures were presented. The conference provided an opportunity to present and discuss recent FCE research, and provided a forum for discourse related to FCE use. Conference presentations covered aspects of practical issues in administration and interpretation; protocol reliability and validity; consideration of specific injury populations; and a focused discussion on proposed inclusion of work physiology principles in FCE testing with the Heart Rate Reserve Method. Details of this Third International FCE Research Conference are available from http://repro.rcnheliomare.nl/FCE.pdf . Conclusions Researchers, clinicians, and other professionals in the FCE area have a common desire to further improve the content and quality of FCE research and to collaborate to further develop research across systems, cultures and countries. A fourth, 2-day, International FCE research conference will be held in Valens, Switzerland in August or September 2018. A 'FCE research Society' will be developed.

Functional Capacity Evaluation in Upper Limb Reduction Deficiency and Amputation: Development and Pilot Testing.

Purpose To develop and pilot test a functional capacity evaluation (FCE) for individuals with upper limb absence (ULA) due to reduction deficiency or amputation, and to examine the relationship between FCE results and presence of musculoskeletal complaints (MSC). Method Five tests (overhead lifting, overhead working, repetitive reaching, fingertip dexterity, and handgrip strength) were selected and adapted if necessary. The newly developed FCE, called FCE-One-Handed (FCE-OH), was pilot tested in 20 adults individuals with ULA, and 20 matched controls. MSC were assessed via a questionnaire. Results Adaptations were considered necessary for all tests, except the handgrip strength test. The repetitive overhead lifting test of the non-affected limb was added. On the overhead lifting test, individuals with above-elbow ULA (ten males), performed similar to controls using one hand. When lifting bimanually using the prosthesis, a trend for lower lifting capacity of individuals with below-elbow ULA (seven males, three females) was observed compared to controls. On the overhead working test, individuals with above-elbow ULA performed worse compared to controls. Other tests showed no significant differences between groups. Relationships between FCE results and presence of MSC were non-significant. Conclusion The FCE-OH can be used to test functional capacity of one-handed individuals. Individuals with ULA generally showed similar functional capacity as two-handed individuals. FCE results were not related to MSC. It was discussed that a higher physical load on the non-affected limb might reflect a relative deficit of functional capacity.

Repeatability and Safety of the Functional Capacity Evaluation-One-Handed for Individuals with Upper Limb Reduction Deficiency and Amputation.

Purpose To assess repeatability and safety of the functional capacity evaluation-one-handed (FCE-OH), a FCE-OH individuals, consisting of eight items. Method The FCE-OH protocol was administered twice to 23 individuals with upper limb absence (87% male; median age 46 years; median 2 days between sessions). To examine repeatability, test-retest reliability and agreement were assessed with the intraclass correlations coefficient (ICC) and limits of agreement (LoA), respectively. Reliability was considered acceptable when ICC-values were ≥0.75. Widths of LoA of four tests were compared with those of healthy adults. Safety and pain response were assessed with a questionnaire. Results After controlling for stability of construct, ICC-values ranged between 0.23 and 0.96, and widths of LoA ranged between 16 and 79%. Intertrial (learning) effects were present in three test items. No serious adverse reactions were reported. A pain response was reported by 30% of the participants. Conclusion Good or excellent reliability was observed in five tests, while three items showed poor or moderate test-retest reliability. Interpretation of agreement was possible for four tests, of which three showed widths of LoA similar to those reported in healthy adults. Learning effects were present; therefore, interpretation at the individual level should be performed with care. As the CI of several items were wide, confirmation of results in a larger sample is warranted. Safety was confirmed.

Can a smart chair improve the sitting behavior of office workers?

Prolonged sitting can cause health problems and musculoskeletal discomfort. There is a need for objective and non-obstructive means of measuring sitting behavior. A 'smart' office chair can monitor sitting behavior and provide tactile feedback, aiming to improve sitting behavior. This study aimed to investigate the effect of the feedback signal on sitting behavior and musculoskeletal discomfort. In a 12-week prospective cohort study (ABCB design) among office workers (n = 45) was measured sitting duration and posture, feedback signals and musculoskeletal discomfort. Between the study phases, small changes were observed in mean sitting duration, posture and discomfort. After turning off the feedback signal, a slight increase in sitting duration was observed (10 min, p = 0.04), a slight decrease in optimally supported posture (2.8%, p < 0.01), and musculoskeletal discomfort (0.8, p < 0.01) was observed. We conclude that the 'smart' chair is able to monitor the sitting behavior, the feedback signal, however, led to small or insignificant changes.

Reliability and Agreement of Neck Functional Capacity Evaluation Tests in Patients With Chronic Multifactorial Neck Pain.

OBJECTIVES: To analyze test-retest reliability and agreement, and to explore the safety of neck functional capacity evaluation (Neck-FCE) tests in patients with chronic multifactorial neck pain. DESIGN: Test-retest; 2 FCE sessions were held with a 2-week interval. SETTING: University-based outpatient rehabilitation center. PARTICIPANTS: Individuals (N=18; 14 women) with a mean age of 34 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Neck-FCE protocol consists of 6 tests: lifting waist to overhead (kg), 2-handed carrying (kg), overhead working (s), bending and overhead reaching (s), and repetitive side reaching (left and right) (s). Intraclass correlation coefficients (ICCs) and limits of agreement (LoA) were calculated. ICC point estimates between .75 and .90 were considered as good, and >.90 were considered as excellent reliability. RESULTS: ICC point estimates ranged between .39 and .96. Ratios of the LoA ranged between 32.0% and 56.5%. Mean ± SD numeric rating scale pain scores in the neck and shoulder 24 hours after the test were 6.7±2.6 and 6.3±3.0, respectively. CONCLUSIONS: Based on ICC point estimates and 95% confidence intervals, 3 tests had excellent reliability and 3 had poor reliability. LoA were substantial in all 6 tests. Safety was confirmed.