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What is the role of "nonorganic somatic components" in functional capacity evaluations in patients with chronic nonspecific low back pain undergoing fitness for work evaluation?


Oesch, Peter; Meyer, Kathrin; Jansen, Beatrice; Mowinckel, Petter; Bachmann, Stefan; Hagen, Kare Birger (2012). What is the role of "nonorganic somatic components" in functional capacity evaluations in patients with chronic nonspecific low back pain undergoing fitness for work evaluation? Spine, 37(4):E243-E250.

Abstract

OBJECTIVE: To assess the association of "nonorganic somatic components" together with physical and other psychosocial factors on functional capacity evaluation (FCE) in patients with chronic nonspecific low back pain (NSLBP) undergoing fitness-for-work evaluation.
SUMMARY OF BACKGROUND DATA: Functional capacity evaluation is increasingly used for physical fitness-for-work evaluation in patients with chronic NSLBP, but results seem to be influenced by physical as well as psychosocial factors. The influence of nonorganic somatic components together with physical and other psychosocial factors on FCE performance has not yet been investigated.
METHODS: One hundred twenty-six patients with chronic NSLBP referred for physical fitness-for-work evaluation were included. The 4 FCE tests were lifting from floor to waist, forward bend standing, grip strength, and 6-minute walking. Nonorganic somatic components were assessed with the 8 nonorganic somatic signs as defined by Waddell and were adjusted for age, sex, days off work, salary in the previous occupation, pain intensity, fear avoidance belief, and perceived functional ability in multivariate regression analyses.
RESULTS: Between 42% and 58% of the variation in the FCE tests was explained in the final multivariate regression models. Nonorganic somatic components were consistent independent predictors for all tests. Their influence was most important on forward bend standing and walking distance, and less on grip strength and lifting performance. The physical factors of age and/or sex were strongly associated with grip strength and lifting, less with walking distance, and not at all with forward bend standing. The influence of at least 1 other psychosocial factor was observed in all FCE tests, having the highest proportion in the 6-minute walking test.
CONCLUSION: Nonorganic somatic components seem to be consistent independent predictors in FCE testing and should be considered for interpretation of test results.

OBJECTIVE: To assess the association of "nonorganic somatic components" together with physical and other psychosocial factors on functional capacity evaluation (FCE) in patients with chronic nonspecific low back pain (NSLBP) undergoing fitness-for-work evaluation.
SUMMARY OF BACKGROUND DATA: Functional capacity evaluation is increasingly used for physical fitness-for-work evaluation in patients with chronic NSLBP, but results seem to be influenced by physical as well as psychosocial factors. The influence of nonorganic somatic components together with physical and other psychosocial factors on FCE performance has not yet been investigated.
METHODS: One hundred twenty-six patients with chronic NSLBP referred for physical fitness-for-work evaluation were included. The 4 FCE tests were lifting from floor to waist, forward bend standing, grip strength, and 6-minute walking. Nonorganic somatic components were assessed with the 8 nonorganic somatic signs as defined by Waddell and were adjusted for age, sex, days off work, salary in the previous occupation, pain intensity, fear avoidance belief, and perceived functional ability in multivariate regression analyses.
RESULTS: Between 42% and 58% of the variation in the FCE tests was explained in the final multivariate regression models. Nonorganic somatic components were consistent independent predictors for all tests. Their influence was most important on forward bend standing and walking distance, and less on grip strength and lifting performance. The physical factors of age and/or sex were strongly associated with grip strength and lifting, less with walking distance, and not at all with forward bend standing. The influence of at least 1 other psychosocial factor was observed in all FCE tests, having the highest proportion in the 6-minute walking test.
CONCLUSION: Nonorganic somatic components seem to be consistent independent predictors in FCE testing and should be considered for interpretation of test results.

Citations

6 citations in Web of Science®
6 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Rheumatology Clinic and Institute of Physical Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:25 Oct 2012 12:54
Last Modified:05 Apr 2016 16:01
Publisher:Lippincott Wiliams & Wilkins
ISSN:0362-2436
Publisher DOI:10.1097/BRS.0b013e31822e6088
PubMed ID:21857400

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