Comparing self-report, clinical examination and functional testing in the assessment of work-related limitations in patients with chronic low back pain

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Abstract
To compare the work-related limitations assessed using self-report, clinical examination and functional testing in patients with chronic low back pain (CLBP). Work-related limitations of 92 patients were assessed using self-report, clinical examination and functional testing. To obtain the assessed limitations the patient (self-report), the physician (clinical examination) and a trained evaluator (functional testing) completed a scorings form about the work-related limitations of the patient. The Isernhagen Work Systems Functional Capacity Evaluation (IWS FCE) was used to obtain the functional testing results. A kappa value of more than 0.60, absolute agreement of more than 80% and ICC of more than 0.75 were considered as acceptable. Little agreement and correlation among self-report, clinical examination and functional testing were found for the assessment of work-related limitations. Self-reported limitations were considerably higher than from those derived from clinical examination or functional testing. Additionally, the limitations derived from the clinical examination were higher than those derived from the IWS FCE. Comparing self-report, clinical examination and functional testing for assessing work-related limitations in CLBP patients showed large considerable differences in limitations. Professional health care workers should be aware of these differences when using them in daily practice.