Inter-rater reliability and predictive validity of a new functional capacity evaluation for chronic back pain

背部疼痛给澳大利亚社会造成了数百亿美元的损失。背部疼痛是造成工伤和失去工作时间的主要原因之一。一个人离开工作岗位的时间越长，让他重返工作岗位就越困难。澳大利亚各地的工人赔偿制度旨在让背部疼痛的受伤工人尽快重返工作岗位。这个过程中的困难之一是确定背痛患者在工作场所可以做些什么。一种被称为功能能力评估（FCE）的评估技术，是一种用来找出背痛患者身体上能做什么和不能做什么的方法。在FCE中，训练有素的健康专业人员，如职业治疗师，观察患者进行一系列身体活动，如他或她在工作中可能必须进行的活动。治疗师密切观察患者进行的活动，如举起、搬运、跪下、蹲下、保持平衡和行走，并注意患者完成这些活动的能力的任何限制。治疗师对患者在工作中可能遇到的困难作出评论，并就如何减少或消除这些困难提出建议。从这些评估中获得的信息对主治医生来说很有价值，可以决定患者是否准备好回去工作，以及患者在工作中可以做什么，不能做什么。由于它们提供的价值，FCE通常用于澳大利亚各地工人补偿系统认可的康复计划。尽管对这些评价所作评级的可靠性研究有限，但FCE的广泛使用和认可仍在发生。有必要了解FCE给出的建议在治疗师之间是否一致（即可靠），并了解FCE是否准确地预测了患者的身体工作能力。这项研究将检查这些问题与受伤的工人背部疼痛。

Back pain costs the Australian community tens of billions of dollars. Back pain is one of the main causes of work injury and lost time from work. The longer a person is off work, the harder it is to get them back to work. Workers' compensation systems around Australia aim at getting the injured worker with back pain back to work as soon as possible. One of the difficulties in this process is determining what the person with back pain can physically do in the workplace. An evaluation technique, called functional capacity evaluation (known as FCE), is one method used to find out what the person with back pain physically can and cannot do. In a FCE, a trained health professional such as an occupational therapist, observes the person performing a range of physical activities like the ones he or she may have to perform in a job. The therapist closely observes the person performing activities such as lifting, carrying, kneeling, crouching, balancing, and walking and notes any limitations in the person's ability to complete the activities. The therapist makes comments about what difficulties the person may have on the job and recommendations about how these could be reduced or eliminated. The information gained from these evaluations can be valuable for the treating doctor in deciding whether the person is ready to go back to work and what duties the person can and cannot do on the job. Because of such value they provide, FCE is commonly used in rehabilitation programs endorsed by workers' compensation systems around Australia. This widespread use and endorsement of FCE occurs despite limited research on the soundness of the ratings made from these evaluations. There is a need to see whether recommendations made from FCEs are consistent between therapists (i.e. reliable) and to see if the FCE accurately predicts the person's physical capacity for work. This research will examine these issues with injured workers with back pain.