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Validation of the Work-Disability Physical Functional Assessment Battery

      Abstract

      Objective

      To examine the validity of the self-report Work-Disability Functional Assessment Battery (WD-FAB) physical function scales relative to clinician ratings of function and a performance-based functional capacity evaluation called the Physical Work Performance Evaluation (PWPE).

      Design

      Cross-sectional.

      Setting

      Outpatient rehabilitation.

      Participants

      Adults (N=50) participating in physical therapy for musculoskeletal conditions.

      Interventions

      Not applicable.

      Main Outcome Measures

      Patients completed the PWPE and the WD-FAB physical function scales including Changing and Maintaining Body Position, Whole Body Mobility, Upper Body Function, and Upper Extremity Fine Motor. The physical therapist also answered the WD-FAB questions on the patient’s physical functioning. The WD-FAB computer-adaptive test version administered up to 10 items for each scale. The PWPE produces ratings from 0 to 5 indicating overall Level of Work ability: 0 (unable to work); 1 (sedentary); 2 (light); 3 (medium); 4 (heavy); 5 (very heavy). The PWPE also produces Level of Work ability ratings in the Dynamic Strength, Position Tolerance, and Mobility subsections.

      Results

      Participating in the study were 50 patients with 1 or more conditions (shoulder, n=21; knee, n=16; low back, n=13; ankle/foot, n=10; neck, n=8; hip, n=7). The patient-based WD-FAB scores demonstrated moderate, statistically significant correlations with the provider proxy WD-FAB report (R=.49-.65). The WD-FAB Upper Body Function scale scores demonstrated moderate strength relationships with the PWPE overall ratings. The Whole Body Mobility and Changing and Maintaining Body Position scales did not demonstrate statistically significant relationships with the PWPE overall ratings.

      Conclusions

      We found moderate evidence for validity for the WD-FAB Upper Body Function, Whole Body Mobility, and Changing and Maintaining Body Position scales relative to clinician report and varied evidence relative to the PWPE in this clinical sample.

      Keywords

      List of abbreviations:

      FCE (Functional Capacity Evaluation), PWPE (Physical Work Performance Evaluation), SSA (U.S. Social Security Administration), WD-FAB (Work-Disability Functional Assessment Battery)
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      References

        • Social Security Administration
        Annual statistical report on the Social Security Disability Insurance program, 2015.
        (Available at:) (Accessed January 14, 2017)
        • Institute of Medicine
        Improving the Social Security disability decision process.
        National Academies Press, Washington, D.C2007
        • Marfeo E.E.
        • Jette A.M.
        • Eisen S.E.
        • et al.
        A conceptual foundation for measures of physical function and behavioral health function for Social Security work disability evaluation.
        Arch Phys Med Rehabil. 2013; 94: 1645-1652
        • Marfeo E.E.
        • Ni P.
        • Chan L.
        • et al.
        Interpreting physical and behavioral health scores from new work disability instruments.
        J Rehabil Med. 2015; 47: 394-402
        • Marfeo E.E.
        • Ni P.
        • Haley S.M.
        • et al.
        Development of an instrument to measure behavioral health function for work disability: item pool construction and factor analysis.
        Arch Phys Med Rehabil. 2013; 94: 1670-1678
        • Marfeo E.E.
        • Ni P.
        • Haley S.M.
        • et al.
        Scale refinement and initial evaluation of a behavioral health function measurement tool for work disability evaluation.
        Arch Phys Med Rehabil. 2013; 94: 1679-1686
        • Marino M.E.
        • Meterko M.
        • Marfeo E.E.
        • et al.
        Work-related measures of physical and behavioral health function: Test-retest reliability.
        Disabil Health J. 2015; 8: 652-657
        • McDonough C.M.
        • Jette A.M.
        • Ni P.
        • et al.
        Development of a self-report physical function instrument for work disability assessment: item pool construction and factor analysis.
        Arch Phys Med Rehabil. 2013; 94: 1653-1660
        • McDonough C.M.
        • Ni P.S.
        • Peterik K.
        • et al.
        Improving measures of work-related physical functioning.
        Qual Life Res. 2017; 26: 789-798
        • Meterko M.
        • Marfeo E.E.
        • McDonough C.M.
        • et al.
        Work disability functional assessment battery: feasibility and psychometric properties.
        Arch Phys Med Rehabil. 2015; 96: 1028-1035
        • Ni P.S.
        • McDonough C.M.
        • Jette A.M.
        • et al.
        Development of a computer-adaptive physical function instrument for Social Security Administration disability determination.
        Arch Phys Med Rehabil. 2013; 94: 1661-1669
        • Terwee C.B.
        • Mokkink L.B.
        • Knol D.L.
        • Ostelo R.W.
        • Bouter L.M.
        • de Vet H.C.
        Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist.
        Qual Life Res. 2012; 21: 651-657
        • Prinsen C.A.C.
        • Mokkink L.B.
        • Bouter L.M.
        • et al.
        COSMIN guideline for systematic reviews of patient-reported outcome measures.
        Qual Life Res. 2018; 27: 1147-1157
        • Bean J.F.
        • Olveczky D.D.
        • Kiely D.K.
        • LaRose S.I.
        • Jette A.M.
        Performance-based versus patient-reported physical function: what are the underlying predictors?.
        Phys Ther. 2011; 91: 1804-1811
        • Latham N.K.
        • Mehta V.
        • Nguyen A.M.
        • et al.
        Performance-based or self-report measures of physical function: which should be used in clinical trials of hip fracture patients?.
        Arch Phys Med Rehabil. 2008; 89: 2146-2155
        • Matheson L.N.
        The functional capacity evaluation.
        in: Andersson G. Demeter S. Smith G. Disability evaluation. 2nd ed. Mosby Yearbook, 2003
        • Brouwer S.
        • Reneman M.F.
        • Dijkstra P.U.
        • Groothoff J.W.
        • Schellekens J.M.
        • Goeken L.N.
        Test-retest reliability of the Isernhagen Work Systems Functional Capacity Evaluation in patients with chronic low back pain.
        J Occup Rehabil. 2003; 13: 207-218
        • Dusik L.A.
        • Menard M.R.
        • Cooke C.
        • Fairburn S.M.
        • Beach G.N.
        Concurrent validity of the ERGOS work simulator versus conventional functional capacity evaluation techniques in a workers' compensation population.
        J Occup Rehabil. 1993; 35: 759-767
        • Gibson L.
        • Strong J.
        Expert review of an approach to functional capacity evaluation.
        Work. 2002; 19: 231-242
        • Lechner D.E.
        • Jackson J.R.
        • Roth D.L.
        • Straaton K.V.
        Reliability and validity of a newly developed test of physical work performance.
        J Occup Rehabil. 1994; 36: 997-1004
        • Reneman M.F.
        • Jorritsma W.
        • Schellekens J.M.
        • Goeken L.N.
        Concurrent validity of questionnaire and performance-based disability measurements in patients with chronic nonspecific low back pain.
        J Occup Rehabil. 2002; 12: 119-129
        • Reneman M.F.
        • Wittink H.
        • Gross D.P.
        The scientific status of functional capacity evaluation.
        in: Genovese E. Galper J.S. Guide to the evaluation of functional ability: how to request, interpret, and apply functional capacity evaluations. American Medical Association, 2009: 393-420
        • Lechner D.E.
        • Page J.J.
        • Sheffield G.
        Predictive validity of a functional capacity evaluation: the physical work performance evaluation.
        Work. 2008; 31: 21-25
      1. Social Security Administration. SSR 83-10: Titles II and XVI: determining capability to do other work—the medical–vocational rules of appendix 2. Available at: https://www.ssa.gov/OP_Home/rulings/di/02/SSR83-10-di-02.html. Accessed January 12, 2017.

        • Waddell G.
        • Main C.J.
        Assessment of severity in low-back disorders.
        Spine. 1984; 9: 204-208
        • Waddell G.
        Clinical assessment of lumbar impairment.
        Clin Orthop Relat Res. 1987; : 110-120
        • Hazard R.G.
        • Haugh L.D.
        • Green P.A.
        • Jones P.L.
        Chronic low back pain: the relationship between patient satisfaction and pain, impairment, and disability outcomes.
        Spine. 1994; 19: 881-887
        • Kuijer P.P.
        • Gouttebarge V.
        • Brouwer S.
        • Reneman M.F.
        • Frings-Dresen M.H.
        Are performance-based measures predictive of work participation in patients with musculoskeletal disorders? A systematic review.
        Int Arch Occup Environ Health. 2012; 85: 109-123
        • National Academy of Sciences. Committee on Occupational Classification and Analysis
        Dictionary of Occupational Titles (DOT): Part I - Current Population Survey, April 1971, Augmented With DOT Characteristics and Dictionary of Occupational Titles (DOT): Part II - Fourth Edition Dictionary of DOT Scores for 1970 Census Categories.
        U.S. Dept. of Commerce, Bureau of the Census, Washington, DC1971
        • Cohen J.
        Statistical power analysis for the behavioral sciences.
        2nd edition. Lawrence Erlbaum Associates, 1988
        • Monti K.L.
        Folded empirical distribution function curves: mountain plots.
        Am Stat. 1995; 49: 342-345
        • McDowell I.
        Measuring health: a guide to rating scales and questionnaires.
        3rd edition. Oxford University Press, 2006
        • Andresen E.M.
        • Vahle V.J.
        • Lollar D.
        Proxy reliability: Health-related quality of life (HRQoL) measures for people with disability.
        Qual Life Res. 2001; 10: 609-619
        • Hilari K.
        • Owen S.
        • Farrelly S.J.
        Proxy and self-report agreement on the Stroke and Aphasia Quality of Life Scale-39.
        J Neurol Neurosurg Psychiatry. 2007; 78: 1072-1075
        • Horowitz A.
        • Goodman C.R.
        • Reinhardt J.P.
        Congruence between disabled elders and their primary caregivers.
        Gerontologist. 2004; 44: 532-542
        • Sneeuw K.C.
        • Sprangers M.A.
        • Aaronson N.K.
        The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease.
        J Clin Epidemiol. 2002; 55: 1130-1143
        • Barrett A.M.
        Rose-colored answers: neuropsychological deficits and patient-reported outcomes after stroke.
        Behav Neurol. 2010; 22: 17-23
        • Sneeuw K.C.
        • Aaronson N.K.
        • de Haan R.J.
        • Limburg M.
        Assessing quality of life after stroke. The value and limitations of proxy ratings.
        Stroke. 1997; 28: 1541-1549