Towards better understanding of FCE performance in different societal contexts

A considerable amount of research has been conducted on Functional Capacity Evaluation (FCE) performance. Evidence is accumulating on a bio-psycho-social model influence; differences in age, gender, self-efficacy, motivation, country, and mother language have been found associated with FCE performance. Previous research has focused on biological and psychological factors; however, studies on social factor’s influence are lacking. The present project aims to provide better understanding of the societal variables that affect FCE results.

This is a cross-sectional study, developed as close as possible to ‘care as usual’. Patients enrolled will be between 18 and 65 years of age, diagnosed with non-specific sub-acute or chronic pain, and undergo FCE as part of routine clinical care. Bio-psycho-social data and FCE characteristics will be collected from different countries, institutions and evaluators. Patients are asked to fill a short questionnaire about pain intensity, factors associated with pain, work ability, and disability. Clinicians are asked to complete two data collection forms: one with patient and FCE characteristics; and another one with information about themselves, including an adapted Back Beliefs Questionnaire. A core set of lifting, and walking or handgrip strength test will be measured.

Collected data will be de-identified. It will be sent periodically to country liaisons who will de-identify patients and clinicians, merge data, and send to the principal investigator. The data collection phase will last 6 months. Country liaisons are in charge of adapting the protocol to their country guidelines and regulations, and coordinating data collection.

Differences in the healthcare, workplace, legislative, and personal systems (see figure) as well as evaluator and patient characteristics may better explain differences in FCE results

September 2015 - March 2016: study conduct, including data entry.

The study is designed as ‘care as usual’ for the patients, and as close as possible to care as usual for clinicians.
FCE will be performed according to regular protocols, with a mandatory core set of tests: low lifting (all patients), and walking or handgrip strength (clinician’s decision depending on the affected region or work demands). Other tests can be performed for FCE, but data will not be collected for this study.