title: Reliability and safety of functional capacity evaluation in patients with whiplash associated disorders.
abstract: BACKGROUND
  Whiplash-associated disorders (WAD) are a burden for both individuals and society. It is recommended to evaluate patients with WAD at risk of chronification to enhance rehabilitation and promote an early return to work. In patients with low back pain (LBP), functional capacity evaluation (FCE) contributes to clinical decisions regarding fitness-for-work. FCE should have demonstrated sufficient clinimetric properties. Reliability and safety of FCE for patients with WAD is unknown.
  
  
  METHODS
  Thirty-two participants (11 females and 21 males; mean age 39.6 years) with WAD (Grade I or II) were included. The FCE consisted of 12 tests, including material handling, hand grip strength, repetitive arm movements, static arm activities, walking speed, and a 3 min step test. Overall the FCE duration was 60 min. The test-retest interval was 7 days. Interclass correlations (model 1) (ICCs) and limits of agreement (LoA) were calculated. Safety was assessed by a Pain Response Questionnaire, observation criteria and heart rate monitoring.
  
  
  RESULTS
  ICCs ranged between 0.57 (3 min step test) and 0.96 (short two-handed carry). LoA relative to mean performance ranged between 15 % (50 m walking test) and 57 % (lifting waist to overhead). Pain reactions after WAD FCE decreased within days. Observations and heart rate measurements fell within the safety criteria.
  
  
  CONCLUSIONS
  The reliability of the WAD FCE was moderate in two tests, good in five tests and excellent in five tests. Safety-criteria were fulfilled. Interpretation at the patient level should be performed with care because LoA were substantial.
authors.affiliation: Department of Work Rehabilitation, Rehaklinik Bellikon, Suva Care, 5454 Bellikon, Switzerland. maurizio.trippolini@rehabellikon.ch
authors.forename: M A
authors.initials: MA
authors.lastname: Trippolini
authors.forename: M F
authors.initials: MF
authors.lastname: Reneman
authors.forename: B
authors.initials: B
authors.lastname: Jansen
authors.forename: P U
authors.initials: PU
authors.lastname: Dijkstra
authors.forename: J H B
authors.initials: JH
authors.lastname: Geertzen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D059350:Chronic Pain / Q000534:rehabilitation*; D003697:Delphi Technique; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D015203:Reproducibility of Results; D062707:Return to Work; D012449:Safety; D013557:Switzerland; D014911:Whiplash Injuries / Q000534:rehabilitation*; D014938:Work Capacity Evaluation