The Work Ability Index Predicts Application for Disability Pension after Work-related Medical Rehabilitation for Chronic Back Pain.

The Work Ability Index Predicts Application for Disability Pension after Work-related Medical Rehabilitation for Chronic Back Pain.

Arch Phys Med Rehabil. 2013 May 22;

Authors: Bethge M, Gutenbrunner C, Neuderth S

Abstract
OBJECTIVE: To determine whether the Work Ability Index (WAI), a short 7-item self-report questionnaire addressing issues of perceived disability, impairment, and expectations for resuming work, predicts application for disability pension, recommendations for further treatment and other adverse work-related criteria in chronic back pain patients following rehabilitation. DESIGN: Cohort study with 3-month follow-up. SETTING: Seven inpatient rehabilitation centers. PARTICIPANTS: Patients (N = 294; 168 women; mean age: 49.9 years) with chronic back pain. Interventions: The WAI was completed at beginning of rehabilitation. All patients were treated according to the German rehabilitation guidelines for chronic back pain and work-related medical rehabilitation. MAIN OUTCOME MEASURE: Application for disability pension as assessed by a postal questionnaire three months after discharge. RESULTS: Receiver operating characteristic curve analysis of the association between WAI at baseline and subsequent application for disability pension revealed an area under the curve of 0.80 (95 % CI: 0.62 to 0.97). Youden’s index was highest when the WAI cut-off value was ≤ 20 points (sensitivity: 72.7 %, specificity: 82.2 %, total correct classification: 81.7 %). After adjusting for age and gender, persons with a baseline WAI of ≤ 20 points had 15.6 times (95 % CI: 3.6 to 68.2) higher odds of subsequent application for disability pension, 4.9 times (95 % CI: 1.5 to 16.8) higher odds of unemployment, and 6 times (95 % CI: 2.4 to 15.2) higher odds of long-term sick leave at follow-up. CONCLUSIONS: The WAI could help rehabilitation professionals identify back pain patients with a high risk of a subsequent application for disability pension.

PMID: 23707864 [PubMed – as supplied by publisher]