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Background: Enhancement of physical activities is an important goal in rehabilitation programmes for patients with chronic musculoskeletal pain (CMP). A relationship between activity level and psychological factors is suggested but studied scarcely. Aim: To explore the relationship between the activity level and psychological factors in patients with CMP. Methods: Study design is cross-sectional, explorative. Participants are patients with CMP, included for outpatient multidisciplinary pain rehabilitation. Measures: Activity level was measured by the RT3 accelerometer during 1 week; pain intensity was measured with a 100-mm visual analogue scale; depression, somatization and distress were measured with Symptom Checklist-90-Revised (SCL-90-R), coping strategy with the Utrecht Coping List (UCL, scales active coping, passive coping, avoiding), fear of movement measured with Tampa Scale of Kinesiophobia (TSK), scale activity avoidance. Depending on data distribution, correlations between the mean number of activity counts and psychological factors were tested with Pearson or Spearman correlation coefficients. Results: Fifty three patients were included: age mean 39.9 years [standard deviation (SD) 11.3]; activity counts per day mean 198,243 (SD 78,000); pain intensity mean 58 (SD 27.7); SCL-90-R mean 149.4 (SD 42.5); UCL active coping mean 17.9 (SD 3.7); UCL passive coping mean 12.3 (SD 3.7); UCL avoiding mean 15.3 (SD 3.0); TSK total mean 35.4 (SD 7.4); TSK activity avoidance mean 16.9 SD (4.7). Correlations between psychological factors and the mean number of activity counts per day ranged from r = -0.27 to r = 0.01 and were all non-significant (p >= 0.05). Conclusion: Psychological factors and activity level were unrelated in patients with CMP

Background: Theoretically, acceptance of chronic pain (CP) is an important determinant in the functional status and well-being of patients with CP. Several questionnaires that aim to measure acceptance of CP have been developed. An overview of the psychometric properties of these questionnaires is unavailable. Methods: A systematic review of the literature of the psychometric properties of questionnaires that aim to measure acceptance of CP was performed. Psychometric properties including content construct and criterion validity, internal consistency. agreement, reliability, responsiveness, floor/ceiling effects and interpretability, were assessed using a standardized protocol. All studies were assessed by two observers independent from each other. Results: A total of 23 studies including 4 questionnaires or subscales were identified. The questionnaires/subscales included were the Chronic Pain Acceptance Questionnaire (CPAQ), Illness Cognitions Questionnaire (ICQ), Pain Solutions Questionnaire (PASOL) and Acceptance of Illness Scale (AIS) adapted to pain. When applying the criteria of the protocol, results indicate that none of the questionnaires are currently able to meet all 9 criteria for psychometric quality. Individual questionnaires met between 0 and 3 of the criteria. Conclusions: If strict psychometric quality criteria are applied, none of the questionnaires are currently able to meet all nine criteria for psychometric quality, but overlooking the cumulative results over all the studies conducted, especially for the CPAQ, it can be concluded that information on several important characteristics has been reported and a fairly clear picture emerges about the psychometric properties of the CPAQ. (C) 2009 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

Background: The problem of inconsistent terminology in Functional Capacity Evaluation (FCE) has been widely addressed in the international literature. Many different terms seem to be used interchangeably while other terms appear to be interpreted differently. Objective: To gain consensus in operational definitions in FCE and conceptual framework to classify terminology used in FCE. Methods: A Delphi Survey was conducted which consisted of three rounds of questioning, using semi- and full-structured questions. The expert group was formed from international experts in FCE. Consensus of definitions was considered when 75% or more of all experts agreed with a definition. Results: In total, 22 international experts from 6 different countries in Australia, Europe and North America, working in different health related sectors, participated in this study. Consensus concerning conceptual framework of FCE was met in 9 out of 20 statements. Consensus on definitions was met in 10 out of 19 definitions. Experts agreed to use the ICF as a conceptual framework in which terminology of FCE should be classified and agreed to use pre-defined terms of the ICF. No consensus was reached about the definition of “Functional Capacity Evaluation,” for which two potential eligible definitions remained. Conclusion: Consensus was reached in many terms used in FCE. For future research, it was recommended that researchers use these terms, use the ICF as a conceptual framework and clearly state which definition for FCE is used because no definition of FCE was consented.

Background: Functional Capacity Evaluations (FCEs) are evaluations designed to measure capacity to perform activities and are used to make recommendations for participation in work. Normative values of healthy working subjects' performances are unavailable, thus patients' performances cannot be compared to those values. Objective: To establish normative values for FCE of healthy working subjects. Methods: Healthy subjects working in over 180 professions performed an FCE consisting of 12 work-related tests. Subjects were classified into categories based on physical demands according to the Dictionary of Occupational Titles (DOT). Means, ranges, standard deviations, percentiles were calculated and a regression analyses for outcome of the 12 tests was performed. Results: Normative FCE values of 701 healthy working subjects (448 male, 253 female) were established for 4 physical demand categories. Conclusion: The normative values enable comparison of patients' performances to these values. If the patients' performances exceed the lowest scores in his/her corresponding demand category, the patients' capacity is very likely to be sufficient to defy the work load. Further, clinicians can make more precise return to work recommendations and set goals for rehabilitation programs. Comparisons to normative values are useful for the fields of rehabilitation, occupational and insurance medicine. Further research is needed to test validity of the normative references with respect to work place assessments and return to work recommendations.