Functional Capacity Evaluation bij patienten met Whiplash Associated Disorders

De meeste mensen met nekletsel dat valt binnen de categorie Whiplash-Associated Disorder (WAD) herstellen snel en kunnen binnen enkele dagen of weken weer aan het werk. Sommigen blijven echter klachten en beperkingen houden. Artsen gebruiken o.a. functionele testen voor diagnostiek.
The majority of people who are exposed to a musculoskeletal injury recover quickly and return to work within days. However, some individuals with neck-injury also termed as whiplash associated disorder (WAD) report substantial levels of disability which can lead to considerable burden to the individual and society due high costs of health care and work loss. To determine the level of (dis)ability, clinicians must rely on history taking, questionnaires and assessments e.g. such as Functional Capacity Evaluation (FCE). FCE applied in this thesis consists of 8 performance based tests to measure the work-related physical capacity. FCE tests are used to make recommendations for participation in work. Another way of measuring functioning is the use of self-reported measures such as the picture-based questionnaire called the Spinal Function Sort (SFS). The aim of this thesis was to determine the measurement properties of FCE tests and SFS in patients with WAD. The main results are: FCE tests can be used to determine level of physical effort. The reliability of FCE tests is sufficient, although clinicians should be aware of measurement error. Validity has been established. Social variables such cultural background should be taken into account in the interpretation of FCE tests. Return to work over 12 months can be predicted by work capacity at baseline, time since injury, cultural background and self-reported disability. The SFS questionnaire appears utile in patients with WAD and back pain and can be optimized without loss of quality by reducing the number of questions. These results have several implications for the patient, for health professionals and work specialists: a prediction-model has been developed which whom one can determine/calculated future work capacity for an individual patient. The number of FCE tests will be reduced and some tests adapted and therefore are less time consuming. A research project was launched to develop an adapted version of