A test to measure lift capacity of physically impaired adults. Part 1--Development and reliability testing.

STUDY DESIGN: Two laboratory studies and one field study evaluated the safety and test-retest reliability of a new test of lift capacity. The first two studies were conducted in a carefully controlled laboratory setting. The first study investigated the safety and intra-rater reliability of the EPIC Lift Capacity test protocol with healthy adult subjects. The second study assessed the safety and inter-rater reliability of the test with disabled subjects. The third study was conducted in the field with 65 evaluators and investigated the safety and intra-rater reliability of the test with healthy adult subjects. OBJECTIVE: To assess the safety and reliability of a new test of lift capacity. SUMMARY OF BACKGROUND DATA: A new test of lift capacity has been developed. Test development occurred within the context of ergonomic standards and guide-lines of the major professional associations and public agencies that govern test development in the United States. METHODS: In study no. 1, 26 healthy subjects participated. In study no. 2, 14 disabled subjects participated. In study no. 3, 318 healthy subjects participated. After subjects underwent basic screening and warm-up, the EPIC Lift Capacity test was administered. One to 2 weeks later, the test was administered again. Correlations between the times of testing were calculated. RESULTS: No subjects were injured. Hamstring soreness the next day that resolved without complication was reported by some healthy subjects. None of the disabled subjects reported new symptoms. CONCLUSION: The safety and reliability of the EPIC Lift Capacity test was adequately demonstrated in a laboratory setting and across multiple field sites with evaluators who have varying types and degrees of professional preparation.

Clinical effectiveness of behavioral signs for screening chronic low-back pain patients in a work-oriented physical rehabilitation program.

This prospective study investigated the relationship between behavioral sign scores (from Waddell) and the return to work status of chronic low-back pain patients who completed a work-oriented physical rehabilitation program without formal facility-related psychologic or social services. Further, the authors monitored the effect of this program on changing these scores. The program consisted of physical reconditioning through resistive exercises, flexibility and aerobic training, posture and body mechanics education, and progressive work simulation tasks and activities of daily living. One hundred eighty-three nonworking or partially disabled low-back pain patients with an average duration of 8.7 months' disability were included in the study. The presence of each of eight behavioral signs was tested for on entry and again on completion of the program. Analysis showed a significant drop in behavioral sign scores for patients who successfully returned to work. There was no significant reduction in scores for patients who did not return to work. The results suggest these signs may predict the effectiveness of treating chronic low-back pain patients in a return-to-work physical rehabilitation program. Conversely, screening for behavioral signs may identify low-back pain patients who would benefit from intensive behavioral and psychiatric testing and intervention efforts.

Treatment of chronic low-back pain. A community-based comprehensive return-to-work physical rehabilitation program.

A retrospective evaluation of treatment methods used in 1981 and 1982 and the subsequent rate of return to work was conducted on 350 consecutive patients with low-back pain. Two hundred nine patients completed 12 or more treatments in sessions that occurred three times a week. Of these, 120 were chronically disabled. The program aimed at maximizing function and return to work through graded exercise, biomechanics education, work simulation exercises, endurance activities, and flexibility training. All patients remained under the care of their own physicians. Return-to-work or work status improvement was accomplished in 58.1% of the patients. The working hypothesis is that in many back-disabled patients the original cause of disability healed or resolved, and current symptoms were often attributable to deconditioning fear and poor biomechanics. Conservative management is effective in returning many chronic back-pain patients to economic productivity.