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Title: Functional capacity evaluation in different societal contexts : results of a multicountry study
Authors: Echeita, JA
Bethge, M
van Holland, BJ
Gross, DP
Kool, J
Oesch, P
Trippolini, MA
Chapman, E
Cheng, ASK 
Sellars, R
Spavins, M
Streibelt, M
van der Wurff, P
Reneman, MF
Keywords: Internationality
Occupational health
Sociological factors
Chronic pain
Issue Date: 2019
Publisher: Springer
Source: Journal of occupational rehabilitation, Mar. 2019, v. 29, no. 1, p. 222-236 How to cite?
Journal: Journal of occupational rehabilitation 
Abstract: Purpose To examine factors associated with Functional Capacity Evaluation (FCE)
Results in patients with painful musculoskeletal conditions, with focus on social factors across multiple countries.
Methods International cross-sectional study was performed within care as usual. Simple and multiple multilevel linear regression analyses which considered measurement's dependency within clinicians and country were conducted: FCE characteristics and biopsychosocial variables from patients and clinicians as independent variables; and FCE results (floor-to-waist lift, six-minute walk, and handgrip strength) as dependent variables.
Results Data were collected for 372 patients, 54 clinicians, 18 facilities and 8 countries. Patients' height and reported pain intensity were consistently associated with every FCE result. Patients' sex, height, reported pain intensity, effort during FCE, social isolation, and disability, clinician's observed physical effort, and whether FCE test was prematurely ended were associated with lift. Patient's height, Body Mass Index, post-test heart-rate, reported pain intensity and effort during FCE, days off work, and whether FCE test was prematurely ended were associated with walk. Patient's age, sex, height, affected body area, reported pain intensity and catastrophizing, and physical work demands were associated with handgrip. Final regression models explained 3865% of total variance. Clinician and country random effects composed 1-39% of total residual variance in these models.
Conclusion Biopsychosocial factors were associated with every FCE result across multiple countries; specifically, patients' height, reported pain intensity, clinician, and measurement country. Social factors, which had been under-researched, were consistently associated with FCE performances. Patients' FCE results should be considered from a biopsychosocial perspective, including different social contexts.
ISSN: 1053-0487
EISSN: 1573-3688
DOI: 10.1007/s10926-018-9782-x
Rights: © The Author(s) 2018, Corrected publication June/2018
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
The following publication Echeita, J. A., Bethge, M., van Holland, B. J., Gross, D. P., Kool, J., Oesch, P., ... & Reneman, M. F. (2019). Functional Capacity Evaluation in different societal contexts: results of a multicountry study. Journal of occupational rehabilitation, 29(1), 222-236 is available at
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