Validity of the Multidimensional Task Ability Profile

Work-Readiness self report lift capacity test short form

BACKGROUND

The Multidimensional Task Ability Profile (MTAP) is a measure of self reported physical work capacity developed for injured workers with musculoskeletal disorders (MSDs) to determine readiness to return to work.

OBJECTIVE

This study compared the concurrent validity of a new short form MTAP (MTAP-SF) comprised of 16 lifting and/or carrying items with the MTAP 55-item version. The hypothesis addressed is whether the validity of a version that imposes less respondent burden (MTAP-SF) would be comparable to the more burdensome instrument (MTAP-55).

METHODS

MTAP scores were compared with demonstrated lift capacity in 1,252 healthy adults. Parallel regression analyses were conducted to examine the explanatory power of both MTAP versions.

RESULTS

Age, gender, body mass and MTAP-SF explained 55% of the variance (p < 0.001) in demonstrated lift capacity, equivalent to MTAP-55.

CONCLUSIONS

Self reported performance in physical work capacity tasks accounts for significant variance in lifting performance. MTAP-SF diminishes respondent burden while maintaining validity and may be useful for managing MSDs by enhancing understanding of the evaluee's psychophysical component in return-to-work rehabilitation planning.

Comparison Between Disability, Physical Performance, and Other Biopsychosocial Factors in Full-Duty Career Firefighters Working With and Without Current Low Back Pain

INTRODUCTION

Low back pain (LBP) is highly prevalent and a top cause of disability-related early retirement in firefighters. Those with a lifetime history of LBP have various deficiencies that are associated with increased injury risk and absenteeism. However, the influence of working with current LBP on disability, physical performance, and other biopsychosocial factors has not been fully characterized in this population. The purpose of this study was to compare anthropometric measures, exercise habits, physical fitness/performance, disability/work ability, and other biopsychosocial factors of firefighters working with and without current LBP.

METHODS

A cross-sectional study was conducted using baseline assessments from 419 full-duty career firefighters without documented work restrictions (age: 37.6 ± 8.8 y; 5 F, 414 M) who were enrolled in a regional wellness initiative in Southern California, USA. Current LBP status was determined by a questionnaire and confirmed by an interview. Anthropometric measures, patient-reported outcomes, and physical fitness tests were used to assess body mass index; body fat %; waist circumference; strengthening, cardiovascular, and flexibility exercise frequency; back and core muscular endurance; functional movement quality, perceived back-related disability, lift and carry ability, and firefighter task ability; sleep quality; and perceptions of fear and fatigue and catastrophic injustice experience. Scores for participants with and without current LBP were compared using analysis of variance and chi-square analysis.

RESULTS

The point prevalence of current LBP was 19.81% (83/419). For the entire cohort, those with current LBP had significantly worse scores than those without current LBP for all assessed variables, except core muscular endurance and functional movement quality. These trends held up when analyses were stratified by age and obesity categories, and approximately half of the comparisons retained statistical significance. A significantly greater percentage of participants with current LBP were working with some level of back-related disability and/or perceived physical demand characteristics of work level below the required very heavy job demands.

CONCLUSION

Nearly one-fifth of full-duty career firefighters without documented work restrictions reported having current LBP, and these individuals had deficits in several modifiable biopsychosocial factors across five health domains. These findings can help guide future research and implementation efforts in the fire service designed to improve performance, resiliency, work readiness, recovery, and quality of life, as well as to reduce impairment, disability, and absenteeism and increase presenteeism.

Development and validation of a method to screen for co-morbid depression by non-behavioral health practitioners treating musculoskeletal pain

BACKGROUND:

Although diagnosis and treatment of depressive illness is outside the scope of practice for non-behavioral health practitioners such as occupational therapists, physical therapists, kinesiotherapists, and chiropractors, it frequently is comorbid with painful musculoskeletal disorders such as low back pain and it negatively affects outcomes, including return to work. As psychologically-informed practice becomes more widely implemented without the immediate availability of behavioral health practitioners, safe and effective methods to screen for and appropriately triage depressive illness by nonbehavioral health practitioners are necessary.

OBJECTIVES:

To demonstrate the efficacy and validity of a method employed by non-behavioral health practitioners to screen for and appropriately triage musculoskeletal pain patients who also are experiencing depressive illness.

METHODS:

As part of a previously-published psychometric research study conducted in a community-based musculoskeletal pain rehabilitation program, a method was developed for nonbehavioral health practitioners to screen for and appropriately triage patients for co-morbid depressive illness, thus providing the current opportunity to examine the effects of depressive illness on work outcomes. The first step in the two-step process involves a 22-item questionnaire, providing scores used in the second step to triage for outside consultation with behavioral health practitioners. This paper describes the screening method and its application in an observational study of the impact of depressive illness on work outcomes.

RESULTS:

Among 156 consecutive patients who were presenting with musculoskeletal pain disorders to an outpatient rehabilitation program, 22.3% also were identified to have co-morbid clinical depression. The screening process allowed all patients to continue in the rehabilitation program. Those who were already receiving behavioral health care were encouraged to inform care providers of their participation in the program. Those who were not receiving behavioral health care were successfully triaged to care outside of the clinic. Depressive illness was found to affect success in the program, confirming the validity of the screening process for outpatient rehabilitation program participants experiencing chronic pain.

CONCLUSIONS:

A simple and effective depression screening process that triages patients without interruption of musculoskeletal treatment can be employed by nonbehavioral health practitioners. Because return to work outcomes were found to be negatively affected by depressive illness, this approach has the potential to improve overall program efficacy.