Does the Upper-Limb Work Instability Scale Predict Transitions Out of Work Among Injured Workers?

• Published in: Archives of physical medicine and rehabilitation Vol. 96; no. 9; pp. 1658 - 1665
• Main Authors: Tang, Kenneth, PhD, Beaton, Dorcas E., PhD, Hogg-Johnson, Sheilah, PhD, Côté, Pierre, PhD, Loisel, Patrick, PhD, Amick, Benjamin C., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2015
• Subjects: Adult; Aged; Chronic Disease; Cohort Studies; Female; Health Status Indicators; Humans; Male; Mental Health; Middle Aged; Musculoskeletal Diseases - rehabilitation; Occupational Diseases - rehabilitation; Occupational injuries; Physical Medicine and Rehabilitation; Predictive value of tests; Rehabilitation; Upper Extremity; Work; Work Capacity Evaluation; Workers’ compensation; Young Adult; positive predictive value; OR; Occupational injuries; CI; Upper-Limb Work Instability Scale; organizational policy and practice; WRUED; odds ratio; Upper extremity; Predictive value of tests; OPP; work-related upper extremity disorder; WI; work instability; NPV; Workplace Safety and Insurance Board; PPV; Work; confidence interval; Rehabilitation; UL-WIS; WSIB; Workers’ compensation; negative predictive value
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2015.04.022

Abstract Objective To investigate the predictive ability of the Upper-Limb Work Instability Scale (UL-WIS) for transitioning out of work among injured workers with chronic, work-related upper extremity disorders (WRUEDs). Design Secondary analysis of a 12-month cohort study with data collection at baseline and 3-, 6-, and 12-month follow-up. Survey questionnaires were used to collect data on an array of sociodemographic, health-related, and work-related variables. Setting Upper extremity specialty clinics. Participants Injured workers (N=356) with WRUEDs who were working at the time of initial clinic attendance. Interventions Not applicable. Main Outcome Measure Transitioning out of work. Results Multivariable logistic regression that considered 9 potential confounders revealed baseline UL-WIS (range, 0–17) to be a statistically significant predictor of a subsequent transition out of work (adjusted odds ratio, 1.18; 95% confidence interval [CI], 1.07–1.31; P =.001). An assessment of predictive values across the UL-WIS score range identified cut-scores of <6 (negative predictive value, .81; 95% CI, .62–.94) and >15 (positive predictive value, .80; 95% CI, .52–.96), differentiating the scale into 3 bands representing low, moderate, and high risk of exiting work. Conclusions The UL-WIS was shown to be an independent predictor of poor work sustainability among injured workers with chronic WRUEDs; however, when applied as a standalone tool in clinical settings, some limits to its predictive accuracy should also be recognized.