Related Experiment Video
Updated: Jun 27, 2026
Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
ISSLS prize winner: early predictors of chronic work disability: a prospective, population-based study of workers
Judith A Turner1, Gary Franklin, Deborah Fulton-Kehoe
1Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195-6560, USA. jturner@u.washington.edu
Study Design:
Prospective population-based cohort study.
Objective:
To identify early predictors of chronic work disability after work-related back injury.
Summary Of Background Data:
Identification of early predictors of prolonged disability after back injury could increase understanding concerning the development of chronic, disabling pain, and aid in secondary prevention. Few studies have examined predictors across multiple domains in a large, population-based sample.
Methods:
Workers (N = 1885) were interviewed 3 weeks (average) after submitting a lost work-time claim for a back injury. Sociodemographic, employment-related, pain and function, clinical, health care, administrative/legal, health behavior, and psychological domain variables were assessed via worker interviews, medical records, and administrative databases. Logistic regression analyses identified early predictors of work disability compensation 1 year after claim submission.
Results:
Significant baseline predictors of 1-year work disability in the final multidomain model were injury severity (rated from medical records), specialty of the first health care provider seen for the injury (obtained from administrative data), and worker-reported physical disability (Roland-Morris disability questionnaire), number of pain sites, "very hectic" job, no offer of a job accommodation (e.g., light duty), and previous injury involving a month or more off work. The model showed excellent ability to discriminate between workers who were/were not disabled at 1 year (area under the receiver operating characteristic curve = 0.88, 95% CI = 0.86-0.90).
Conclusion:
Among workers with new lost work-time back injury claims, risk factors for chronic disability include radiculopathy, substantial functional disability, and to a lesser extent, more widespread pain and previous injury with extended time off work. The roles of employers and health care providers also seem important, supporting the need to incorporate factors external to the worker in models of the development of chronic disability and in disability prevention efforts.