Importance of an Integrated Assessment of Functional Disability and
Work Ability in Workers Affected by Low Back Pain

Importance of an Integrated Assessment of Functional Disability and
Work Ability in Workers Affected by Low Back Pain

Depression
Disability
Low back pain
Oswestry Disability Index
Work Ability Index

This study examines the relationship between functional disability and work ability in
workers affected by low back pain (LBP) through an analysis of correlations between the Oswestry
Disability Index (ODI) and Work Ability Index (WAI). The role of personal and work factors on functional
disability/work ability levels has also been studied. LBP is the most common musculoskeletal problem and a
major disabling health problem worldwide. Its etiology is multifactorial. Multidisciplinary approaches may
help reduce the burden of pain and disability and improve job continuity and reintegration at work.
Methods: A cohort of 264 patients affected by LBP from an Italian outpatient clinic were included in a
clinical diagnostic/therapeutic trial aiming at rehabilitation and return to work through an integrated
investigation protocol. Data were collected during the first medical examination using anamnestic and
clinical tools. The final sample is composed of 252 patients, 57.1% man, 44.0 % blue collars, 46.4% with the
high school degree, 45.6% married.
Results: WAI and ODI reported a negative and fair correlation (r ¼ e0.454; p ¼ .000). Workers with acute
LBP symptoms have a higher probability of severe disability than those with chronic LBP symptoms.
White collars without depressive symptoms reported higher work ability e even in chronic disability
conditions-than those with depressive symptoms.
Conclusion: The study found that ODI and WAI have a convergent validity and this suggests that the two
tools measure capture distinctive aspects of disability related to personal, environmental, and occupational characteristics. The most important and modifiable prognostic factors found for ODI and WAI were
depressive symptoms, workday absence, and intensity of back pain. The study also found a mild association between age and ODI. The study’s findings highlight the importance of using a multidisciplinary
approach to manage and prevent disability due to LBP.

Fabrizio Russo 1,2
, Cristina Di Tecco 3,*, Simone Russo 3
, Giorgia Petrucci 2
,
Gianluca Vadalà 1,2
, Vincenzo Denaro 1,2
, Sergio Iavicoli 4

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Research Unit of Orthopaedic and Trauma Surgery, Campus Bio-Medico University Hospital Foundation, Rome, Italy
2 Research Unit of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
3 Italian Workers’ Compensation Authority (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy 4 Ministry of Health, Directorate for Communication and International Affairs, Rome, Italy

18 November 2023

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