Relation of pre-existing lower-back problems with post-offer pre-placement physical testing

Abstract

Background

Physical Capacity Profile (PCP) testing involves a series of physical fitness tests to assess physical capabilities of newly-hired workers for specific job requirements. Studies have found a higher incidence of work-related lower-back injuries in employees with PCP scores below their job level as defined by the U.S. Department of Labor.

Objective

This study evaluated associations between demographics, history of lower-back pain (HxLBP), and associated surgery (HxLBP+Surgery) with PCP results of newly hired workers from a large database.

Methods

This retrospective, cross-sectional study used data collected from 150 test sites between March 19, 2015 and December 31, 2018. Regressions were conducted for overall PCP score as well as individual tests for spinal range of motion (ROM) and dynamic strength, controlling for demographics, anthropometrics, and medical history.

Results

PCP data from the first 100,000 consecutive subjects entered into a database were assessed (mean age 33.2 ± 12.4 years, 32,926 [32.9%] female) of whom 12,246 (12.2%) had HxLBP and 531 (0.5%) had HxLBP + Surgery. Higher age predicted increased odds of HxLBP (OR = 1.02/year; p < 0.001) and HxLBP + Surgery (OR = 1.03/year; p < 0.001). Males had lower odds of HxLBP compared to females (OR = 0.45; p < 0.001). Overall PCP scores and each ROM and dynamic strength test were significantly reduced with HxLBP; all but overall PCP and one dynamic strength test (squats) were also significantly decreased with HxLBP + Surgery.

Conclusions

HxLBP is common in employees, moreso among females and older workers, and predicts slightly decreased PCP performance. Future work should explore the suitability of PCP in predicting injury rates in the context of multiple comorbidities.