Besides, van Abbema et al. (2011) showed that a “low lifting test” was not related to pain duration Epigenetics inhibitor and showed conflicting evidence for associations with pain intensity, fear of movement/(re)injury, depression, gender, and age. Thereby, these lifting tests assess more than “just” physical components. Moreover, lifting is an important predictor of work ability in patients with MSDs (Martimo et al. 2007; Van Abbema et al. 2011). Additionally, it is plausible that “shared behaviors” occur between the tests, in which case the added value of extra tests decreases.

The selection of the lifting tests appears in line with the three-step model as suggested by Gouttebarge et al. (2010) to assess physical work ability in workers with MSDs more efficiently using a limited number of tests. Regarding its predictive value, this study showed that strong evidence exists that a number of performance-based measures are predictive of work participation for patients with chronic MSDs, irrespective whether it concerns complaints of the upper extremity, lower extremity, or low back. All patients in the included studies were considered able to perform these reliable tests, and no comments were made that see more patients were unwilling to perform these tests. Of course,

one has to bear in mind that the results of the performance-based measures are often used in clinical decision making regarding work participation. Moreover, patients are often not blinded to the outcome of the test itself (Reneman and Soer 2010). Gross and Battié (2004, 2006) and Gross et al. (2004) adjusted their outcome for the recommendation of the physician and Streibelt et al. (2009) for the expectation of the patient. Nevertheless, they still found that a number of performance-based tests were predictive of work participation. It seems worthwhile to establish how physicians and patients take into account Branched chain aminotransferase the results of the performance-based tests and other instruments in their decision making regarding work participation. Finally,

the studies in this review used outcome measures in terms of future work participation and/or future non-work participation. Although not all studies presented relevant statistics, it seemed that the predictive strength of performance-based measures is higher for non-work participation than for work participation. For instance, for non-work participation, the predictive quality varied between poor (Vowles et al. 2004; Streibelt et al. 2009), moderate (Bachman et al. 2003; Streibelt et al. 2009), and good (Kool et al. 2002). For work participation, the predictive quality was mostly poor (Gross et al. 2004, 2006; Gross and Battié 2006; Gouttebarge et al. 2009a). Future directions A number of performance-based measures are predictive of work participation.