Assessing Work Functioning in Patients with Persistent Low Back Pain: Exploring the Structural Validity of the Work Rehabilitation Questionnaire.

The sample came from an outpatient hospital spine centre and excluded people already retired, not available for work, or completely unlikely to be working in six months, so it may not apply to patients with more severe work disability or to primary care settings. 107 of 532 consented patients did not complete the WORQ; the paper reports no significant differences except a negligible gender difference, but nonresponse remains a limitation. The paper reports 425 participants completing the WORQ, but Table 2 says the item distribution is based on 524 patients; this discrepancy is not explained. The sample size was based on a rule of thumb of a participant-to-item ratio of 10:1 rather than a formal sample size estimate. The grouping was exploratory, and some item placements relied on clinical reasoning and ICF alignment, so other researchers might interpret the domains differently. The study did not test whether WORQ scores change after intervention or whether using the questionnaire improves work outcomes. Fifteen items did not fit the three areas but were kept as screening items, so the total score and the domain scores are not interchangeable. Inclusion and exclusion relied on self-reported registry data, which may introduce selection bias, although a non-responder analysis was reported.

Funded by Region Syddanmark and University of Southern Denmark. The supplied text gives no further conflict-of-interest declaration.

Do not use the WORQ total score as if it measures a single work ability problem. The items grouped into psychological wellbeing, physical functioning, and cognitive ability, and fifteen items did not fit these areas.