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Measuring Residual Functional Capacity in Chronic Low Back Pain Patients Based on the Dictionary of Occupational Titles

Study Design. This study designed and tested a functional battery based on the Dictionary of Occupational Titles (DOT). Objectives. Such a battery can be used to measure residual functional capacity (RFC) in chronic pain patients (CPP) and results can be matched against the demand minimum functional capacities (DMFC) of DOT jobs. Summary of Background Data. Physicians have difficulty translating medical impairment into functional limitation and thereby establishing the RFC of CPPs. Methods. The DOT, a USA government publication, provides information about physical demands of every USA job according to 36 factors and subfactors. The authors defined and developed a fuctional battery based on these factors/subfactors. This battery was tested on 67 consecutive CPPs to determine the percentage of CPPs able to pass specific job factors and the full battery and return to some DOT job, and evaluated the effects of pain on battery performance. The data were factor analyzed. Results. The battery determined if CPPs could perform DOT job factors and had the necessary RFC to be placed in a DOT job. The vast majority of CPPs could not pass the full battery and the presence of pain and original job classification predicted whether a CPP could perform a job factor. Factor analyses grouped the factors into four independent categories supporting the design of the battery. Conclusion. The battery can assess whether CPPs are able to return to work.