Functional, postural and perceived balance for predicting the work ability of firefighters

Abstract
Objective: The importance of balance abilities for firefighting and rescue work has already been recognized, but there are no valid balance tests available in the test batteries for the physical work capacity of firefighters. Moreover, few studies have examined the associations between balance and work ability in general. Valid work-related balance tests are needed for the purpose of screening in occupational health care and in rehabilitation for assessing the effects of balance training. This study aimed to investigate the predictive value of functional, postural and perceived balance in respect to work ability among firefighters at baseline and after a 3-year follow-up. Methods: The subjects were 135 male firefighters aged 33–56 years. The outcome variables were the work ability index and perceived physical work ability (PWA), determined by questionnaire in 1996 and 1999. The predictors assessed in 1996 were postural balance (tested with a force platform), functional balance (measured during walking on a wooden plank), and perceived balance abilities, enquired about through a questionnaire. Results: Most of the balance test results and the perceived balance ability were associated with the perceived PWA at baseline. The final logistic regression models showed that the best predictors of decreased work ability among firefighters after 3 years were poor-to-moderate perceived balance [odds ratios (ORs) 2.4, 95% confidence interval (CI) 0.9–6.6]; more than one error in the functional balance test (OR 3.6, 95% CI 1.0–12.7); and a high mean amplitude of postural sway with the eyes closed (OR 2.7, 95% CI 0.9–6.1). Conclusions: The results support the work-related and predictive validity, in terms of perceived work ability, perceived balance, errors in the functional balance test and amplitude of postural sway with the eyes closed, of measuring balance among firefighters.