A practical tool for clinicians and researchers: psychometric evaluation of a single-item recovery expectation measure in occupational low back pain

Purpose: Recovery expectations are key predictors of rehabilitation following injury. Despite their widespread use in clinical and research settings, most assessments rely on single-item measures that lack formal validation. This study aims to evaluate the construct validity and test-retest reliability of a single-item recovery expectation measure in individuals with occupational low back pain. Methods: Fifty-eight participants with occupational low back pain enrolled in physical therapy and a pain management course completed a single-item recovery expectation measure (“What is the probability that you will return to work?”) rated on a 0-100 scale. Baseline assessments included psychological measures of pain catastrophizing, perceived injustice, anxiety, and depression. Follow-up assessments were conducted four weeks later. Construct validity (convergent and predictive) and test-retest reliability were analyzed. Results: The single-item measure demonstrated significant negative correlations with psychological variables, supporting convergent validity. A logistic regression showed the baseline recovery expectation measure significantly predicted return-to-work status at four weeks (OR=1.05, p=0.024). Test-retest reliability was high (ICC=0.88), with Bland-Altman plots indicating strong agreement across time. Conclusions: A single-item recovery expectation measure demonstrated good psychometric properties in individuals with occupational low back pain, offering a low-burden, practical tool for clinical and research settings. Its use may facilitate early identification of individuals at risk for prolonged work disability, supporting targeted rehabilitation strategies.