Journal of Occupational Rehabilitation

, Volume 17, Issue 3, pp 422–435 | Cite as

Evaluation of a Short-form Functional Capacity Evaluation: Less may be Best

  • Douglas P. GrossEmail author
  • Michele C. Battié
  • Alexander K. Asante



Functional Capacity Evaluation (FCE) contributes to clinical decisions regarding fitness-for-work and may improve return-to-work outcomes. However, FCE is a burdensome clinical tool in terms of time and cost. We evaluated the effectiveness of a short-form FCE protocol.


A cluster randomized controlled trial was conducted. Data were collected on all claimants undergoing FCE at Alberta’s workers’ compensation rehabilitation facility. Twenty-three clinicians who were trained and experienced with FCE were randomized to either an intervention or control group. The intervention group was trained to conduct short-form FCE and used this protocol through the trial’s duration, while the control group continued standard FCE procedures. Data on subject characteristics, administrative outcomes (days to suspension of time loss benefits, days to claim closure, and future recurrence) and claimant satisfaction were extracted from the WCB-Alberta computer databases. Clinicians logged time taken to complete assessments. Analysis included examining differences between groups using independent samples t tests, Cox and logistic regression.


Subjects included 372 claimants of whom 173 were tested with short-form FCE. Subjects were predominantly employed (64%) males (69%) with chronic musculoskeletal conditions (median duration 252 days). Administrative recovery outcomes were similar between groups as were claimant satisfaction ratings. No statistically significant or clinically relevant differences were observed on these outcomes between groups. A 43% reduction in functional assessment time was seen.


A short-form FCE appears to reduce time of assessment while not affecting recovery outcomes when compared to standard FCE administration. Such a protocol may be an efficient option for therapists performing fitness-for-work assessments.


Return-to-work Compensation Fitness for work Assessment Disability insurance 



Funding was received from the Clinical Research Partnership Fund sponsored by the Alberta Physiotherapy Association and University of Alberta’s Department of Physical Therapy. WCB-Alberta/ Millard Health assisted with data acquisition and study implementation.


  1. 1.
    King, P. M., Tuckwell, N., & Barrett, T. E. (1998). A critical review of functional capacity evaluations. Physical Therapy, 78, 852–866.PubMedGoogle Scholar
  2. 2.
    Gouttebarge, V., Wind, H., & Kuijer, P. P. et al. (2004). Reliability and validity of functional capacity evaluation methods: A systematic review with reference to Blankenship system, Ergos work simulator, Ergo-Kit and Isernhagen work system. International Archives of Occupational and Environmental Health, 77, 527–537.PubMedCrossRefGoogle Scholar
  3. 3.
    Gross, D. P., & Battié, M. C. (2005). Functional capacity evaluation performance does not predict sustained return to work in claimants with chronic back pain. Journal of Occupational Rehabilitation, 15, 285–294.PubMedCrossRefGoogle Scholar
  4. 4.
    Ruan, C. M., Haig, A. J., & Geisser, M. E. et al. (2001). Functional capacity evaluations in persons with spinal disorders: predicting poor outcomes on the Functional Assessment Screening Test (FAST). Journal of Occupational Rehabilitation, 11, 119–132.PubMedCrossRefGoogle Scholar
  5. 5.
    Gross, D. P., Battié, M. C., & Asante, A. (2006). Development and validation of a short-form functional capacity evaluation for use in claimants with low back disorders. Journal of Occupational Rehabilitation, 16, 53–62.PubMedCrossRefGoogle Scholar
  6. 6.
    Gross, D. P., Battié, M. C., & Cassidy, J. D. (2004). The prognostic value of functional capacity evaluation in patients with chronic low back pain: part 1: timely return to work. Spine, 29, 914–919.PubMedCrossRefGoogle Scholar
  7. 7.
    Matheson, L. N., Isernhagen, S. J., & Hart, D. L. (2002). Relationships among lifting ability, grip force, and return to work. Physical Therapy, 82, 249–256.PubMedGoogle Scholar
  8. 8.
    Cutler, R. B., Fishbain, D. A., & Steele-Rosomoff, R. et al. (2003). Relationships between functional capacity measures and baseline psychological measures in chronic pain patients. Journal of Occupational Rehabilitation, 13, 249–258.PubMedCrossRefGoogle Scholar
  9. 9.
    Gross D. P., & Battié M. C. (2006). Does functional capacity evaluation predict recovery in workers compensation claimants with upper extremity disorders? Occupational and Environmental Medicine, 63(6), 404–410.Google Scholar
  10. 10.
    Puffer, S., Torgerson, D. J., & Watson, J. (2005). Cluster randomized controlled trials. Journal of Evaluation in Clinical Practice, 11, 479–483.PubMedCrossRefGoogle Scholar
  11. 11.
    Donner, A., & Klar, N. (2004). Pitfalls of and controversies in cluster randomization trials. American Journal of Public Health, 94, 416–422.PubMedCrossRefGoogle Scholar
  12. 12.
    Voaklander, D. C., Beaulne, A. P., & Lessard, R. A. (1995). Factors related to outcome following a work hardening program. Journal of Occupational Rehabilitation, 5, 71–85.CrossRefGoogle Scholar
  13. 13.
    Isernhagen, S. J. (1992). Functional capacity evaluation: rationale, procedure, utility of the kinesiophysical approach. Journal of Occupational Rehabilitation, 2, 157–168.CrossRefGoogle Scholar
  14. 14.
    Klar, N., & Donner, A. (2001). Current and future challenges in the design and analysis of cluster randomization trials. Statistics in Medicine, 20, 3729–3740.PubMedCrossRefGoogle Scholar
  15. 15.
    Eldridge, S., Cryer, C., & Feder, G. et al. (2001). Sample size calculations for intervention trials in primary care randomizing by primary care group: an empirical illustration from one proposed intervention trial. Statistics in Medicine, 20, 367–376.PubMedCrossRefGoogle Scholar
  16. 16.
    Gross, D. P., & Battié, M. C. (2002). Reliability of safe maximum lifting determinations of a functional capacity evaluation. Physical Therapy, 82, 364–371.PubMedGoogle Scholar
  17. 17.
    Brouwer, S., Reneman, M. F., & Dijkstra, P. U. et al. (2003). Test-retest reliability of the Isernhagen work systems functional capacity evaluation in patients with chronic low back pain. Journal of Occupational Rehabilitation, 13, 207–218.PubMedCrossRefGoogle Scholar
  18. 18.
    Reneman, M. F., Dijkstra, P. U., & Westmaas, M. et al. (2002). Test-retest reliability of lifting and carrying in a 2-day functional capacity evaluation. Journal of Occupational Rehabilitation, 12, 269–275.PubMedCrossRefGoogle Scholar
  19. 19.
    Tait, R. C., Chibnall, J. T., & Krause, S. (1990). The pain disability index: psychometric properties. Pain, 40, 171–182.PubMedCrossRefGoogle Scholar
  20. 20.
    Finch, E., Brooks, D., & Stratford, P. et al. (2002). Physical rehabilitation outcome measures: A guide to enhanced clinical decision making (2nd edn). Toronto: Canadian Physiotherapy Association.Google Scholar
  21. 21.
    Ware, J. E., & Gandek, B. (1994). The SF-36 Health Survey: development and use in mental health research at the IQLOA project. International Journal of Mental Health, 23, 73.Google Scholar
  22. 22.
    Chatman, A. B., Hyams, S. P., & Neel, J. M. et al. (1997). The Patient-Specific Functional Scale: Measurement properties in patients with knee dysfunction. Physical Therapy, 77, 820–829.PubMedGoogle Scholar
  23. 23.
    Gross, D. P., & Battié, M. C. (2005). Work-related recovery expectations and the prognosis of chronic low back pain within a workers’ compensation setting. Journal of Occupational and Environmental Medicine, 47, 428–433.PubMedCrossRefGoogle Scholar
  24. 24.
    Amick, B. C., III, Habeck, R. V., & Hunt, A. et al. (2000). Measuring the impact of organizational behaviours on work disability prevention and management. Journal of Occupational Rehabilitation, 10, 21–38.CrossRefGoogle Scholar
  25. 25.
    Gross, D. P., & Battié, M. C. (2005). Predicting timely recovery and recurrence following multidisciplinary rehabilitation in patients with compensated low back pain. Spine, 30, 235–240.PubMedCrossRefGoogle Scholar
  26. 26.
    Cole, D. C., Mondloch, M. V., & Hogg-Johnson, S. (2002). Listening to injured workers: How recovery expectations predict outcomes-a prospective study. CMAJ, 166, 749–754.PubMedGoogle Scholar
  27. 27.
    Cote, P., Hogg-Johnson, S., & Cassidy, J. D. et al. (2001). The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplash. Journal of Clinical Epidemiology, 54, 275–286.PubMedCrossRefGoogle Scholar
  28. 28.
    Hosmer, D. W., & Lemeshow, S. (1999). Applied survival analysis: Regression modeling of time to event data. (1 edn.). New York: Wiley.Google Scholar
  29. 29.
    Hosmer, D. W., & Lemeshow, S. (2000). Applied logistic regression. (2nd edn.). New York: Wiley.Google Scholar
  30. 30.
    Crook, J., Milner, R., & Schultz, I. Z. et al. (2002). Determinants of occupational disability following a low back injury: A critical review of the literature. Journal of Occupational Rehabilitation, 12, 277–295.PubMedCrossRefGoogle Scholar
  31. 31.
    Krause, N., Dasinger, L. K., & Deegan, L. J. et al. (1999). Alternative approaches for measuring duration of work disability after low back injury based on administrative workers’ compensation data. American Journal of Industrial Medicine, 35, 604–618.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Douglas P. Gross
    • 1
    • 2
    Email author
  • Michele C. Battié
    • 1
  • Alexander K. Asante
    • 3
  1. 1.Department of Physical TherapyUniversity of AlbertaEdmontonCanada
  2. 2.Workers’ Compensation Board Alberta/Millard HealthEdmontonCanada
  3. 3.Peter Lougheed CentreCalgary Health RegionCalgaryCanada

Personalised recommendations