Skip to main content
Log in

Safety Issues in Functional Capacity Evaluation: Findings From a Trial of a New Approach for Evaluating Clients With Chronic Back Pain

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Although safety is recognized as a critical issue in functional capacity evaluations (FCEs), it has rarely been investigated. This paper reports on the findings of a study which examined safety aspects of a new approach to FCE. Fourteen rehabilitation clients with chronic back pain participated in the study. Aspects examined included the pre-FCE screening procedures, the monitoring of performance and safety during the FCE, and the end of FCE measures and follow-up procedures. Support was found for the screening procedures of the approach, particularly blood pressure measurement, and for the combined approach to monitoring of the person’s performance from biomechanical, physiological and psychophysical perspectives. Issues for FCE safety in general are identified and discussed, including the importance of screening procedures to determine readiness for FCEs and the issue of load handling in FCEs, especially in relation to clients with chronic back pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Deen M, Gibson L, Strong J. A survey of occupational therapy in Australian work practice. Work 2002; 19: 219–230.

    Google Scholar 

  2. Jundt J, King PM. Work rehabilitation programs: A 1997 survey. Work 1999; 12: 139–144.

    Google Scholar 

  3. Gibson L, Strong J. A review of functional capacity evaluation practice. Work 1997; 9: 3–11.

    Article  Google Scholar 

  4. Gross DP. Measurement properties of performance-based assessment of functional capacity. J Occup Rehab 2004; 14: 165–174.

    Google Scholar 

  5. Hart D, Isernhagen S, Matheson L. Guidelines for functional capacity evaluation of people with medical conditions. J Orthop Sports Phys Ther 1993; 18: 682–686.

    CAS  PubMed  Google Scholar 

  6. Isernhagen SJ. Advancements in functional capacity evaluation. In: D’Orazio B, ed. Back pain rehabilitation. Boston, MA: Andover Medical Publishers, 1993, pp. 181–205.

    Google Scholar 

  7. King PM, Tuckwell N, Barrett TE. A critical review of functional capacity evaluations. Phys Ther 1998; 78: 852–866.

    CAS  PubMed  Google Scholar 

  8. Tramposh AK. The functional capacity evaluation: measuring maximal work abilities. Occup Med: State Art Rev 1992; 7: 113–124.

    Google Scholar 

  9. Abdel-Moty E, Compton R, Steele-Rosomoff R, Rosomoff HL, Khalil TM. Process analysis of functional capacity assessment. J Back Musculo Rehab 1996; 6: 223–236.

    Google Scholar 

  10. Pransky GS, Dempsey PG. Practical aspects of functional capacity evaluation. J Occup Rehab 2004; 14: 217–229.

    Google Scholar 

  11. Innes E, Straker L. Attributes of excellence in work-related assessments. Work 2003; 20: 63–76.

    Google Scholar 

  12. Matheson LN. Industrial rehabilitation resource book. California: Performance and Capacity Testing, 1990.

    Google Scholar 

  13. Matheson LN. Vocational assessment and retraining. In: Mayer TG, Gatchel RJ, Polatin PB, eds. Occupational musculoskeletal disorders. Philadelphia: Lippincott & Williams (Wilkins, 2000, pp. 707–720.

    Google Scholar 

  14. Matheson LN, Mooney V, Grant JE, Leggett S, Kenny K. Standardized evaluation of work capacity. J Back Musculo Rehab 1996; 6: 249–264.

    Google Scholar 

  15. Matheson LN, Mooney V, Grant JE, Affleck M, Hall H, Melles T, Lichter RL, McIntosh G. A test to measure lift capacity of physically impaired adults Part 1—Development and reliability testing. Spine 1995; 20: 2119–2129.

    Google Scholar 

  16. Bhambani Y, Esmail S, Brintnell S. The Baltimore Therapeutic Equipment Work Simulator: Biomechanical norms and physiological norms for three attachments in healthy men. Am J Occup Ther 1994; 48: 19–25.

    Google Scholar 

  17. Chaloupka EC, Kang J, Mastrangelo MA, Scibilia G, Leder GM, Angelucci J. Metabolic and cardiorespiratory responses to continuous box lifting and lowering in nonimpaired subjects. J Orthop Sports Phys Ther 2000; 30: 249–257.

    Google Scholar 

  18. Matheson LN, Leggett MS, Mooney V, Schneider K, Mayer J. The contribution of aerobic fitness and back strength to lift capacity. Spine 2002; 27: 1208–1212.

    Google Scholar 

  19. United States Department of Labor. Dictionary of occupational titles, 4th edn. Washington, DC: U.S. Government Printing Office, 1991.

    Google Scholar 

  20. Gibson L, Strong J, Wallace A. Functional capacity evaluation as a performance measure: Evidence for a new approach for clients with chronic back pain. Clin J Pain (in press).

  21. Innes E, Straker L. A clinician’s guide to work-related assessments: 3—Administration and interpretation problems. Work 1998; 11: 207–219.

    Google Scholar 

  22. Gibson L, Strong J. The role of psychological factors in functional capacity evaluation of clients with chronic back pain. Australian Association of Occupational Therapists—Qld 4th State Conference. Twin Waters, Queensland; 1996.

    Google Scholar 

  23. Rudy TE, Lieber SJ, Boston JR. Functional capacity assessment: Influence of behavioural and environmental factors. J Back Musculo Rehab 1996; 6: 277–288.

    Google Scholar 

  24. Gibson L, Strong J. Expert review of an approach to functional capacity evaluation. Work 2002; 19: 231–242.

    Google Scholar 

  25. Kersnovske S, Gibson L, Strong J. Item validity of the physical demands from the Dictionary of Occupational Titles for functional capacity evaluation of clients with chronic back pain. Work (in press).

  26. World Health Organization. ICIDH-2: International classification of functioning, disability and health. Prefinal draft full version. Geneva, Switzerland: World Health Organization, 2000. http://www.who.int/icidh.

    Google Scholar 

  27. Canadian Society for Exercise Physiology. Physical Activity Readiness Questionnaire—PAR-Q; 1994.

  28. American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription, 5th edn. Baltimore: Williams & Wilkins, 1995.

    Google Scholar 

  29. Suni JH, Miilunpalo SI, Asikainen T-M, Laukkanen RT, Oja P, Pasanen ME, Bos K, Vuori IM. Safety and feasibility of a health-related fitness test battery for adults. Phys Ther 1998; 78: 134–148.

    Google Scholar 

  30. Kennedy LE, Bhambani YN. The Baltimore Therapeutic Equipment Work Simulator: reliability and validity of three work intensities. Arch Phys Med Rehab 1991; 72: 511–516.

    Google Scholar 

  31. Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: A comparison of six methods. Pain 1986; 27: 117–126.

    Article  Google Scholar 

  32. Jensen MP, Karoly P, O’Riordan EF, Bland F, Jr, Burns RS. The subjective experience of acute pain. An assessment of the utility of 10 indices. Clin J Pain 1989; 5: 153–159.

    Google Scholar 

  33. U.S. Preventive Services Task Force. Screening for high blood pressure. Recommendations and rationale. Am J Prev Med 2003; 25: 159–164.

    Google Scholar 

  34. National Heart Foundation of Australia. Guide to Management of Hypertension for Doctors. National Heart Foundation, 1999. http://www.heartfoundation.com.au.

  35. Innes E, Straker L. Workplace assessments and functional capacity evaluations: current practices of therapists in Australia. Work 2002; 18: 51–66.

    PubMed  Google Scholar 

  36. Innes E, Straker L. Strategies used when conducting work-related assessments. Work 2002; 19: 149–165.

    Google Scholar 

  37. Nadler SF, Stitik TP, Malanga GA. Optimizing outcome in the injured worker with low back pain. Crit Rev Phys Rehab Med 1999; 11: 139–169.

    Google Scholar 

  38. Verbunt JA, Seelen HA, Vlaeyen JW, van der Heijden GJ, Heuts PH, Pons K, Knottnerus JA. Disuse and deconditioning in chronic low back pain: concepts and hypotheses on contributing mechanisms. Eur. J Pain 2003; 7: 9–21.

    Google Scholar 

  39. Rice A. An investigation into the Gibson FCE: A physiological perspective [unpublished manuscript]. The University of Queensland; 2000.

  40. Straker LM. A review of research on lifting techniques for lifting low-lying objects: 2. Evidence for a correct technique. Work 2003; 20: 83–96.

    Google Scholar 

  41. Gardener L, McKenna K. Reliability of occupational therapists in determining safe, maximal lifting capacity. Austral Occup Ther J 1999; 46: 110–119.

    Google Scholar 

  42. van Dieën JH, Hoozemans MJM, Toussaint HM. Stoop or squat: A review of biomechanical studies on lifting technique. Clin Biomech 1999; 14: 685–696.

    Google Scholar 

  43. McGill S. Invited commentary. J Orthop Sports Phys Ther 2000; 30: 258–259.

    Google Scholar 

  44. Department of Employment Training and Industrial Relations. Manual tasks advisory standard 2000. Department of Employment Training and Industrial Relations, 2000. http://www.whs.qld.gov.au/advisory/adv028.pdf.

  45. Reneman MF, Dijkstra PU, Westmaas M, Göeken LNH. Test–retest reliability of lifting and carrying in a 2-day functional capacity evaluation. J Occup Rehab 2002; 12: 269–275.

    Google Scholar 

  46. National Institute for Occupational Safety and Health. Applications manual for the Revised NIOSH Lifting Equation. National Institute for Occupational Safety and Health, 1994. http://www.cdc.gov.niosh/94-110.html.

  47. Mital A, Nicholson AS, Ayoub MM. A guide to manual materials handling. London: Taylor & Francis, 1993.

    Google Scholar 

  48. Andrews DM, Norman RW, Wells RP, Neumann P. The accuracy of self-report and trained observer methods for obtaining estimates of peak load information during industrial work. Int J Ind Ergon 1997; 19: 445–455.

    Google Scholar 

  49. Johns RE, Jr, Bloswick DS, Elegante JM, Colledge AL. Chronic recurrent low-back pain—A methodology for analyzing fitness for duty and managing risk under the Americans with Disabilities Act. J Occup Environ Med 1994; 36: 537–547.

    Google Scholar 

  50. Waters TR, Baron SL, Piacitelli LA, Anderson VP, Skov T, Haring-Sweeney M, Wall DK, Fine LJ. Evaluation of the Revised NIOSH Lifting Equation. A cross-sectional epidemiologic study. Spine 1999; 24: 386–395.

    Google Scholar 

  51. Waddell G. The back pain revolution. Edinburgh: Churchill Livingstone, 1998.

    Google Scholar 

  52. Hall H, McIntosh G, Melles T, Holowachuk B, Wai E. Effect of discharge recommendations on outcome. Spine 1994; 19: 2033–2037.

    Google Scholar 

  53. Fishbain D, Abdel-Moty E, Cutler R, Khalil T, Sadek S, Rosomoff R, Rosomoff H. Measuring residual functional capacity in chronic low back pain patients based on the Dictionary of Occupational Titles. Spine 1994; 19: 872–880.

    Google Scholar 

  54. Matheson LN, Rogers LC, Kaskutas V, Dakos M. Reliability and reactivity of three new functional assessment measures. Work 2002; 18: 41–50.

    Google Scholar 

  55. Reneman MF, Joling CI, Soer EL, Göeken LNH. Functional capacity evaluation: Ecological validity of three static endurance tests. Work 2001; 16: 227–234.

    PubMed  Google Scholar 

  56. Reneman MF, Bults MMWE, Engbers LH, Mulders KKG, Göeken LNH. Measuring maximum holding times and perception of static elevated work and forward bending in healthy young adults. J Occup Rehab 2001; 11: 87–97.

    Google Scholar 

  57. Miedema MC, Douwes M, Dul J. Recommended maximum holding times for prevention of discomfort of static standing postures. Int J Ind Ergon 1997; 19(1): 9–18.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jenny Strong.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gibson, L., Strong, J. Safety Issues in Functional Capacity Evaluation: Findings From a Trial of a New Approach for Evaluating Clients With Chronic Back Pain. J Occup Rehabil 15, 237–251 (2005). https://doi.org/10.1007/s10926-005-1222-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-005-1222-z

Keywords

Navigation