Abstract
Purpose
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.
Methods
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.
Results
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.
Conclusion
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.
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References
King, P. M., Tuckwell, N., & Barrett, T. E. (1998). A critical review of functional capacity evaluations. Physical Therapy, 78, 852–866.
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.
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.
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.
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.
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.
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.
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.
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.
Puffer, S., Torgerson, D. J., & Watson, J. (2005). Cluster randomized controlled trials. Journal of Evaluation in Clinical Practice, 11, 479–483.
Donner, A., & Klar, N. (2004). Pitfalls of and controversies in cluster randomization trials. American Journal of Public Health, 94, 416–422.
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.
Isernhagen, S. J. (1992). Functional capacity evaluation: rationale, procedure, utility of the kinesiophysical approach. Journal of Occupational Rehabilitation, 2, 157–168.
Klar, N., & Donner, A. (2001). Current and future challenges in the design and analysis of cluster randomization trials. Statistics in Medicine, 20, 3729–3740.
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.
Gross, D. P., & Battié, M. C. (2002). Reliability of safe maximum lifting determinations of a functional capacity evaluation. Physical Therapy, 82, 364–371.
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.
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.
Tait, R. C., Chibnall, J. T., & Krause, S. (1990). The pain disability index: psychometric properties. Pain, 40, 171–182.
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.
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.
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.
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.
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.
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.
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.
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.
Hosmer, D. W., & Lemeshow, S. (1999). Applied survival analysis: Regression modeling of time to event data. (1 edn.). New York: Wiley.
Hosmer, D. W., & Lemeshow, S. (2000). Applied logistic regression. (2nd edn.). New York: Wiley.
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.
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.
Acknowledgements
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.
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Gross, D.P., Battié, M.C. & Asante, A.K. Evaluation of a Short-form Functional Capacity Evaluation: Less may be Best. J Occup Rehabil 17, 422–435 (2007). https://doi.org/10.1007/s10926-007-9087-y
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DOI: https://doi.org/10.1007/s10926-007-9087-y