A functional capacity evaluation (FCE) may be useful where a client's treating Doctor is unable to provide clear and specific return to work medical guidelines. An FCE may also be indicated where a client reports difficulties with work tasks that are inconsistent with the current return to work medical guidance.
An FCE can assess a person's physical capabilities for work, performing specific tasks or for their overall strength and activity capacity. An FCE determines functional limitations based on a physical examination, and provides objective evaluation of performance and reporting.
An FCE is the evaluation of an injured person's functional and physical abilities as they relate to work performance or general functioning. However, an FCE can maximise the use of objective measurements of an injured person's ability to perform the physical demands of specified work tasks in the vocational rehabilitation setting.
In this setting it is useful for:
One of the major decisions that must be made following an injury is deciding when a person is physically ready to return to work. The FCE can be tailored to consider the specific tasks that are essential to the job in question and to help the rehabilitation service provider and an employer develop a specific return to work program for the injured person in consultation with that person, the Rehabilitation Coordinator and approved and cleared by the person's treating doctor. An FCE can also be used to develop a graduated program of safe, appropriate and thorough tasks to guide a successful work-hardening process as part of a return to work program.
Clearance to undertake an FCE must be obtained from the client's treating doctor before a rehabilitation service provider can do the FCE. The referral must clearly explain the specific purpose of the evaluation request. Details of the medical conditions impacting on a person's ability to work and any other restrictions should also be included. FCE reports should contain details about the person's capacity for work, a summary of the assessment process and findings, and clear recommendations for ongoing management to achieve agreed goals.
Functional education, as a result of a functional evaluation is the process of educating a person with an injury or disability, or a person who is at risk of an injury, on strategies to maintain good physical and mental health at home and or in the workplace. It helps a person to take responsibility for maximising function, avoiding injury or further aggravation.
Much of the following information has been provided by Dr Ev Innes, an occupational therapist. The intention is to provide some basic information for Rehabilitation Delegates about the types of FCEs, to help inform decisions about when conducting an FCE may be appropriate. It should be noted that most assessors within rehabilitation service provider organisations will only have access to a single tool.
Situational assessments may be conducted in artificial work environments or during formalised work trials. These assessments are reliant on observation by the assessor and self-reporting from the client. While functional testing is best assessed in the workplace, this may not always be possible. Therefore, a rehabilitation service provider may recommend a clinically-based assessment using one of the tools referred to below.
The Ergo-Kit FCE incorporates fifty five standardised work-related tasks, including lifting, carrying and simulation exercises. The Physical Agility Tester, a component of the Ergo-Kit FCE, is used to test work postures and movements, handling and dexterity.
The Ergoscience Physical Work Performance Evaluation (PWPE) consists of thirty six standarised tasks covering six areas including dynamic strength, position tolerance, mobility, balance, endurance, and coordination of fine motor skills.
The Isernhagen Work Systems (IWS) FCE consists of twenty work-related tasks covering weighted tasks, flexibility and positional tasks, static work, ambulation/mobility tasks, and upper limb coordination.
The EPIC Lift Capacity Test examines an individual's capacity for occasional lifting and frequent lifting over three ranges, waist to shoulder, floor to waist, and floor to shoulder.
The Progressive Isoinertial Lifting Evaluation (PILE) assesses lifting through two ranges, the lumbar test from floor to waist, and the cervical test from waist to shoulder.
Baltimore Therapeutic Equipment (BTE) has three work capacity evaluation devices. The BTE Work Simulator II assesses a wide range of movements associated with various functional tasks. It was developed primarily for upper limb assessment. The BTE Primus has application for the upper and lower limbs and trunk. The BTE ER Functional Testing System incorporates a computerised version of the EPIC Lift Capacity Test and the Functional Range of Movement (FROM) Assembly Test.
The Ergos Work Simulator consists of five work stations that use simulated work tasks to assess strength, body mechanics, cardiovascular endurance, movement speed, and accuracy.
There are more than twenty Valpar Component Work Samples (VCWS) that simulate generalised work-like tasks associated with industrial jobs. VCWS 4 assesses upper extremity range of motion. VCWS 8 assesses simulated assembly. VCWS 9 assess whole body range of motion. VCWS 11 assesses eye-hand-foot coordination. VCWS 19 assesses dynamic physical capacities.
A Jamar dynamometer is used to assess grip strength, often comparing bilateral grip strength with community norms.
Some other functional capacity assessment tools include: the WorkHab functional capacity evaluation, Key functional assessment, Blankenship functional assessment, Work evaluation systems technology, Jebsen hand function assessment, Bennett hand tool dexterity test, Purdue pegboard, Minnesota rate of manipulation test, and Crawford's small parts dexterity test.
Innes, E., Matthews, L. R., & Johnson, K. L. (2010). Assessment of occupational functioning. In E. Mpofu & T. Oakland (Eds.), Assessment in rehabilitation and health (pp. 466-485). Upper Saddle River, NJ: Merrill/Pearson Education.
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