In May 2007, was published a review of FCE of the neck. Their analysis found: “At this moment, however, no validated performance based instrument has been described in literature.” They also found various necks tests were not without danger.
Basis for a Functional Capacity Evaluation Methodology for Patients with Work-related
Disorders
David D. Reesink, Wim Jorritsma, Michiel F. Reneman
J Occup Rehabil (2007) 17:436–449
abstract here
Risky test included:
- Repetitive movements
- Awkward positions
- Forceful movements
- Static contractions.
None of the usual tests did not have some of these risk factors.The best the article could come up with was some context validity – there is some consensus that certain tests measure something – however that is a long way from showing that these tests actually predict ability to work. These tests are based on the idea that strength determines ability to work, but unfortunately it does not – the waning and waning of disc and facet disease does and strength has no effect on that. A study following the course of sciatic disc disease in the back, clinically and by MRI, found exercise programs (and hence aka strength) had no effect on the course of disc disease.
I have had two patients semi-permanently injured by FCE. Both were on Morphine which masked their pains. Dr. Gross from U. of Alberta has published several articles contending that FCE poorly predict ability to work without reinjury.
abstract here
I have found FCE findings can vary from physio to physio and that was the results from one Quebec study.
abstract here
Given that neck FCE’s have NO practical validity, they should not be done.
Say NO to neck FCE’s…
Very informative article. I found the study performed in Quebec had an interesting conclusion. There is obviously a reason FAE tests are still highly regarded so we need to look at all sides. Thank you for doing this research.
I was severely injured in an FCE in 2011 and still not able to return to work. They should be administered only under the care of a physician, not OT’s, PT’s etc. and my preference would be to eliminate them altogether as validity seems suspect.