1: Occup Environ Med. 2006 Jun;63(6):404-10. Epub 2006 Mar 21.

Does functional capacity evaluation predict recovery in workers' compensation
claimants with upper extremity disorders?

Gross DP, Battié MC.

Department of Physical Therapy, University of Alberta, Edmonton, Canada.
dgross@ualberta.ca

OBJECTIVES: Functional capacity evaluations (FCEs) are commonly used to determine
return-to-work readiness and guide decision making following work related injury,
yet little is known of their validity. The authors examined performance on the
Isernhagen Work Systems' FCE as a predictor of timely and sustained recovery in
workers' compensation claimants with upper extremity disorders. A secondary
objective was to determine whether FCE is more predictive in claimants with
specific injuries (that is, fracture) as compared to less specific, pain mediated
disorders (that is, myofascial pain). METHODS: The authors performed a
longitudinal study of 336 claimants with upper extremity disorders undergoing
FCE. FCE indicators were maximum performance during handgrip and lift testing,
and the number of tasks where performance was rated below required job demands.
Outcomes investigated were days receiving time-loss benefits (a surrogate of
return to work or work readiness) in the year following FCE, days until claim
closure, and future recurrence defined as whether benefits restarted, the claim
reopened, or a new upper extremity claim was filed. Cox and logistic regression
were used to determine the prognostic effect of FCE crudely and after controlling
for potential confounders. Analysis was performed separately on claimants with
specific and pain mediated disorders. RESULTS: Most subjects (95%) experienced
time-loss benefit suspension within one year following FCE. The one year
recurrence rate was 39%. Higher lifting performance was associated with faster
benefit suspension and claim closure, but explained little variation in these
outcomes (r2 = 1.2-11%). No FCE indicators were associated with future recurrence
after controlling for confounders. Results were similar between specific injury
and less specific groups. CONCLUSIONS: Better FCE performance was a weak
predictor of faster benefit suspension, and was unrelated to sustained recovery. 
FCE was no more predictive in claimants with specific pathology and injury than
in those with more ambiguous, pain mediated conditions.

PMID: 16551753 [PubMed - indexed for MEDLINE]

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