Functional capacity Evaluation

Question 1

what does a functional capacity evaluation measure?

Answer 1

objectively measures an injured employee’s capability, not DISABILITY

Question 2

how does a functional capacity evaluate a client?

Answer 2

by identifying safe performance capabilities & comparing them to the job requirements detailed in the job analysis

Question 3

what are the priorities of the FCE?

Answer 3

Patient safety
Reliability
Useful measures

Question 4

how does OT help pt with FCE?

Answer 4

readiness for discharge
return to work safely
Work ability status for vocational rehab
Worker’s comp settlement (\$\$$)
Disability status
Ability to meet job demands for hiring
Ability to meet demands of other activities

Question 5

what are the time requirements of FCE and how are they determined?

Answer 5

2-8 hours

Determined by extent of injury, job responsibilities, functional abilities of person being tested

Question 6

Who should be referred for FCE?

Answer 6

Pts who..
have reached maximum medical benefits & are awaiting case closure,
Need function quantified prior to RTW
Have history of subjective complaints but without objective findings

Question 7

what kinds of actions does the FCE measure?

Answer 7

Repetitive lifting 
Repetitive push/pull
Hand grip strength
Tolerance for elevated work
Prolonged trunk flexion, sitting & standing
Prolonged trunk rotation
Prolonged crawl, kneel, sustained crouch
Repetitive squat
Tolerance for sitting/standing
Maximum walking, stairs, ladder capacity
Balance
Hand coordination

Question 8

who are FCE clients?

Answer 8

The injured worker
The employer
The insurer

Question 9

what does FCE in the military observe?

Answer 9

examination & evaluation that objectively measures Soldier’s current level of fx, within context of the demands of competitive employment/duty, activities of daily living (ADLs), or leisure activities

Question 10

who provides the national standards and physical demands of jobs?

Answer 10

US Dept. of Labor

Question 11

what are some UE physical demands?

Answer 11

Fingering
Handling
Reaching
Pushing
Pulling
Lifting
Carrying
Twisting 
Feeling
Crawling
Climbing

Question 12

what are UE aptitudes?

Answer 12

specific capacities & abilities required to learn or perform adequately a task or duty

Question 13

what are examples of UE aptitudes?

Answer 13

Motor coordination
Finger dexterity
Manual dexterity
Eye-hand/foot coordination

Question 14

what is done first in an FCE?

Answer 14

Intake or initial interview

Question 15

what is assessed in the subjective eval?

Answer 15

Pain assessment
Effect of injury on ADLs
Effect on cosmesis

Question 16

what is assessed in the Physical (neuro-musculoskeletal) Eval?

Answer 16

ROM
Strength
Sensation
Volume 
Soft-tissue status
Special tests

Question 17

what is assessed in the Physical Demand (Activity) Testing?

Answer 17

Standardized tests
Work simulation
Computerized variable resistance tests
Lifting, carrying (manual materials handling)

Question 18

what is assessed in the re-eval?

Answer 18

Inflammatory response to activity
Sensation
Pain Level
Follow-up questionnaire

Question 19

what does the therapist want to know in the pain assessment?

Answer 19

Changes in pain level over course of day and over course of many months
Factors that increase or decrease pain
Effect of pain on sleep
Intensity of pain (see handout)

Question 20

what are examples of Standardized Tests of Hand Function?

Answer 20

Grooved Peg Board
O’Connor Tweezer Dexterity Test
9-Hole peg
Purdue Peg Board
Rosenbusch Test
Pennsylvania Small Parts
Minnesota Dexterity
Jebsen
Crawford Small Parts Dexterity

Question 21

how must OT write FCE documentation?

Answer 21

comprehensive report in language of reader
withstand legal scrutiny
backup results with data

Question 22

what do you do if patient/client not ready to RTW?

Answer 22

work hardening

Question 23

what is work hardening?

Answer 23

Highly structured, goal oriented, individualized treatment programs designed to maximize the person’s ability to return to work

Question 24

what is the goal of work hardening program?

Answer 24

Progressively improve the biomechanical, neuromuscular, cardiovascular/metabolic and psychosocial functions

Question 25

what is work hardening a transition btwn?

Answer 25

Transition between acute care and return to work

Question 26

what does work hardening address?

Answer 26

productivity, safety, physical tolerances, and worker behaviors

Question 27

why is work hardening a interdisciplinary process?

Answer 27

it in volves 
PT
OT
Voc professional- not only retraining, but also relearning or learning new info
Psychologist
Foreman- industrial background
Nutritionist
Rehab nurse
Exercise physiologist