Functional capacity Evaluation Flashcards
what does a functional capacity evaluation measure?
objectively measures an injured employee’s capability, not DISABILITY
how does a functional capacity evaluate a client?
by identifying safe performance capabilities & comparing them to the job requirements detailed in the job analysis
what are the priorities of the FCE?
Patient safety
Reliability
Useful measures
how does OT help pt with FCE?
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
what are the time requirements of FCE and how are they determined?
2-8 hours
Determined by extent of injury, job responsibilities, functional abilities of person being tested
Who should be referred for FCE?
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
what kinds of actions does the FCE measure?
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
who are FCE clients?
The injured worker
The employer
The insurer
what does FCE in the military observe?
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
who provides the national standards and physical demands of jobs?
US Dept. of Labor
what are some UE physical demands?
Fingering Handling Reaching Pushing Pulling Lifting Carrying Twisting Feeling Crawling Climbing
what are UE aptitudes?
specific capacities & abilities required to learn or perform adequately a task or duty
what are examples of UE aptitudes?
Motor coordination
Finger dexterity
Manual dexterity
Eye-hand/foot coordination
what is done first in an FCE?
Intake or initial interview
what is assessed in the subjective eval?
Pain assessment
Effect of injury on ADLs
Effect on cosmesis
what is assessed in the Physical (neuro-musculoskeletal) Eval?
ROM Strength Sensation Volume Soft-tissue status Special tests
what is assessed in the Physical Demand (Activity) Testing?
Standardized tests
Work simulation
Computerized variable resistance tests
Lifting, carrying (manual materials handling)
what is assessed in the re-eval?
Inflammatory response to activity
Sensation
Pain Level
Follow-up questionnaire
what does the therapist want to know in the pain assessment?
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)
what are examples of Standardized Tests of Hand Function?
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
how must OT write FCE documentation?
comprehensive report in language of reader
withstand legal scrutiny
backup results with data
what do you do if patient/client not ready to RTW?
work hardening
what is work hardening?
Highly structured, goal oriented, individualized treatment programs designed to maximize the person’s ability to return to work
what is the goal of work hardening program?
Progressively improve the biomechanical, neuromuscular, cardiovascular/metabolic and psychosocial functions
what is work hardening a transition btwn?
Transition between acute care and return to work
what does work hardening address?
productivity, safety, physical tolerances, and worker behaviors
why is work hardening a interdisciplinary process?
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
