Title: Functional Capacity Evaluation (FCE)
Headings: Functional Capacity Evaluation (FCE)
9 Articles in Volume 10, Issue #4
Functional Capacity Evaluation (FCE)
Selecting The Appropriate Test
FCEs Current Scope
Measurement Properties of the FCE
Responsiveness and Reliability of the FCE
Impairment/Disability Testing
Conclusion

Content: “The results of these assessments have implications for employment, compensability determinations, further medical/ rehabilitative efforts, disability evaluations, and indemnity/cash benefits.7”
How much precision do we expect from an FCE test? After all, we are trying to get at a functional rating score made up of measures that tend to vary from day to day and based on a constellation of variables—such as co-morbidities, aging, injury, weather, sleep level, motivation, stress etc. We often try and characterize sincerity levels when performing the FCE test items since the psych-physical connection will ultimately determine the actual scores on each test item. A number of possible methods have been proposed to get an estimate of patient sincerity levels when performing the FCE—including using the coefficient of variation (ratio of the standard deviation of a set of scores to its mean, expressed as a percentage). The validity of using the CV statistic, in isolation, for measuring sincerity of effort has been challenged however. 8,9 The consensus appears to be that the CV statistic is a valuable component in the determination of sincerity of effort but should be used in conjunction with other protocol measures—creating what Matheson refers to as a reliability profile. 10
In many cases, the FCE and WCE testing is performed prior to commencing a work recovery program to identify functional deficits and, at the end of a work program, to determine if goals were met and return to work is possible. This is the case where there is an injured worker who has been through formal physical and/or occupational therapy but is not ready to return to work. It is important to note that physical therapy is designed to focus on restoring normal range of motion, strength, muscle endurance etc. It is not unusual that a person, who has restored strength and mobili