What is Functional Capacity Evaluation (FCE)?
A Functional Capacity Evaluation (FCE) is a series of standardised tests used to assess an individual’s functional capacities for work. It aims to determine a person’s functional abilities over a range of physical demands. Objective information is gained about a worker’s ability to perform work, including manual tasks, such as lifting, pushing and pulling, as well as the ability to adopt certain postures and movements that could be required in their job. Mobility tasks such as climbing and squatting are measured, while additional information on specific job needs, such as hand dexterity or ability to balance are assessed objectively.
What we offer.
We use the Ergoscience FCE system from the United States – the Physical Work Performance Evaluation [PWPE]. The components of the Ergoscience FCE [PWPE] are based on published, peer-reviewed studies with demonstrated validity and reliability.
Its outstanding features include:
- Accurate and objective functional information
- Accurate and objective functional information
- A patented and validated scoring system.
- A standardised testing protocol supported by peer-reviewed research.
- Concise and easy to interpret reports.
Our expert and experienced staff with qualifications in occupational therapy or physiotherapy and specific FCE system training, perform these assessments and use a series of standardised screening tools and evaluations to gain a better understanding of a worker’s functional capacity for their designated or proposed role.
Uses and benefits of Functional Capacity Evaluation (FCE).
An FCE is used to determine a worker’s abilities over a range of physical demands in order to facilitate functional recovery. An FCE should be used to match what the worker can actually do physically against the physical demands of a job.
An FCE may be used as a source of information for:
- Developing return to work [RTW] plans
- Communicating relevant information to involved parties including the worker, the doctor and employer
- Reporting key observations in relation to appropriate and inappropriate activities and behaviours (i.e. pain reporting that does not match actual physical ability)
- Making recommendations about interventions such as safe manual handling and other actions which will facilitate return to work
- Assessing the worker’s capacity to meet the physical demands of specific duties when other sources do not provide this information
- Specifying suitable duties including proposed return to work duties or different duties that reduce the risk of aggravation or re-injury
- Pre-employment screening or part of a pre-employment screening package based on specific job and task requirements
- Assessing performance and progress, identifying alternative treatment modes and providing direction for vocational activity and graduated return to work programs
In conjunction with a structured return to work program, an FCE helps minimise injury risk and rehabilitation / return to work costs.
What to expect:
A variety of tests are used to determine a person’s acceptable work limits. It is necessary to wear appropriate clothing and footwear for the evaluation (eg. sturdy covered footwear, singlet top) and to bring their glasses and a list of medications.
The key elements of an FCE include:
- detailed information gathering prior to the assessment including history taking, relevant medical information, and current treatment.
- medical agreement from the treating doctor for the FCE.
- a detailed physical evaluation
- physical tasks similar to actual work tasks where possible.
- a clear written record of testing and scores.
Evaluation is a dynamic process in which the evaluator makes professional, clinical judgements based on data gathered during the examination. The FCE involves physical examination/screening, including components of neuro-musculoskeletal examination. This is a prelude to the assessment of functional abilities. The evaluator should be aware that there are limitations to the correlation between function and basic measures including range of movement and muscle strength.
Assessment of functional abilities is undertaken over a range of physical demands. The physical demands assessed during the evaluation should be relevant to the nature of the workers injury and the physical demands of the specified duties/jobs in question. The evaluator observes and analyses the body mechanics used during the assessment of specific functional abilities.
The following components may be assessed:
- Overhead reaching
- Forward reaching
After the assessment we will:
• provide feedback to the client, and/or other relevant parties.
• follow up the client the next day to obtain post assessment status where appropriate.
• use the test findings to identify an individual’s abilities over a full workday.
• complete a job match that offers a professional opinion about whether a person will be able to safely and sustainably perform a job.
• complete a report
Contra-Indication for an FCE includes one or more of the following:
- Unstable medical conditions
- Recent surgery
- The performance of the test would compromise the patient/client’s safe medical condition
- Communication barriers/concerns preclude the understanding of instructions and interpretation of reactions during an FCE
- Substantial psychiatric or behavioural issues
It may be appropriate to seek further relevant advice, through consultation with the treating medical practitioner (or another medical practitioner if necessary and appropriate), on the appropriateness of conducting a FCE when contra-indications apply.
The main focus while undertaking an FCE must be the prevention of further injury. A number of factors are fundamental to maintaining the safety of the worker during the evaluation:
- The injury/condition must be medically stable.
- The evaluator must use his/her professional judgment in determining a safe maximal level for each test component.
- Our assessors have standardised decision-making criteria for ceasing each test. Conditions for which criteria have been developed include pain, nausea, dizziness, blurred vision and radicular symptoms.
- If during the assessment, the worker consistently demonstrates unsafe body mechanics the evaluator uses their professional judgment about whether or not an FCE should be continued.
- The FCE is performed by evaluator who has education, training and competencies evident by certification specific to the FCE system they are using.
- Cardiovascular monitoring during the evaluation is undertaken. The FCE is modified if there are excessive rises in pulse rate, blood pressure or respiratory rate.
- Only the required testing is undertaken to provide accurate results for assessing capabilities for the job(s) under evaluation.
The FCE will be stopped if:
• the person asks
• when the advised medical restrictions or specified job demands have been reached
• when a safe limit has been reached in the opinion of the assessor.
Evaluation of performance:
Whatever performance is demonstrated is used to inform the results and conclusions of the FCE.
Validity and reliability:
Our evaluators our aware of the validity and reliability of the FCE system we use and the individual test components they choose to administer.
When Should a Functional Capacity Evaluation be used?
Physical work capacity is of central importance in the management of a safe and successful return to work following injury and in the prevention of injuries in manual work performance. A Functional Capacity Evaluation can be used in the following situations to determine:
• The worker’s safety to perform their current role
• Capacity for full duties before receiving a full medical clearance
• Current capacity for suitable duties following an injury/illness
• As a part of a pre-employment screening package based on specific job and task requirements
• When assessing performance and progress, identifying alternative treatment modes and providing direction for vocational activity and graduated return to work programs
Why choose us for your next Functional Capacity Evaluation?
• Our Physiotherapists and Occupational Therapists working with injured or ill workers and their employers understand contemporary injury management practices, as well as relevant legislation and its practical application to RTW processes. Such knowledge and expert application can positively impact on health, social, financial and personal outcomes of injured or ill workers through early intervention, treatment and occupational rehabilitation services.
• We understand the benefits of cost-effective and evidence-based injury management, rehabilitation and RTW services, including a focus on activity and independence and facilitating interventions that promote the achievement of functional goals and the injured worker’s self-management of their symptoms.• We recognise and promote the importance of the workplace as the focus for the rehabilitation of injured and ill workers.
• Our Specialist Occupational Health Physiotherapists are certified to have additional training and experience in working with individuals and employers to improve the prevention and treatment of work related injury and illness
• We have a long track record for delivering safe and durable return to work outcomes.
Implementing best-practice and evidence-based rehabilitation processes, incorporating ergonomic principles, helps to prevent workplace injury, re-occurrence of injury and achieve productivity increases.
Reference: Guidelines for Functional Capacity Evaluations (FCE) [WorkCover SA 2006]