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Functional capacity evaluation performance does not predict sustained return to work in claimants with chronic back
Douglas Paul Gross1, Michele Crites Battié
1Department of Physical Therapy, University of Alberta, Edmonton, Canada. dgross@ualberta.ca
Journal of Occupational Rehabilitation
|August 27, 2005
Summary
Functional Capacity Evaluations (FCE) can predict faster return-to-work for chronic back pain patients. However, FCE performance does not predict future pain, disability, or recurrence of back problems.
Area of Science:
- Occupational medicine
- Rehabilitation science
- Pain management
Background:
- Functional Capacity Evaluation (FCE) is a common tool to assess an individual's ability to return to work.
- Chronic back pain significantly impacts workers' compensation claimants, necessitating reliable return-to-work assessments.
- The Isernhagen Work Systems' FCE is frequently utilized in these evaluations.
Purpose of the Study:
- To evaluate the predictive accuracy of the Isernhagen Work Systems' FCE for sustained return-to-work in chronic back pain patients.
- To determine if FCE results can predict future pain intensity and disability levels.
- To assess the relationship between FCE performance and the recurrence of back problems.
Main Methods:
- A prospective study involving 130 workers' compensation claimants with chronic back pain undergoing FCE.
- Key FCE indicators included the number of failed tasks and the weight lifted in floor-to-waist tasks.
- Recovery outcomes measured included time to benefit suspension, recurrence, and one-year follow-up for pain and disability, analyzed using Cox and logistic regression.
Main Results:
- Improved performance on FCE tasks, specifically fewer failed tasks and higher floor-to-waist lift capacity, was mildly associated with a faster return to work.
- The FCE was not found to be a significant predictor of future pain recurrence.
- No association was observed between FCE performance and self-reported pain intensity or disability at the one-year follow-up.
Conclusions:
- While better performance on Functional Capacity Evaluations may indicate a slightly quicker return to work, it does not predict long-term outcomes.
- FCE is not demonstrably linked to preventing recurrent back issues or mitigating future pain and disability.
- The findings suggest a limited role for FCE in predicting sustained recovery and future health status for chronic back pain claimants.