Are functional capacity evaluations affected by the patient's pain?

Area of Science:

• Occupational Medicine
• Rehabilitation Science
• Pain Management

Background:

• Functional Capacity Evaluations (FCEs) are widely used for return-to-work decisions.
• Musculoskeletal conditions often involve pain, directly affecting work capacity.
• Pain is a critical, yet complex, factor in assessing functional performance.

Purpose of the Study:

• To review the literature on how pain influences Functional Capacity Evaluations.
• To determine the validity of FCEs as objective measures of impairment.
• To inform the interpretation of FCE results in clinical and claims settings.

Main Methods:

• Literature review of studies examining pain and FCE performance.
• Analysis of the relationship between pain intensity and functional test results.
• Consideration of behavioral and perceptual factors in FCE.

Main Results:

• FCEs are behavioral assessments demonstrably influenced by pain intensity.
• Higher pain levels consistently correlate with lower FCE performance.
• FCEs should not be viewed as purely objective measures of functional impairment.

Conclusions:

• Pain significantly impacts Functional Capacity Evaluations, affecting performance.
• FCEs can aid return-to-work but require careful consideration of pain factors.
• Shorter FCE protocols may offer comparable effectiveness to longer ones.