Does functional capacity evaluation predict recovery in workers' compensation claimants with upper extremity...

Area of Science:

• Occupational Medicine
• Rehabilitation Science
• Biostatistics

Background:

• Functional capacity evaluations (FCEs) are standard tools for assessing work readiness after injury.
• The predictive validity of FCEs for return-to-work outcomes remains largely unestablished.
• Upper extremity disorders are common in workers' compensation claims.

Purpose of the Study:

• To evaluate the Isernhagen Work Systems' FCE as a predictor of timely and sustained recovery in upper extremity injury claimants.
• To compare the predictive accuracy of FCEs for specific injuries versus pain-mediated conditions.

Main Methods:

• A longitudinal study of 336 workers' compensation claimants with upper extremity disorders who underwent FCE.
• FCE indicators included maximum grip/lift strength and task performance ratings.
• Outcomes included time-loss benefit duration, claim closure time, and recurrence rates, analyzed using Cox and logistic regression.

Main Results:

• 95% of subjects had benefits suspended within one year post-FCE; 39% experienced recurrence.
• Higher lifting performance weakly predicted faster benefit suspension and claim closure (R²=1.2-11%).
• No FCE indicators predicted sustained recovery or recurrence after controlling for confounders; results were similar across injury types.

Conclusions:

• FCE performance is a weak predictor of short-term return to work and unrelated to sustained recovery.
• FCEs demonstrate similar predictive utility for both specific injuries and ambiguous pain-mediated conditions.
• The findings question the current utility of FCEs in guiding return-to-work decisions for upper extremity injuries.