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Are performance-based functional assessments superior to semistructured interviews for enhancing return-to-work
Douglas P Gross1, Alexander K Asante2, Maxi Miciak3
1Department of Physical Therapy, University of Alberta, Edmonton, Alberta; Workers' Compensation Board-Alberta/Millard Health, Edmonton, Alberta.
Archives of Physical Medicine and Rehabilitation
|February 8, 2014
Summary
Functional capacity evaluations (FCEs) did not improve return-to-work (RTW) outcomes for injured workers compared to functional interviewing. Semistructured interviews offer an efficient alternative without compromising worker outcomes.
Area of Science:
- Occupational health
- Rehabilitation medicine
- Workplace injury management
Background:
- Functional capacity evaluations (FCEs) are standard tools to assess injured workers' abilities and guide return-to-work (RTW) decisions.
- The impact of FCEs on RTW outcomes requires further investigation.
Purpose of the Study:
- To determine if using functional capacity evaluations (FCEs) improves outcomes for injured workers.
- To compare the effectiveness of standard FCEs versus semistructured functional interviewing for RTW assessments.
Main Methods:
- A cluster randomized controlled trial was conducted in a rehabilitation facility.
- 203 claimants with chronic musculoskeletal conditions were included; 103 underwent FCE.
- Clinicians were randomized to either standard FCE procedures or semistructured functional interviewing.
Main Results:
- No statistically significant differences were found in RTW recommendations, functional work levels, or compensation outcomes between the FCE and functional interviewing groups.
- Observed differences in functional work levels were minimal (3%-8%) and not clinically significant.
Conclusions:
- Performance-based FCEs did not demonstrate superior RTW outcomes compared to semistructured functional interviewing.
- Functional interviewing may enhance RTW assessment efficiency without negatively impacting clinical, RTW, or compensation results.
