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Published on: April 23, 2014
Functional capacity assessment: Influence of behavioral and environmental factors
T E Rudy1, S J Lieber2, J R Boston3
1Departments of Anesthesiology, Psychiatry, and Biostatistics, University of Pittsburgh Medical Center, 4601 Baum Blvd., Pittsburgh, PA, 15213, USA Pain Evaluation and Treatment Institute, University of Pittsburgh Medical Center, 4601 Baum Blvd., Pittsburgh, PA, 15213, USA.
Abstract:
The environment surrounding the functional capacity evaluation (FCA) is complex and determined by both external factors as well as those specific to the testing situation. In this paper we (1) briefly review existing models of pain, (2) highlight how current FCAs of pain patients adhere in general to behavioral conceptualizations of chronic pain, (3) review some inadequacies of current conceptualizations of FCA when it applies to chronic pain, (4) review the many internal and external environmental factors that can significantly influence FCAs, and (5) consider some psychosocial factors that play an important role in patients' performances. We conclude that not only should evaluators more carefully consider the central influences of psychosocial factors when interpreting the results of FCAs, but that an alternate conceptual model that emphasizes both environmental and psychological factors is also needed to more adequately describe the physical performances obtained during FCAs.
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