Association between social factors and performance during Functional Capacity Evaluations: a systematic review

Area of Science:

• Rehabilitation Science
• Occupational Health
• Clinical Psychology

Background:

• Functional Capacity Evaluation (FCE) performance is influenced by various factors, yet the impact of social determinants remains under-researched.
• Understanding these influences is crucial for accurate FCE interpretation and effective rehabilitation planning.

Purpose of the Study:

• To systematically review and synthesize evidence on the association between social factors and Functional Capacity Evaluation (FCE) performance in adults.
• To identify social factors that significantly influence FCE outcomes and assess the quality of evidence for these associations.

Main Methods:

• A systematic literature search was conducted across MEDLINE, CINAHL, and PsycINFO databases.
• Included studies examined social factors associated with adult FCE performance.
• Evidence was synthesized using best-evidence methods, with methodological quality and quality of evidence assessed.

Main Results:

• Thirteen studies identified 11 social factors associated with FCE performance.
• High-quality evidence supports associations with country of FCE and examiner's fear behavior.
• Moderate evidence links FCE performance to previous job salary; low/very low evidence for compensation, litigation, language, ethnicity, instruction type, and time of day.

Conclusions:

• While associations between social factors and FCE performance exist, robust conclusions are limited by heterogeneity and variable evidence quality.
• Further research, particularly within a biopsychosocial framework, is essential to fully understand FCE performance and its influencing factors.
• Improved understanding can enhance FCE interpretation, guide rehabilitation program design, and inform future research directions.