Objective evaluation of functional capacity: medical, occupational, and legal settings

Clinicians are called upon to perform objective evaluation of functional capacity in a variety of treatment and evaluation settings. To assist the clinician in selecting the appropriate testing methods for assessment of functional capacity in different settings, a survey of available techniques is presented. It is structured around the goals of treatment as the patient progresses from the stage of acute injury or disease through early postacute care to long-term rehabilitation. The role of the clinician in treatment of the patient is contrasted to the role of the clinician in evaluation of the patient for reasons other than making clinical decisions. In particular, the specific demands of workers fitness and risk evaluation are described. The goal-related differences in the design and the correct use of clinical dynamometers vs. work simulators are presented. The key concepts are the professional role of the clinician, reliability of measurements, and validity in the sense of the decisions one is justified in making based on the results of these measurements in a particular context.