Functional Capacity Evaluations Flashcards Preview

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Flashcards in Functional Capacity Evaluations Deck (25)
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1
Q

What is a FCE?

A
  • Primarily for work injuries

- Medical model unable to provide answers for longer term/serious injuries as to whether worker is ready to RTW

2
Q

Definition

A

A systematic process of measuring, recording and
analysing an individual’s ability to perform activities in
response to broadly defined work demands

3
Q

Stages of FCE

A
  1. Preparation
  2. Execution
  3. Report writing
4
Q

Functional Ax?

A

used in conjunction with other medical and physical testing or examinations to strengthen the overall assessment

5
Q

Functional Testing?

A

used as a means to demonstrate and

measure changes over time

6
Q

Functional screening?

A

used as a means to screen large numbers to determine if further testing or investigation is required – usually Pre Employment testing

7
Q

Why is FCE conducted?

A
  • RTW
  • medico-legal
  • pre-employment
  • ongoing risk mgmt
  • rehab planning
8
Q

Signs of fatigue?

A
  1. Biomechanical slowing
  2. Accessory muscle usage
  3. Sliding the load over self or using lower extremity to push or nudge the load
  4. Using lower extremity to nudge the load from the floor to a shelf
  5. Trembling or muscle fatigue
9
Q

FCE limits reached by?

A
  1. HR >= 85% max, or >70% if on Beta Blockers
  2. Physical/biomechanical indicators - asymmetrical postures, muscle tremors, changes in cadence/pace, momentum, weight controls person, muscle tremor, accessory muscle use, NOT PAIN
  3. Psychophysical limits - person identifies their own limits
10
Q

Contraindications??

A
  1. Unstable medical condition, recent flu, infection
  2. Recent surgery or injury (within 6wks)
  3. Substantial psychiatric or behavioural issues
  4. Communication barriers that prevent instructions being understood
  5. Non-compensable medical co-morbidities restricting performance or exclusion from work
  6. Inappropriately dressed
11
Q

If concerned about contraindications?

A

Medical clearance prior to proceeding

12
Q

Preparation stage includes..?

A
  • gather medical reports, current medical certificate for restrictions, job analysis, progress reports from rehab providers,
    – purpose of FCE – to return to a job, or is employer uncertain of what worker is capable of; medico‐legal, no job but physical tolerances to be determined
    – Authority to exchange information
    – Informed consent
13
Q

Execution stage includes..?

A
-  Client/Patient interview
– Subjective Ax
– Objective Ax – brief neuromuscular, and physical screen,  functional testing, work specific activities
– Safety considerations
– Post test symptoms
14
Q

When should you always obtain medical approval?

A

If BP >195/100

15
Q

List the interview components (13)

A
---History, progress to date
 Medical History
 Diagnostic Tests 
 Types of Medical Treatment
 Medication
 Pain Description
 Contraindications
--Current ADL
 Employment History
 Training/Education
 Employment Goals
 Job Description Review
 Individual perception of abilities
16
Q

What equipment is required?

A

—Heart Rate Monitor
 Blood Pressure Cuff
 Hand dynamometer to measure grip strength
 Varying weights
 Items to be lifted – boxes, weights, specific work items
such as tools, cables,
 Equipment specific to persons work duties – ladder,
shovel, work tools
 Fitness Ax equip – bike, steps,
 Equipment depends on the type of FCE to
be performed

17
Q

What are some subjective tools?

A
  1. VAS
  2. Modified Borg
  3. (optional) Oswestry, Roland Morris, Pain Disability Index, FABQ
18
Q

What does the objective assessment include? (4)

A

—Basic ROM (inclinometry, goniometry joint measures),
muscle strength, posture
 Neuro‐musculoskeletal
 Fitness tests – step up or bicycle ergometer
 Any other useful physical measurement that would be
appropriate to the purpose of the FCE

19
Q

What test do you use for motor dexterity?

A

Purdue Peg Board

20
Q

Determining end points of performance?

A
  1. Biomechanical = strength, endurance, coordination, balance
  2. Physiological = heart rate and blood pressure
  3. Psychophysical = pain intensity, fear of
    movement/(re)injury, pain behaviours
21
Q

Can FCE predict RTW?

A

Floor to waist lift can predict RTW in short term

but not long term

22
Q

Choice of FCE protocol depends on…?

A
---Purpose of test
 Outcome expected
 Complexity of case
 Time
 Price
 Training available
 Equipment 
 Testing venue
 Evaluators professional background
 Political, corporate, legal climate
23
Q

The report includes…?

A

Word this VERY CAREFULLY
 Direct toward the purpose
 Participant’s overall level of work – sedentary to very
heavy
 Abilities on specific tasks
 Tolerance for an 8‐hr day
 Level of cooperation or sincerity of effort
 Comparison of current abilities with job demands
 Conclusion
 Recommendations

24
Q

Should you ask for a job description or should you assess job demands yourself?

A

YOU ASSESS - better understanding of demands of job

25
Q

Examples of FCE’s?

A
  • F.A.S.T
  • Blankeship
  • WorkHab