Functional Capacity Evaluation

Aka: Functional Capacity Evaluation, Functional Evaluation, Functional Assessment

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II. Definition

  1. Formal evaluation of functional capacity as it relates to patient Impairment
  2. Functional Evaluation is most often directed at work capacity in specific occupations and roles
    1. Contrast with Disability Evaluation that is not directed at a specific task

III. Indications

  1. Musculoskeletal Impairment that subjectively limits a patient's work capacity

IV. Evaluation

  1. Performed by physical therapists and occupational therapists
  2. Uses a standardized battery of performance based tests
    1. Typically requires 4-6 hours to perform (up to 2-3 days in some cases)
  3. Identify a list of body regions required for a specific job
    1. Identify both maximal and sustainable levels of physical exertion
    2. Measure what an employee is willing to perform
  4. Areas of testing
    1. Strength
    2. Endurance
    3. Positional tolerance
    4. Body mechanics
    5. Repetitive activity tolerance
    6. Work simulation

V. Types

  1. General Evaluation
  2. Job-Specific Evaluation

VI. Resources: Tools

  1. General functioning assessment
    1. Short Form Health Survey (SF-36)
      1. http://www.rand.org/health/surveys_tools/mos/mos_core_36item.html
    2. Functional Activities Questionnaire
      1. http://www.healthcare.uiowa.edu/familymedicine/fpinfo/Docs/functional-activities-assessment-tool.pdf
    3. Health and Work Questionnaire
      1. https://tobaccocontrol.bmj.com/content/suppl/2001/09/13/10.3.233.DC1/halpern.pdf
    4. Medical Outcomes Study 36-item Short Form (quality of life survey)
      1. https://www.brandeis.edu/roybal/docs/SF-36_website_PDF.pdf
    5. Patient Reported Outcomes Measurement Information System (PROMIS, requires purchase)
      1. https://commonfund.nih.gov/promis/index
    6. Patient Specific Functional Scale
      1. https://bynder.uwhealth.org/m/2d1829df14c70449/original/Patient-Specific-Functional-Scale.pdf
    7. Workability Index
      1. https://workbox.chrodis.eu/repository/pdf/WAI_Work-Ability-Index.pdf
  2. Psychosocial
    1. Fear Avoidance Beliefs Questionnaire
      1. https://www.tac.vic.gov.au/files-to-move/media/upload/fear_avoidance.pdf
    2. Patient Health Questionaire (PHQ-9 for Major Depression)
      1. https://med.stanford.edu/fastlab/research/imapp/msrs/_jcr_content/main/accordion/accordion_content3/download_256324296/file.res/PHQ9%20id%20date%2008.03.pdf
  3. Pain Assessment
    1. Pain Disability Index
      1. http://www.med.umich.edu/1info/FHP/practiceguides/pain/detpdi.pdf
    2. McGill Pain Questionnaire
      1. https://www.sralab.org/sites/default/files/2017-07/McGill%20Pain%20Questionnaire%20%281%29.pdf
      2. https://neurotoolkit.com/sf-mpq/
    3. Orebro Musculoskeletal Pain Questionnaire
      1. https://www.nzgp-webdirectory.co.nz/site/nzgp-webdirectory2/files/Orebro_Questionnaire.pdf
    4. Tampa Scale of Kinesiophobia
      1. https://novopsych.com.au/assessments/health/tampa-scale-of-kinesiophobia-tsk/
  4. Neck Pain assessment
    1. Neck Disability Index
      1. https://www.smcnd.org/assets/docs/pt/neck_disability_index.pdf
  5. Low Back Pain assessment
    1. Oswestry Low Back PainDisability Questionnaire
      1. https://www.aaos.org/globalassets/quality-and-practice-resources/patient-reported-outcome-measures/spine/oswestry-2.pdf
    2. Roland Morris Disability Questionnaire
      1. http://www.rmdq.org/
    3. Quebec Back Pain Disability Scale
      1. https://www.tac.vic.gov.au/files-to-move/media/upload/quebec_scale.pdf
  6. Upper Extremity assessment
    1. Disabilities of the Arma, Shoulder and Hand Outcomes Measure (DASH Outcome Measure, requires purchase)
      1. http://dash.iwh.on.ca/
    2. Upper Extremity Functional Index
      1. https://www.fitasaphysio.com/uploads/4/3/3/4/43345381/uefi_upper_extremity_functional_index_questionnaire.pdf
    3. Michigan Hand Outcomes Questionnaire
      1. https://www.thompsonhealth.com/Portals/0/_RehabilitationServices/PT Mgmt of Knee/Brief_Michigan_Hand_Questionnaire_with_Scoring.pdf
    4. Upper Extremity Functional Scale
      1. https://www.chugachpt.com/uploads/2/4/1/4/24146306/upper_extremity_functional_scale___uefs_.pdf
  7. Lower Extremity assessment
    1. Lower Limb Outcomes Questionnaire
      1. https://www.emoryhealthcare.org/ui/pdfs/msk-pt-forms/hip-lefs.pdf

VII. Resources

  1. Functional Capacity Evaluation
    1. https://www.physio-pedia.com/Functional_Capacity_Evaluation

VIII. References

  1. Evensen (2023) Am Fam Physician 107(5): 490-8 [PubMed]
  2. Maness (2015) Am Fam Physician 91(2): 102-9 [PubMed]

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