Functional Capacity Evaluation

1. See Also
   1. Disability
   2. Impairment Evaluation
   3. Disability Evaluation
   4. Disability Management
   5. Assistive Technology
   6. Letter of Medical Necessity
   7. Disability Referral
   8. Activities of Daily Living
   9. Failure to Thrive in the Elderly
   10. Elderly Drivers with Cognitive Impairment
   11. Medication Use in the Elderly (Beers List, STOPP)
2. 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
3. Indications
   1. Musculoskeletal Impairment that subjectively limits a patient's work capacity
4. 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
5. Types
   1. General Evaluation
   2. Job-Specific Evaluation
6. 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
   2. Pain Assessment
      1. Pain Disability Index
         1. http://www.med.umich.edu/1info/FHP/practiceguides/pain/detpdi.pdf
      2. McGill Pain Questionnaire
         1. http://www.ama-cmeonline.com/pain_mgmt/pdf/mcgill.pdf
   3. Neck Pain assessment
      1. Neck Disability Index
         1. http://www.maic.qld.gov.au/forms-publications-stats/pdfs/NDI.pdf
   4. Low Back Pain assessment
      1. Oswestry Low Back PainDisability Questionnaire
         1. http://www.rehab.msu.edu/_files/_docs/Oswestry_Low_Back_Disability.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
   5. Upper Extremity assessment
      1. Disabilities of the Arma, Shoulder and Hand Outcomes Measure (DASH Outcome Measure)
         1. http://dash.iwh.on.ca/
      2. Upper Extremity Functional Index
         1. http://www.rehab.msu.edu/_files/_docs/Upper_Extremity.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. http://www.rehab.msu.edu/_files/_docs/Upper_Extremity.pdf
   6. Lower Extremity assessment
      1. Lower Limb Outcomes Questionnaire
         1. http://www.aaos.org/research/outcomes/Lower_Limb.pdf
7. References
   1. Maness (2015) Am Fam Physician 91(2): 102-9 [PubMed]