A Function Capacity Evaluation can tell you if it’s safe to return to work after you’ve done rehabilitation therapy for an injury or illness.
The test takes about four hours and involves a series of exercises designed to measure strength and range of motion.
Patients may be cleared to return to work, asked to complete additional therapy, or deemed eligible for disability benefits.
Getting back to work after an injury is a huge step toward resuming normal life – but how do you know you’re physically ready?
Regional One Health’s Center for Rehabilitative Medicine can help. Therapists can perform a Functional Capacity Evaluation, a test created using research-based protocol to determine whether it is safe for patients to return to work and how much physical work they can perform.
Physical therapist Audrey Pinner, PT, DPT, NCS said a Functional Capacity Evaluation, or FCE, is done after a patient goes through physical therapy or occupational therapy for a traumatic or repetitive motion injury. For some patients, the goal is to decide if they have recovered enough to go back to their previous job. For others, the test is a requirement for receiving disability benefits if their injury is chronic or long-standing and prevents them from working.
Pinner let patients know what to expect if they are having an FCE.
“You should expect to spend about four hours on the test,” she said. “You should eat ahead of time, arrive on time, wear clothing that is easy to move in, and take any medication as usual as prescribed by your provider.”
To start, patients sign a consent form and Pinner gets a detailed history of their injury, from the cause to how it impacts them to what therapy they’ve already done.
Then, they move onto a series of exercises designed to test strength and range of motion. Some patients are also given a sensation test if necessary.
After you complete physical or occupational therapy for an illness or injury, a Functional Capacity Evaluation can tell you if it’s safe to return to work.
For the most part, patients do each test three times so the therapist can see if they’re providing a consistent effort. Pinner said that helps ensure the FCE findings are accurate.
“We look at data that shows whether the patient’s effort is following a normal pattern or if it is random, which could suggest the patient is either overdoing it or not performing as well as they’re able to,” Pinner said. “We also look for signals like sweat and heartrate to monitor the patient’s effort and pain levels.”
Therapists can stop the tests before three rounds if they feel it is no longer safe to proceed, if the patient reports they are unable to continue, or if the patient reaches their maximum heartrate.
The exercises themselves are designed to gauge a patient’s ability to perform activities they’d be doing at their job.
Grip-and-pinch and grip strength machine tests are used to measure strength. Patients also test on handling and fingering ability, which involves picking up objects and moving them around.
Non-material handling tests involve doing movements without lifting or carrying an object. Pinner said therapists test mobility by having the patient sit, stand, walk, climb stairs, climb a ladder, crawl and balance. They evaluate range of motion by having the patient reach up and out using both sides of the body, bend, squat and kneel.
An FCE also includes a material handling portion, or doing movements while lifting a weighted object. Patients lift the object from the floor to their waist, their waist to their shoulder, their shoulder to overhead, the floor to the shoulder, and the floor to overhead. Finally, patients are asked to carry and then push and pull a weighted object.
A Functional Capacity Evaluation takes about four hours and includes a series of exercises designed to test strength and range of motion.
Pinner said the test is an effective way to gauge whether it is safe to get back to many types of work. She added it’s best if the patient’s employer provides a Jobs Demand Analysis, which provides specific information about how much the individual needs to lift, push or pull, carry, etc. to perform their job.
“Most of the clients who seek a FCE have a job that is physical in nature, such as warehouse or factory work,” she said. “We also see a lot of drivers who unload and load their vehicles.”
An FCE can result in a “yes or no” answer about returning to work, Pinner said, or the result can be somewhere in the middle.
“In some cases, accommodations can allow a patient to return to work in some capacity. They may need restrictions on how much they can lift or some sort of adaptation that allows them to perform their work safely,” Pinner said. “For some patients, the answer is to return to physical or occupational therapy so they can continue to improve their strength and mobility.”