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PubMed2006

Use of Functional Capacity Evaluations by rehabilitation providers in NSW.

Returning the disabled worker to maximum productivity is a shared responsibility between the treating health practitioners and employers, with the insurer as an overseer of the injury management plan. Allied health professionals have responded to the need for standardized tools to assess work capacity by developing Functional Capacity Evaluations (FCEs). Literature exists outlining the limitations of FCEs in injury management systems; however, little is known about their uses and perceived usefulness. Questionnaires were posted to managers and therapists of accredited rehabilitation providers. The questionnaires consisted of both open and closed format questions. The response rate for the managers' questionnaire was 53%, while the therapists' questionnaire was 27%. The majority of rehabilitation providers use an assessment of their Own Design. Eight commercial FCEs were identified as being used. The majority of therapists use only one type of FCE. Therapists rated FCEs highly on their flexibility with Own Design assessment rated as significantly more flexible than the most frequently used commercial FCEs. From the data collected, it appears that cost is the main factor influencing choice of assessment. Level of evidence supporting capabilities of particular assessments does not appear to influence use. It seems that, despite there being poor research evidence to support the use of many brands of FCEs, they are still commonly used by rehabilitation providers. To achieve optimal use of FCEs, further research is required on the types of adaptations therapists make to commercial assessments and properties of Own Design assessments, including reliability and validity studies.

Health Personnel↗
PubMed1993

Concurrent validity of the ERGOS work simulator versus conventional functional capacity evaluation techniques in a workers' compensation population.

A prospective blinded cohort study was performed in an interdisciplinary vocational evaluation program to investigate the concurrent validity of the ERGOS work simulator in comparison to current methods of evaluation. Seventy men and eight women, aged 22 to 64 years, who attended for a 2-week physical capacity assessment participated in the study. Physical activity factors as defined by the Canadian Classification and Dictionary of Occupations and the American Dictionary of Occupational Titles were assessed for all subjects under three evaluation conditions: the ERGOS work simulator, an exercise-oriented physical evaluation by a rehabilitation therapist, and performance of project-format industrial tasks. In addition, 17 men and 7 women were assessed with VALPAR standardized work sample tests. The statistical significance of the relationships between results obtained by the various evaluation methods was examined. There was a strong correlation between the ERGOS dynamometry and the clinical assessment of strength for all standard movements tested (P < .001). The Methods Time Measurement rating by the ERGOS for dexterity variables, according to industrial engineering standards, tended to rate subjects as more restricted than did the clinical evaluators. There was a significant relationship (P < .001) between the "overall physical activity rating" from ERGOS dynamometry, clinical evaluation, and performance in an industrial workshop setting. There was also a significant relationship (P < .001) between the "overall physical activity rating" for endurance of a full workday produced by the 4-hour ERGOS evaluation and by the 2-week functional capacity evaluation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Work capacity of housewives with complete laceration of the rotator cuff].

OBJECTIVE: The aim of the this study is to evaluate the work capacity of housewives with full thickness tear of the rotatory cuff (FTTRC). METHODS: Twenty-five subjects have been studied. The FTTRC was located un the right shoulder in 16 cases, in the left shoulder in 5 cases and was bilateral in 4 patients. All patients were female; the average age was 72.4 +/- 4 (range 62-81). The Assessments were made using the Constant Scale, the Groningen Activity Restriction Scale and the Simon's Test. RESULTS: The result of this study confirmed that none of the housewives was able to carry out the houseworks quite independently and with no effort. 16% of the patients did the houseworks with great effort while 84% was helped in making some activities. Help is necessary for the usual housework and heavy domestic works (washing glasses, using vacuum cleaner to clean the floor). Patient's relatives provided help in 76.2% of cases while 23.8% were assisted by maid. Help was occasional in 33.3% of cases, continuous in 52.3% and full in 14.4% of patients. Disability resulting from FTTRC is heavier in subjects where electrical household appliances are not used (p < 0.05) and in subjects who feel deep pain (p < 0.05). The active movements of shoulder, local shoulder pain and level of use of upper limbs do not affect domestic works. CONCLUSIONS: These study showed that FTTRC reduces work capacity of house wives. These disease is more preventing heavy domestic works.

Age Factors↗
PubMed1988

Cardiopulmonary functioning in adolescent patients with mild idiopathic scoliosis.

This study measured the physical work capacity of adolescent subjects with idiopathic scoliosis to determine whether cardiopulmonary restrictions begin to occur in the early stages of the condition. Nineteen adolescents (four males, 15 females) between the ages of 10 and 17 years (means = 13.4), with idiopathic thoracic scoliosis, served as subjects. The mean scoliotic curve was 21.5 degrees. Each subject had his/her height, weight, and percent body fat (Lange caliper) recorded. Resting vital capacity and forced expiratory volume were evaluated using standardized clinical spirometry techniques. Work capacity was measured via a continuous graded incremental exercise tolerance test, using a treadmill. A running protocol was used. Heart rate was continuously monitored by an ECG, and a Beckman Metabolic Cart analyzed ventilation (VE), breathing rate (f), and oxygen uptake (VO2) every minute. Twelve of the subjects had vital capacity measures that were one or more standard deviations below normal and also had VO2max scores below 40ml/kg/min. Subjects with curves of 25 degrees or higher had a mean VO2max of 32.6ml/kg/min, while subjects with curves of less than 25 degrees had a mean VO2max of 42.6ml/kg/min. It appears that some pulmonary limitations begin even in mild curves. Curves greater than 25 degrees also appear to affect work capacity.

Adolescent↗
PubMed1987

Assessment of upper extremity-injured persons' return to work potential.

Therapists specializing in the rehabilitation of persons with upper extremity disorders--hand therapists--have developed an evaluation procedure to determine if and when an injured worker has the physical capacity to safely return to work. The Return to Work Evaluation has five components: (1) physical evaluation, (2) subjective effects of injury interview, (3) biomechanical job analysis, (4) work stimulation, (5) reevaluation. The therapist designs a work simulation based on the identification of the critical physical demand characteristics of the patient's work. After documenting the patient's response to the work simulation, the therapist formulates recommendations to the physician with regard to the patient's ability to safely return to the workplace. These recommendations may include the need for job/worker modifications or the need for a reconditioning program. The implementation of the Return to Work Evaluation has decreased the physician's liability in return-to-work decisions and has allowed injured workers to maintain optimal function after medical treatment.

Accidents, Occupational↗
PubMed1997

Resource support and heart patient recovery.

This prospective study examines the effects of resources utilized by myocardial infarction (MI) and coronary artery bypass (BY) patients in the recovery process. The resource support model incorporates formal (institutionalized) and semi-formal (mutual aid) services along with informal assistance (social networks). Patient interview data were collected on 147 MI and 159 BY patients at hospitalization and at 3 months. Sociodemographic, illness and resource data were obtained, and hospital records were abstracted. Two outcomes were evaluated: activity limitations and work capacity. Bivariate and multivariate analyses were used to assess individual and resource effects. Multivariate analyses revealed that, for MI patients, a higher level of activity prior to hospitalization and a shorter hospital stay were significantly related to recovery. A smaller social network with greater frequency of contact enhanced recovery. For BY patients, recovery was significantly associated with higher social class higher level of activity prior to hospitalization and fewer health care visits. Outcome based on work capacity revealed that MI patients who were younger in age, male sex and who had fewer prescribed medications were more likely to recover. By patients had a similar pattern as that observed for MI patients in terms of age and sex. Co-morbidity had a negative effect on recovery. Those with less affective informal support were more likely to have recovered. The resource support model employed in this prospective study proved to have mixed results. However, the model may be a useful multifactorial framework for examining the effects on patient recovery over a longer duration.

Activities of Daily Living↗
PubMedDate not supplied

[Dynamics of the bioelectrical activity of human brain during continuous work].

Electroencephalographic parameters can be used to detect early signs of fatigue which is of practical importance. Experiments were carried out on three healthy men to identify a limited number of symptoms allowing a rapid evaluation of operator's work capacity. The subjects were kept in long-term isolation. The study revealed general trends and individual variations in brain bioelectrical activities that reflected their performance during a continuous work with natural sleep deprived for three days.

Adult↗
PubMed2004

Reliability and validity of Functional Capacity Evaluation methods: a systematic review with reference to Blankenship system, Ergos work simulator, Ergo-Kit and Isernhagen work system.

OBJECTIVES: Functional Capacity Evaluation methods (FCE) claim to measure the functional physical ability of a person to perform work-related tasks. The purpose of the present study was to systematically review the literature on the reliability and validity of four FCEs: the Blankenship system (BS), the ERGOS work simulator (EWS), the Ergo-Kit (EK) and the Isernhagen work system (IWS). METHODS: A systematic literature search was conducted in five databases (CINAHL, Medline, Embase, OSH-ROM and Picarta) using the following keywords and their synonyms: functional capacity evaluation, reliability and validity. The search strategy was performed for relevance in titles and abstracts, and the databases were limited to literature published between 1980 and April 2004. Two independent reviewers applied the inclusion criteria to select all relevant articles and evaluated the methodological quality of all included articles. RESULTS: The search resulted in 77 potential relevant references but only 12 papers were identified for inclusion and assessed for their methodological quality. The interrater reliability and predictive validity of the IWS were evaluated as good while the procedure used in the intrarater reliability (test-retest) studies was not rigorous enough to allow any conclusion. The concurrent validity of the EWS and EK was not demonstrated while no study was found on their reliability. No study was found on the reliability and validity of the BS. CONCLUSIONS: More rigorous studies are needed to demonstrate the reliability and the validity of FCE methods, especially the BS, EWS and EK.

Humans↗
PubMed1987

[Diagnostic-expert testimony problems related to the evaluation of the nervous system for determining the capacity for performing professional work].

Those cases of the nervous system diseases or deviations which cause most diagnostic and certificatory problems for occupational health service physicians have been analysed. They included: root pains, encephalopathies caused by the disturbed vascular system, neurones, head injuries, loss of consciousness. The diagnostic and certificatory problems resulted mainly from: deficient recognition of workstations, deficient records on the course of the disease, insufficient range of extra studies, and too rare consultations among physicians representing different specialties. An attempt to establish which procedures could facilitate issuing a certificate on the fitness for professional work has been made.

Expert Testimony↗