A review of functional capacity evaluation practice

The assessment of function: How is it measured? A clinical perspective

Testing for outcome or performance can take many forms; including multiple iterations of self-reported measures of function (an assessment of the individual's perceived dysfunction) and/or clinical special tests (which are primarily assessments of impairments). Typically absent within these testing mechanisms is whether or not one can perform a specific task associated with function. The paper will operationally define function, discuss the construct of function within the disablement model, will overview the multi-dimensional nature of 'function' as a concept, will examine the current evidence for functional testing methods, and will propose a functional testing continuum. Limitations of functional performance testing will be discussed including recommendations for future research.

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.