Functional Capacity testing

Accurate diagnosis is a critical in proper medical treatment decision making.  At the Miami Back Institute we utilize state of the art diagnostic testing procedures to provide our physicians with the tools to make the correct diagnosis and best treatment decisions for our patients.  Functional Capacity Testing is an important component in this process.

What is an FCE?

An FCE (Functional Capacity Evaluation) is a comprehensive evaluation used to determine a patient's functional status, ability to meet minimum job criteria and/or the need for a rehabilitation program.

 Why is an FCE ordered?

• To decrease liability to the physician due to premature return to work recommendations.
• To accurately match the patient's ability to work with the job demands and to return to work safety.
• To assess the need for further treatment by the treating physician.
• To assess, quantify and qualify the need for a rehabilitation, work hardening, or pain management program.

 When do you order an FCE?

• When there is difficulty obtaining authorization for additional treatment from the insurance carrier in workers' compensation cases.
• When determining the patient's ability to return to work.
• Upon completion of a rehabilitation or work conditioning/hardening program to establish the progress the patient has made and to determine his/her current physical demand performance level.

 Functional Capacity Evaluations

The extensive set of tests that assess many factors affecting a patient's ability to perform activities of daily living and work are Functional Capacity Evaluations. These tests include assessment of strength, flexibility, endurance, and body mechanics. Functional activities such as pushing, pulling, lifting, carrying, reaching and gripping are included in testing. The evaluation is broken down into three basic parts: intake interview, physical assessment, and functional assessment. Functional Capacity Evaluations are performed by licensed physical therapists. The testing usually takes 3-4 hours.

A Functional Capacity Evaluation (FCE) is used to determine a patient’s current functional ability to perform various physical tasks. This evaluation determines a person’s ability to work in either a specific occupation or in any occupation. 

Components of a Functional Capacity Evaluation

 CAFT Step Test involves stepping up and down an 8-inch step at a set protocol rate to determine normative cardiovascular function and a corresponding physical demand characteristic (PDC) level for work.

Range of Motion using dual spinal inclinometers and an electronic goniometer. 

Grip/Pinch Strength utilizes a Jamar Hand Dynamometer and Pinch Gauge to determine five position grip strength and key, tip, and palmar pinch strength. Coefficient of variation determines effort given along with five-position grip strength curves and rapid exchange grip strength.

Static Strength utilizes a load cell, or strain gauge, to assess static/isometric strength in various positions including the floor, torso, arm, high near, push, and pull tests. Horizontal strength changes and heart rate responses determine consistency of effort.

Dynamic Lifting (PILE) dynamic lift testing is performed using a weighted box at heights that are specific to the injury and job requirements. Heart rate is constantly monitored for safety and to assist with determining quality of effort. Floor to Knuckle, Floor to Shoulder, Knuckle to Shoulder, and overhead lifting can be assessed.

Methods Time Measurement (MTM) is a method of objectively determining an individual's abilities to demonstrate Occasional, Frequent, or Constant performance for trunk, upper extremity, and lower extremity tasks. Some of the tests are: walking, carrying, reaching, kneeling, stooping, crouching, and handling.

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