Article

OBJECTIVE: To evaluate whether functional capacity evaluation (FCE) scores are
responsive to functional restoration treatment, and to assess the ability of FCEs
at program discharge to predict work outcomes.
DESIGN: An interdisciplinary
cohort study of prospectively collected data. SETTING:
A functional restoration center. PATIENTS: A consecutive sample of 354 patients with chronic disabling
occupational musculoskeletal disorders (CDOMDs) completed a functional restoration program consisting of quantitatively directed exercise progression
and multi-modal disability management with interdisciplinary medical supervision.
METHODS: Each patient participated in an FCE at admission and discharge from
treatment. The results of each FCE yielded the physical demand level (PDL) at
which patients were functioning. Patients were initially divided into 5 PDL
groups, based on job-of-injury lifting, carrying, and pushing/pulling
requirements, for the pre- to posttreatment responsiveness analyses. Patients
were subsequently divided into 5 PDL groups, based on their performance on the
FCE upon program completion. MAIN OUTCOME MEASURES: Outcome measures included
admission-to-discharge changes in PDLs and 2 specific FCE lifting tasks:
isokinetic lifting; and the Progressive Isoinertial Lifting Evaluation (PILE).
Socioeconomic outcomes were also evaluated, including post-discharge work return
and work retention 1-year after treatment completion.
RESULTS: Overall, 96% of
the patients demonstrated improvement in their PDLs from admission to discharge.
A majority of patients (56%) were able to achieve a discharge PDL that was
comparable to their estimated job-of-injury lifting requirement or higher (P <
.001). Lifting ability improved from admission to discharge by approximately 50%
(all P < .001). Discharge PDLs predicted both work return (P < .001) and work
retention (P < .001) 1 year later. CONCLUSIONS: FCE scores were responsive to
functional restoration treatment,
and the associated discharge PDLs predicted
work return after treatment completion and work retention 1 year later.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS