What is the Rate of Functional Improvement During Occupational Rehabilitation in Workers’ Compensation Claimants?

Abstract

The clinically important rate of functional change appears to be 5 kg/week on FCE floor-to-waist lifting and 7 points/week on the PDI (scored out of 100). Rate of functional change appears to be multifactorial, with a variety of physical, demographic, clinical, and environmental factors explaining rate of change.

Improved Functional Capacity Evaluation Performance Predicts Successful Return to Work One Year After Completing a Functional Restoration Rehabilitation Program

“…As noted earlier, although FCEs are often used to help guide treatment planning, few studies to date have evaluated their treatment responsiveness [23,25,26]. The present investigation provides positive evidence for the treatment responsiveness of FCEs in a cohort of CDOMD patients who completed a functional restoration program.…”

“…Raw data from FCE tests of range‐of‐motion, strength, and lifting capacity, were checked against both an external validation method (eg, normative database) and an internal validation method (ie, an effort factor) to determine each patient's PDL. Because there is significant variation in how other treatment facilities perform FCEs and how PDLs are determined [7,23‐26], the results from the present study may not generalize to other treatment facilities. In addition, the Biodex [58] equipment that was used in the FCE is relatively expensive and may not be financially viable for many other treatment facilities.…”

“…It should also be noted that, although FCEs are often used to help with treatment planning, we found relatively few studies that evaluated the treatment responsiveness of FCE scores. Three studies found pre‐ to posttreatment FCE improvements in populations of chronic pain patients with worker's compensation claims who participated in functional restoration [23] and work hardening programs [25,26]. More studies are needed in this area, which was 1 of the major purposes of the present investigation.…”

“…The association between total FCE scores and work outcomes is difficult to determine, because most studies have evaluated only individual components of FCEs. Moreover, although standard FCE protocols do exist, there is significant variation in how different treatment facilities perform them, which specific tests are used, and how PDLs are determined [23,24]. For instance, some authors have determined the PDL from a single floor‐to‐waist lift test [25], some from the combination of a dead lift and an overhead press [26], and others from a combination of several FCE variables, including lifting tests and the number of failed tests [7].…”

Effectiveness of a Multidisciplinary Rehabilitation Program Following Shoulder Injury

“…Recovery in injured workers is multifactorial and a variety of demographic, clinical, and workrelated factors are known to explain a successful treatment (Gross, Haws, & Niemelainen, 2012).…”