Impact of Functional Capacity Evaluation on Patient-Reported Functional Ability: An Exploratory Diagnostic Before-After Study.

Abstract

Introduction Work capacity in patients with orthopedic trauma and long-lasting inactivity is significantly reduced. Functional capacity evaluation (FCE) is a diagnostic approach for developing recommendations for a return to work and further occupational rehabilitation when the ability to carry out previous job demands is uncertain. However, FCE may also have direct effects on the patients' appraisal of their functional ability. Our study therefore evaluated the change in patient-reported functional ability after the performance of an FCE. Methods We performed a diagnostic before-after study in 161 consecutively recruited patients with trauma who were referred for FCE at the end of an interdisciplinary inpatient rehabilitation program in Austria. Patients completed the Spinal Function Sort to assess patient-reported functional ability both prior to the FCE and after completing it. Results Patient-reported functional ability (0-200 points) improved by 14.8 points (95% CI 11.3-18.2). The number of participants who rated their functional ability below their functional capacity as observed by the FCE decreased from 82.6 to 64.6% by about 18 percentage points. Conclusions The performance of the FCE in patients with trauma was associated with an improvement of patient-reported functional ability. The performance of an FCE in trauma rehabilitation may possibly have a direct therapeutic effect on the patient by allowing a more realistic appraisal of the ability to perform relevant work activities.