Functional Capacity Evaluation Research Articles

Efficacy of noninvasive ventilation support on the increase of exercise tolerance in patients with heart failure: a systematic review

The aim of this study was evaluate the efficacy of noninvasive ventilation (NIV) on improving exercise tolerance of patients with heart failure (HF). A systematic review was performed in PubMed/MEDLINE, LILACS, Cochrane, CINAHL, Scopus and Web of Science for randomized and quasi-randomized clinical trials, without language and year of publication restrictions. Descriptors were defined as 'heart failure', 'noninvasive ventilation', 'positive-pressure respiration', 'interactive ventilatory support', 'exercise test' in addition to the keywords 'BIPAP', 'CPAP', 'IPAP', 'EPAP', 'NIV' and their Portuguese equivalents. Studies comparing NIV with one or two pressure levels to groups without intervention, other physiotherapy modalities without positive pressure or a sham group were included. Four studies were selected, including HF patients of various etiologies, considering the staging classification of New York Heart Association. Any included work realized the allocation concealment, all studies participants underwent blinding, but only two trials performed assessors blinding. None of the studies have described an intention to treat analysis and did not use appropriate statistical methods. All selected trials assessed functional capacity and in only two, dyspnea was assessed. The intervention protocols of the included trials were heterogeneous, three studies underwent a single intervention with NIV, two immediately before the functional capacity test and another study performed NIV during the exercise evaluation. The last trial held 14 sessions of NIV, with the functional capacity evaluation being performed on days 0, 4, 9 and 14. There is insufficient evidence on the effectiveness of NIV in increasing exercise tolerance.

Construct Validity of Functional Capacity Evaluation in Patients with Whiplash-Associated Disorders.

Purpose The construct validity of functional capacity evaluations (FCE) in whiplash-associated disorders (WAD) is unknown. The aim of this study was to analyse the validity of FCE in patients with WAD with cultural differences within a workers’ compensation setting. Methods 314 participants (42 % females, mean age 36.7 years) with WAD (grade I and II) were referred for an interdisciplinary assessment that included FCE tests. Four FCE tests (hand grip strength, lifting waist to overhead, overhead working, and repetitive reaching) and a number of concurrent variables such as self-reported pain, capacity, disability, and psychological distress were measured. To test construct validity, 29 a priori formulated hypotheses were tested, 4 related to gender differences, 20 related associations with other constructs, 5 related to cultural differences. Results Men had significantly more hand grip strength (+17.5 kg) and lifted more weight (+3.7 kg): two out of four gender-related hypotheses were confirmed. Correlation between FCE and pain ranged from −0.39 to 0.31; FCE and self-reported capacity from −0.42 to 0.61; FCE and disability from −0.45 to 0.34; FCE and anxiety from −0.36 to 0.27; and FCE and depression from −0.41 to 0.34: 16 of 20 hypotheses regarding FCE and other constructs were confirmed. FCE test results between the cultural groups differed significantly (4 hypotheses confirmed) and effect size (ES) between correlations were small (1 hypothesis confirmed). In total 23 out of 29 hypotheses were confirmed (79 %). Conclusions The construct validity for testing functional capacity was confirmed for the majority of FCE tests in patients with WAD with cultural differences and in a workers’ compensation setting. Additional validation studies in other settings are needed for verification.

Prevalence of urinary incontinence and its association with multimorbidity in women aged 50 years or older: A population-based study.

To evaluate the prevalence and associated risk factors for urinary incontinence, as well as its association with multimorbidity among Brazilian women aged 50 or over. This was a secondary analysis of a cross-sectional population-based study including 622 women 50 years or older, conducted in the city of Campinas-SP-Brazil. The dependent variable was Urinary Incontinence (UI), defined as any complaint of urine loss. The independent variables were sociodemographic data, health-related habits, self-perception of health and functional capacity evaluation. Statistical analysis was carried out using the Chi-square test and Poisson regression. The mean age of the women was 64. UI was prevalent in 52.3% of these women: Mixed UI (26.6%), Urge UI (13.2%) and Stress UI (12.4%). Factors associated with a higher prevalence of UI were hypertension (OR 1.21, CI 1:01-1:47, P = 0.004), osteoarthritis (OR 1.24, CI 1:03-1:50, P = 0.022), physical activity ≥3 days/week (OR 1.21, CI 1:01-1:44, P = 0.039), BMI ≥ 25 at the time of the interview (OR 1.25, CI 1:04-1:49, P = 0.018), negative self-perception of health (OR 1.23, CI 1:06-1:44 P = 0.007) and limitations in daily living activities (PR 1:56 CI 1:16-2:10, P = 0.004). The prevalence of UI was high. Mixed incontinence was the most frequent type of UI. Many associated factors can be prevented or improved. Thus, health policies targeted at these combined factors could reduce their prevalence rate and possibly decrease the prevalence of UI.

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

ObjectiveTo 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. DesignAn interdisciplinary cohort study of prospectively collected data. SettingA functional restoration center. PatientsA 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. MethodsEach 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 MeasuresOutcome 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. ResultsOverall, 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. ConclusionsFCE scores were responsive to functional restoration treatment, and the associated discharge PDLs predicted work return after treatment completion and work retention 1 year later.

Assessment of functional capacity in patients with rheumatoid arthritis: implications for recommending exercise

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic symmetric polyarthritis of large and small joints and by morning stiffness that may lead to musculoskeletal impairment, with functional impotence. The concept of functionality relates to the ability of an individual to perform effectively and independently daily activities and tasks of everyday life. The aim of this review is to familiarize the rheumatologist with the concept of functional capacity evaluation and with the tests that can be applied in this population, as these are important steps for a proper exercise prescription. From functional tests already used in the elderly population, the Physical Fitness and Rheumatology Laboratory – LAR – Brasilia, which is accompanying patients from Brasilia Cohort of Early Rheumatoid Arthritis, describes in this article a protocol of tests to assess functional capacity for application in patients with RA, including the description of tests: 1) Sit and Reach; 2) Agility/Dynamic Balance; 3) Manual Dynamometry; 4) Sit Back and Lift; 5) Biceps Curl and 6) Six-minute Walk Test.

Functional capacity evaluation: Does it change the determination of the degree of work disability?

BackgroundDetermining the degree of work disability following traffic accidents is very challenging. Functional capacity evaluations (FCEs) are becoming more commonly used in the process of disability assessment. ObjectivesThis study aimed to assess the agreement of the physicians' decision regarding the degree of work disability in two conditions: 1) based solely on a medical examination 2) based on a combined medical and FCE. MethodsThis is a cross-sectional study, with 123 individuals who experienced car accidents; 76 with whiplash-associated disorders and 47 with a hip fracture. All subjects underwent an FCE, filled-in questionnaires and underwent a medical examination. The medical charts of each subject were rated twice and the degree of work disability was determined by orthopedic surgeons and occupational medicine specialists; once based solely on medical files and once based on medical files that included data from the FCE. The agreement was assessed by Intra-Class Coefficients (ICC) and the dependency between the two ratings by McNemar's test. ResultsAn excellent ICC and significant dependency were found for the percent disability in the hip injury group whereas a fair ICC and a non significant dependency for the percent disability in the whiplash group. ConclusionsThe use of FCEs highlights the worker's capacity to perform duties that are part of the physical demands at work. The integration of FCEs into the disability assessment procedure seems to be important especially for whiplash injuries or in cases of discrepancies between the rate of disability determined by the physician to the patient's complaints and participation.

Can Functional Capacity Tests Predict Future Work Capacity in Patients With Whiplash-Associated Disorders?

ObjectiveTo determine whether functional capacity evaluation (FCE) tests predict future work capacity (WC) of patients with whiplash-associated disorders (WADs) grades I and II who did not regain full WC 6 to 12 weeks after injury. DesignProspective cohort study. SettingRehabilitation center. ParticipantsWorkers (N=267) listed on workers' compensation with grade I or II WADs 6 to 12 weeks after injury. InterventionsPatients performed 8 work-related FCE tests. Main Outcome MeasuresWC (0–100%) measured at baseline and 1, 3, 6, and 12 months after testing. Correlation coefficients between FCE tests and WC were calculated. A linear mixed-model analysis was used to assess the association between FCE and future WC. ResultsMean ± SD WC increased over time from 20.8%±27.6% at baseline to 32.3%±38.4%, 51.3%±42.8%, 65.6%±42.2%, and 83.2%±35.0% at the 1-, 3-, 6-, and 12-month follow-ups, respectively. Correlation coefficients between FCE tests and WC ranged from r=.06 (lifting low at 12-mo follow-up) to r=.39 (walking speed at 3mo). Strength of the correlations decreased over time. FCE tests did not predict WC at follow-up. The predictors of WC were ln (time) (β=23.74), mother language (β=5.49), WC at baseline (β=1.01), and self-reported disability (β=−.20). Two interaction terms, ln (time) × WC (β=−.19) and ln (time) × self-reported disability (β=−.21), were significant predictors of WC. ConclusionsFCE tests performed within 6 to 12 weeks after WADs injury grades I and II are associated with WC at baseline but do not predict future WC, whereas time course, mother language, WC at baseline, and self-reported disability do predict future WC. Additionally, the interaction between time course WC at baseline and self-reported disability predicted future WC.

Avaliação da capacidade funcional em pacientes com artrite reumatoide: implicações para a recomendação de exercícios físicos

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic symmetric polyarthritis of large and small joints and by morning stiffness that may lead to musculoskeletal impairment, with functional impotence. The concept of functionality relates to the ability of an individual to perform effectively and independently daily activities and tasks of everyday life. The aim of this review is to familiarize the rheumatologist with the concept of functional capacity evaluation and with the tests that can be applied in this population, as these are important steps for a proper exercise prescription. From functional tests already used in the elderly population, the Physical Fitness and Rheumatology Laboratory – LAR – Brasilia, which is accompanying patients from Brasilia Cohort of Early Rheumatoid Arthritis, describes in this article a protocol of tests to assess functional capacity for application in patients with RA, including the description of tests: 1) Sit and Reach; 2) Agility/Dynamic Balance; 3) Manual Dynamometry; 4) Sit Back and Lift; 5) Biceps Curl and 6) Six‐minute Walk Test.

Evaluation of Functional Status, Pulmonary Capacity, Body Composition, and Quality of Life of End-Stage Liver Disease Patients Who are Candidates for Liver Surgery

IntroductionMuscular weakness in combination with malnutrition can induce a global motor impairment and physical inactivity, adversely impairing the daily living activities and quality of life of end-stage liver disease patients who are candidates for liver transplantation. ObjectivesTo evaluate functional status, pulmonary capacity, body composition and quality of life in end-stage liver disease patients who are candidates for liver transplantation; to verify if there is a correlation between the functional variables of the individuals tested through the 6-minute walk test (6MWT) and covariables: pulmonary function test (PFP), quality of life and body composition. MethodsThis study was carried out at the Liver Transplantation Unit of the State University of Campinas (UNICAMP). We included 46 patients with end-stage liver disease who underwent the following evaluations: medical history, quality of life questionnaire “Short Form 36” (SF-36), surface electromyography (sEMG) of the diaphragm and rectus abdominis muscles, body composition assessment by electrical vioimpedance (BIA), 6MWT and PFP. ResultsUnivariate analysis and Pearson's correlation found correlations between distance walked on 6MWT and QOL (P = .006 and P = .02) and TBW (P = .5 and P = .02). Pearson's correlation were found between respiratory variables of 6MWT, QOL, and PFP. ConclusionThe functional status may be correlated to body composition, quality of life and pulmonary capacity of patients with liver disease, candidates for transplantation.

Erratum To: Experts Opinion on the Use of Normative Data for Functional Capacity Evaluation in Occupational and Rehabilitation Medicine and Disability Claims

Erratum To: Experts Opinion on the Use of Normative Data for Functional Capacity Evaluation in Occupational and Rehabilitation Medicine and Disability Claims

Treatment to Improve Nutrition and Functional Capacity Evaluation in Liver Transplant Candidates

Liver transplantation is the definitive therapy for cirrhosis, and malnutrition is the most frequent complication in these patients. Sarcopenia or loss of muscle mass is the major component of malnutrition in cirrhotics and adversely affects their outcome. In addition to the metabolic consequences, functional consequences of sarcopenia include reduced muscle strength and deconditioning. Despite nearly universal occurrence of sarcopenia and its attendant complications, there are no established therapies to prevent or reverse the same. Major reasons for this deficiency include the lack of established standardized definitions or measures to quantify muscle mass, as well as paucity of mechanistic studies or identified molecular targets to develop specific therapeutic interventions. Anthropometric evaluation, bioelectrical impedance analysis, and DEXA scans are relatively imprecise measures of muscle mass, and recent data on imaging measures to determine muscle mass accurately are likely to allow well-defined outcome responses to treatments. Resurgence of interest in the mechanisms of muscle loss in liver disease has been directly related to the rapid advances in the field of muscle biology. Metabolic tracer studies on whole body kinetics have been complemented by direct studies on the skeletal muscle of cirrhotics. Hypermetabolism and anabolic resistance contribute to sarcopenia. Reduced protein synthesis and increased autophagy have been reported in cirrhotic skeletal muscle, while the contribution of the ubiquitin-proteasome pathway is controversial. Increased plasma concentration and skeletal muscle expression of myostatin, a TGFβ superfamily member that causes reduction in muscle mass, have been reported in cirrhosis. Hyperammonemia and TNFα have been reported to increase myostatin expression and may be responsible for sarcopenia in cirrhosis. Nutriceutical interventions with leucine enriched amino acid mixtures, myostatin antagonists and physical activity hold promise as measures to reverse sarcopenia. There is even less data on muscle function and deconditioning in cirrhosis and studies in this area are urgently needed. Even though macronutrient replacement is a major therapeutic goal, micronutrient supplementation, specifically vitamin D, is expected to improve outcomes.

The reliability of WorkWell Systems Functional Capacity Evaluation: a systematic review

BackgroundFunctional capacity evaluation (FCE) determines a person’s ability to perform work-related tasks and is a major component of the rehabilitation process. The WorkWell Systems (WWS) FCE (formerly known as Isernhagen Work Systems FCE) is currently the most commonly used FCE tool in German rehabilitation centres. Our systematic review investigated the inter-rater, intra-rater and test-retest reliability of the WWS FCE.MethodsWe performed a systematic literature search of studies on the reliability of the WWS FCE and extracted item-specific measures of inter-rater, intra-rater and test-retest reliability from the identified studies. Intraclass correlation coefficients ≥ 0.75, percentages of agreement ≥ 80%, and kappa coefficients ≥ 0.60 were categorised as acceptable, otherwise they were considered non-acceptable. The extracted values were summarised for the five performance categories of the WWS FCE, and the results were classified as either consistent or inconsistent.ResultsFrom 11 identified studies, 150 item-specific reliability measures were extracted. 89% of the extracted inter-rater reliability measures, all of the intra-rater reliability measures and 96% of the test-retest reliability measures of the weight handling and strength tests had an acceptable level of reliability, compared to only 67% of the test-retest reliability measures of the posture/mobility tests and 56% of the test-retest reliability measures of the locomotion tests. Both of the extracted test-retest reliability measures of the balance test were acceptable.ConclusionsWeight handling and strength tests were found to have consistently acceptable reliability. Further research is needed to explore the reliability of the other tests as inconsistent findings or a lack of data prevented definitive conclusions.

Experts Opinion on the Use of Normative Data for Functional Capacity Evaluation in Occupational and Rehabilitation Medicine and Disability Claims

Application of normative values for functional capacity evaluation (FCE) is controversial for the assessment of clients for work ability. The objective of this study was to study when clinicians and researchers consider normative values of FCE useful or of no use for their purposes. A focus group meeting was organized among 43 FCE experts working in insurance, occupational and/or rehabilitation medicine from eight countries during the first international FCE research meeting on October 25th, 2012 in the Netherlands. Participants were asked to rate to which degree they agree or disagree with a statement concerning their position toward normative values for FCE on a 10 cm VAS ranging from 0 (completely disagree) to 100 (completely agree) at T0 and T1. Arguments for aspects that are useful and of no use for normative values were systematically collected during the meeting and afterwards independently clustered by two researchers in higher order topics. Baseline opinion of participants on their position toward normative values was 49 ± 29 points. After the meeting, mean VAS was 55 ± 23 (p = 0.07), indicating that participants did not significantly change their opinion toward normative values. Based on arguments provided by the experts, seven higher order topics were constructed namely 'Comparison with job demands or treatment goals'; 'Comparison with co-workers physical ability'; 'Sincerity of effort'; 'Validity for work ability and return to work'; 'Experience of referrer with assessment method'; 'Clinimetrics compared to alternative assessment methods or reference values'; and 'Ease of use for clinician and stakeholders'. Although experts state useful aspects for the use of normative values of FCE for these assessments, it may also lead to over-interpretation of results, leading to dualistic statements concerning work ability, with potential harmful consequences for work ability of patients.

Matching physical work demands with functional capacity in healthy workers: Can it be more efficient?

ObjectivesTo determine if functional capacity (FC) and physical work demands can be matched and to determine the validity of normative values for FC related to physical work demands as a screening instrument for work ability. MethodsForty healthy working subjects were included in this study. Subjects were categorized into four physical work demand categories (sedentary, light, moderate and heavy). FC was tested with a standardized Functional Capacity Evaluation (FCE) following the WorkWell Protocol and physical work demands were determined with an onsite Work Load Assessment (WLA) according to the Task Recording and Analyses on Computer (TRAC) method. Physical work demands were compared to FC and normative values derived from previous research. Results88% of the subjects scored higher on FCE than observed during WLA. The tenth percentile of normative values appeared valid in 98% for sedentary/light work for the subjects tested in this study. For moderate or heavy work, the thirtieth percentile of normative values appeared valid in 78% of all cases. ConclusionFunctional capacity and physical work demands can be matched in most instances, but exceptions should be kept in mind with regards to professions classified as moderate or heavy physical work, especially concerning lifting high. Normative values may be considered as an additional screening tool for balancing workload and capacity. It is recommended to further validate normative values in a broader and more extensive working population.

Assessment of body composition, functional capacity and pulmonary function in patients with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is related to a low body mass index (BMI), reduced functional capacity and reduced bone density, thus justifying the importance of evaluating all of these parameters in the patients with the disease. This is a cross-sectional study, with sample consisting of 20 patients who performed measurement of body composition by bioelectrical impedance, evaluation of functional capacity by the distance traveled in the Incremental Shuttle Walk Test (ISWT) and assessment of severity of obstruction by spirometry. Significant differences were found between the travelled and scheduled distance in the ISWT (p&lt;0.01), positive correlations between muscle mass and distance walked in ISWT (r=0.54 with p=0.01), with FEV1 (r=0.488 with p=0.02), FEV1 and bone mass (r=0.497 with p=0.02) and distance traveled with FEV1 (r=0,541 with p=0.01). The correlations found in this study, besides confirming the hypothesis that the severity of the obstruction presented by the change in the lung parenchyma in patients with COPD is related to changes in body composition and functional capacity reduction, also highlight the correlation with bone mass.

Effects of intensified work-related multidisciplinary rehabilitation on occupational participation

This study examined the effects of work-related multidisciplinary rehabilitation (MR) on occupational participation in patients with chronic musculoskeletal disorders. A randomized-controlled trial was carried out. The sample included patients with chronic musculoskeletal disorders and severe restrictions of work ability (n=222). Participants in the intervention group received a work-related rehabilitation programme following a comprehensive functional capacity evaluation (FCE MR). Controls completed a conventional MR. The analysis was based on 1-year follow-up data. The primary outcome was stable occupational participation (SOP), defined as employment with at most 6 months of sick leave after rehabilitation. The secondary outcomes were the duration of sick leave, employment status and the Pain Disability Index. We included 102 patients in our analysis (intervention: n=55, control: n=47). Despite randomization there were group differences. Adjusting these differences, patients of the FCE MR had 3.5 times higher odds of SOP [95% confidence interval (CI): 1.2-9.8, P=0.018]. However, there was neither a significant difference in the duration of sick leave between both groups (b=-8.0 weeks, 95% CI: -17.4 to 1.4, P=0.095) nor higher odds of employment in favour of the FCE MR after 1 year (odds ratio=2.3, 95% CI: 0.9-5.8, P=0.088). Participants in the FCE MR reported less pain-related disabilities (b=-6.5, 95% CI: -12.6 to -0.4, P=0.038). The study had a limitation in terms of group balance. However, the findings indicate that the work-related FCE MR was more effective for SOP, but did not significantly affect employment rate and sick leave duration.

Do analgesics improve functioning in patients with chronic low back pain? An explorative triple-blinded RCT

TREATMENT of patients with chronic low back pain (CLBP) aims to reduce disability, improve functional capacity, and participation. Time contingent prescription of analgesics is a treatment modality in CLBP. The impact of analgesics on functional capacity is unknown. Aim of the study was to explore the effect of analgesics on functioning measured by functional capacity evaluation, and self-reported disability in patients with CLBP. Explorative Randomized Placebo-Controlled Clinical Trial was performed in an outpatient pain rehabilitation setting on patients waiting for rehabilitation. Included patients had low back pain lasting >3 months, visual analogue scale worst pain ≥4.0 cm, and age >18 years. Outcome measures before (T0) and after treatment (T1): functional capacity, pain intensity, Roland Morris Disability Questionnaire. T1: global perceived pain relief. Patient characteristics and psychological questionnaires were assessed. Fifty patients were included in this study and were randomly assigned to 2 weeks treatment or placebo. acetaminophen/tramadol 325 mg/37.5 mg per capsule. Dose: maximum acetaminophen 1,950 mg and tramadol 225 mg per day; treatment and placebo titrated identically. Compliance and side-effects were monitored. TREATMENT effects between groups over time were compared. One patient (treatment group) was lost to follow-up. Forty-nine patients remained in the study. TREATMENT effects in primary outcomes did not differ significantly between groups. A subgroup of 10 (42%) patients (treatment group) reported global pain relief (responders) who reduced self-reported disability (p < 0.05). Responders had significantly lower catastrophizing scores. Overall treatment effects were small and non-significant. A subgroup, however, reported improved functioning as a result of treatment. Responders had lower catastrophizing scores.

Are Performance-Based Functional Assessments Superior to Semistructured Interviews for Enhancing Return-to-Work Outcomes?

ObjectiveTo examine whether use of functional capacity evaluation (FCE) leads to better outcomes for injured workers. DesignCluster randomized controlled trial conducted with analysis at level of claimant. SettingRehabilitation facility. ParticipantsParticipants included claimants (N=203); of these, 103 were tested with FCE. Data were collected on all claimants undergoing RTW assessment at the facility for musculoskeletal conditions. Participants were predominantly employed (59%) men (73%) with chronic musculoskeletal conditions (median duration, 496d). InterventionsFCEs are commonly used to identify work abilities and inform return-to-work (RTW) decisions. Therefore, FCE results have important consequences. Clinicians who were trained and experienced in performing FCEs were randomized into 2 groups. One group included 14 clinicians who were trained to conduct a semistructured functional interview; the other group (control group) continued to use standard FCE procedures. Main Outcome MeasuresOutcomes included RTW recommendations after assessment, functional work level at time of assessment and 1, 3, and 6 months after assessment, and compensation outcomes. Analysis included Mann-Whitney U, chi-square, and t tests. ResultsAll outcomes were similar between groups, and no statistically or clinically significant differences were observed. Mean differences between groups on functional work levels at assessment and follow-up ranged from 0.1 to 0.3 out of 4 (3%–8% difference, P>.05). ConclusionsPerformance-based FCEs did not appear to enhance RTW outcomes beyond information gained from semistructured functional interviewing. Use of functional interviewing has the potential to improve efficiency of RTW assessment without compromising clinical, RTW, or compensation outcomes.

Evaluation of functional capacity in care of tissue injuries of adults and elderly patients

Objetivo: Avaliar e analisar a capacidade funcional e de apoio social e seu impacto no cuidado das lesões tissulares de pacientes adultos e idosos. Método: Estudo observacional do tipo transversal com cenário no Hospital Universitário Antônio Pedro/UFF. Os sujeitos são pacientes adultos e idosos com lesões tissulares. Os instrumentos foram: protocolo da unidade, as Escalas de Lawton, Katz e de Berg com dados tratados estatisticamente. Resultados: Participaram 20 pacientes. Na escala de Lowton a pontuação esteve entre 19 a 20 pontos em 80% dos pacientes. Na Escala de Katz 95% dos pacientes possuíram uma avaliação satisfatória. Na Escala de Berg a oscilação de necessidades de auxílio foi maior evidenciando de 80% a 65% dos pacientes. Conclusão: Foi possível vislumbrar a prevenção de complicações, a fim de assegurar uma excelente comunicação com a equipe assistencial, pacientes e familiares, garantindo acessibilidade e continuidade no tratamento tendo como recomendação relevante a visita domiciliar.

Evaluation of functional capacity in care of tissue injuries of adults and elderly patients

Evaluation of functional capacity in care of tissue injuries of adults and elderly patients