Article

OBJECTIVE: To examine whether use of functional capacity evaluation (FCE) leads
to better outcomes for injured workers. DESIGN: Cluster randomized controlled
trial conducted with analysis at level of claimant. SETTING: Rehabilitation
facility. PARTICIPANTS: Participants 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). INTERVENTIONS: FCEs 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 MEASURES:
Outcomes 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. RESULTS: All
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). CONCLUSIONS: Performance-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.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS