Study on FCE's - 15 minute test just as effective!
Mon, 06/05/2006 - 11:05am
I'd be curious if there are any comments out there on the work of Doug Gross from the Univ. of Alberta who has recently published his findings on FCE's and concludes that a 15 minute "FAST" test is as effective at predicting RTW as a full day FCE. His test involves a floor to waist lift, static squat for 2 minutes, static kneel for 2 minutes, static bend over, a 5 minute dynamic bend and a 5 minutes dynamic twist. I am curious how this type of evaluation would stand-up in court, how one can comment on all PA's (i.e. reaching, overhead, manipulation etc) and how a client could be satisfied that a clinician can give an opinion on RTW status after such a test. He states that clients were satisfied that they were fairly treated and they did not have a problem with being testing for 15 minutes and then sent back to work! Hmmmmm... :shock:
Mon, 06/26/2006 - 5:07pm
#2
Study on FCE
That is true, the study "talked around" the validity of a typical FCE protocol but the presenter definitely hinted to the fact that his study seems to say that a 15 min test is just as useful as a full protocol (as supported by the comments he received from the audience!). I have looked far and wide for other supporting studies to his work but as yet, have not found anything.
Brent
Fri, 06/23/2006 - 1:41pm
#3
Study on FCE's - 15 minute test just as effective!
I have sourced and read the article in question, "Development and Validation of a Short-Form Functional Capacity Evaluation for use in Claimants with Low Back Disorders", from the May 2006 Journal of Occupational Rehabilitation, by Douglas P. Gross et al. It is a good read, and has some interesting bits in it!
It is a retrospective study of workers who have previously completed an Isernhagen FCE for the WCB of Alberta. In summary, after running a vigorous series of statistical analyses, the author concludes that three elements of the FCE had the strongest predictive ability of RTW (expressed in this study as time to suspension of time loss benefits). The three elements were:
-Pass/Fail vs. actual job demands on floor-to-waist lift;
-60 sec sustained crouch test
-30 min standing tolerance test
In the scope of this study, this mini-FCE "protocol" has not been administered to actual workers - though I'm not certain if the author has indeed subsequently commenced using this protocol. One interesting point he makes (which I agree with), is that perhaps these three factors are only good predictors when administered as part of a full FCE protocol. The article also makes mention of need for future study for comparison to a regular FCE in terms of satisfaction rates, among other things.
So maybe the thing to take out of this is not to switch to a 60 minute FCE protocol (BTW Brent, this particular study makes no mention of a 15 minute protocol), but to instead focus your RTW predictions and recommendations on the test elements highlighted as statistically (through valid historical data) being the strongest predictors of RTW...
Wed, 06/14/2006 - 5:33pm
#4
Study on FCE's - 15 minute test just as effective!
Imagine - you could do 24 FCE's a day! Of course, you'd only get paid $20 for each one... :wink:
I don't agree that he suggests we do a 15 minutes FCE. What he says is that 3 of the many tests of the Isernhagen system were as predictive as all of them.
We also know that the lifting test floor-to-waist, who is shown elsewhere to be also of the most predictive value, in this case, is a pass or fail test.
I believe then that, should we choose to use this test, we have to make sure that there is a job to go to and that we have a pretty good idea of what the job demands are.
It does not address issues or worker's perception about their work capacity, with which we are faced everyday. I have submitted an article to WORK in which I suggest using this short FCE to help a person get back to a former job, while following him on the job. I doubt this would be of good use if we were to use it for disability purposes.
Sonia