Viewing of FCE tape
Sat, 02/05/2005 - 12:23am
I would like to view a taped FCE. Any idea how to obtain one, due to confidentiality issues?
Also, how do you accurately determine if a client can perform a task (ie. kneeling) on an occas., frequent or constant basis? Is there a certain number of minutes or reps to determine this? Asking the client is not always effective, as often times we find clients that can do more than they perceive.
I performed an FCE on an individual who was found to put forth full and consistent effort during the evaluation and no inconsistencies were found. Later, a private investigator with Workers Comp. showed video coverage that was completely inconsistent with the results of the FCE. The PT and I even used distraction based testing and there was no evidence of symptom magnification, max. grip strength and REG testing was valid/ consistent.etc. Any suggestions on how to better detect inconsistencies?
Thank you.
Jessica
Fri, 02/11/2005 - 10:26am
#2
Viewing of FCE tape
We have no way for you to view a videotaped FCE. However, if you check the website (www.roymatheson.com) or our new catalog you will notice that we are offering a new class with an opportunity to view an FCE as part of the class. The class is held in Keene, New Hampshire at our new clinic, Matheson Resolution Services.
Regarding your question about how to determine the frequency capacity of a specific task, the following is taken from the Art and Science chapter of the FCECP manual:
Occasional: Client exhibited the ability to perform required work task on at least a short-term basis, without any sign of safety-related limitation. If participation in the tested activity caused significant post-activity symptoms, and subsequent reduction in function, the evaluator may recommend against participation.
Frequent: Client was directly observed to safely perform the required physical demands on a prolonged basis with not more than minor signs of related discomfort and/or associated limitation. While some level of pain complaint may be present, the client's observed level of function should return to pre-test levels soon after completion of the associated testing activity. If the activity is an essential function of the job, the evaluator should test the client in that activity for a period similar to, or longer, than what is required on the job.
Constant: Client was directly observed to safely perform the required work task on a prolonged basis without any sign of related discomfort and/or associated limitation. A constant rating should be done cautiously, following thorough testing.
Regarding your last question: Using a broad spectrum of Effort and RCR tests strengthens the foundation for making a conclusion about physical effort and reliability of the client?s reports of pain and disability. By using a variety of such tests, a clearer picture of the client emerges. In this case, there may not have been any inconsistencies to detect, but if there were, you'd have a better opportunity to notice them with the use of several tests rather than just a few.
Detecting inconsistencies during an FCE does not imply intent. Someone who may be intentional in their "less than full effort" may also be a very good actor or have previous knowledge on how to respond to our battery of effort validity testing. In that case, the FCE evaluators may not be able to detect any significant inconsistencies. As an evaluator, realizing this limitation is important.