Gross Douglas P, Battié Michele C, Asante Alexander K
Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, Canada, T6G 2G4.
J Occup Rehabil. 2007 Sep;17(3):422-35. doi: 10.1007/s10926-007-9087-y. Epub 2007 May 30.
Functional Capacity Evaluation (FCE) contributes to clinical decisions regarding fitness-for-work and may improve return-to-work outcomes. However, FCE is a burdensome clinical tool in terms of time and cost. We evaluated the effectiveness of a short-form FCE protocol.
A cluster randomized controlled trial was conducted. Data were collected on all claimants undergoing FCE at Alberta's workers' compensation rehabilitation facility. Twenty-three clinicians who were trained and experienced with FCE were randomized to either an intervention or control group. The intervention group was trained to conduct short-form FCE and used this protocol through the trial's duration, while the control group continued standard FCE procedures. Data on subject characteristics, administrative outcomes (days to suspension of time loss benefits, days to claim closure, and future recurrence) and claimant satisfaction were extracted from the WCB-Alberta computer databases. Clinicians logged time taken to complete assessments. Analysis included examining differences between groups using independent samples t tests, Cox and logistic regression.
Subjects included 372 claimants of whom 173 were tested with short-form FCE. Subjects were predominantly employed (64%) males (69%) with chronic musculoskeletal conditions (median duration 252 days). Administrative recovery outcomes were similar between groups as were claimant satisfaction ratings. No statistically significant or clinically relevant differences were observed on these outcomes between groups. A 43% reduction in functional assessment time was seen.
A short-form FCE appears to reduce time of assessment while not affecting recovery outcomes when compared to standard FCE administration. Such a protocol may be an efficient option for therapists performing fitness-for-work assessments.
功能能力评估（FCE）有助于做出关于工作适应性的临床决策，并可能改善重返工作岗位的结果。然而，就时间和成本而言，FCE是一种负担较重的临床工具。我们评估了一种简化版FCE方案的有效性。
进行了一项整群随机对照试验。收集了在艾伯塔省工人赔偿康复机构接受FCE的所有索赔人的数据。23名接受过FCE培训且经验丰富的临床医生被随机分为干预组或对照组。干预组接受简化版FCE的实施培训，并在试验期间使用该方案，而对照组继续采用标准FCE程序。从艾伯塔工人赔偿委员会的计算机数据库中提取了受试者特征、管理结果（停止损失时间福利的天数、索赔结案的天数和未来复发情况）以及索赔人满意度的数据。临床医生记录完成评估所需的时间。分析包括使用独立样本t检验、Cox回归和逻辑回归来检验组间差异。
受试者包括372名索赔人，其中173人接受了简化版FCE测试。受试者主要为在职人员（64%），男性（69%），患有慢性肌肉骨骼疾病（中位病程252天）。两组的管理恢复结果相似，索赔人满意度评分也相似。在这些结果上，两组之间未观察到统计学上显著或临床相关的差异。功能评估时间减少了43%。
与标准FCE管理相比，简化版FCE似乎能减少评估时间，同时不影响恢复结果。这样的方案对于进行工作适应性评估的治疗师来说可能是一种有效的选择。
