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A Participant Guide to Functional Capacity Evaluations

A Participant Guide to Functional Capacity Evaluations

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Published by Bronnie Thompson
This paper is for participants who are asked to take part in a functional capacity evaluation. It is particularly for people with chronic pain.
This paper is for participants who are asked to take part in a functional capacity evaluation. It is particularly for people with chronic pain.

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Published by: Bronnie Thompson on Aug 09, 2012
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A participant guide to Functional Capacity Evaluationsfor people with chronic pain
What is a Functional Capacity Evaluation? 
This is a series of structured activities such as lifting, walking, and reaching that areintended to assess what you can and cannot do safely. There are other names given tothis type of assessment: functional assessment, functional performance measure, physicalcapacity assessment.There are many different types of FCE, ranging from very structured ones in which thetype of movements, the order in which they are presented, and the way in which you areassessed have been standardised, to those that are individualised by a clinician to helpyou establish your abilities relevant to a specific setting.
All FCE’s should be conducted
by registered occupational therapists or physiotherapists,and you should be supervised throughout the assessment.
Why have I been asked to go through one? 
FCE’s can be used to help clinicians, yourself and a medical practitioner determine
whether you are ready to return to your workplace. They can also be used to helpmeasure your progress or response to treatment. Finally, ACC uses FCE results to helpinform medical practitioners about your ability to carry out activities, usually if a work trial has not been successful, or is unable to be found.
What can the FCE tell me? 
The therapist conducting the FCE should be able to give you accurate feedback on howyou have carried out the various activities. Their focus should be to give you informationabout how efficiently you have used your body, on aspects of safety (Such as whetheryou have a stable base of support; whether you can control the load throughout the entiremovement; how well are you maintaining a paced level of activity?), and on areas youmight need to develop.You can use the findings from an FCE to help you decide upon the areas of your
 performance that you’d like to improve. The results may help you
identify whether thereare some activities at work that you might find too difficult, or that might surprise you
 because they are easier than you’d thought.
 
An FCE can’t predict exactly how you will function in a workplace, and it does have
limitations. The main limitation is that a clinic-based test conducted over even a fewhours is not like a real work situation where you usually work for days and weeks. The
 
findings from FCE’s are time
-limited because your functional level can change over time,especially if you are actively working on your rehabilitation.
What should I do to prepare for an FCE? 
In the days before an FCE appointment, follow your usual routine. It’s important to use
your pain management coping strategies in the days before, during and after the FCE.This means you should take your usual medications, do your normal exercises, work at apaced level of activity and use breathing, relaxation and coping statements.It can be helpful to plan a slightly lighter day than normal for the day after completing
your FCE. This is because it’s common for people to experience a short
-term increase inmuscle pain after doing activities that perhaps are not part of your usual daily routine.
For people with a chronic pain condition, it’s also common to experience a delay in this
pain settling down. You should manage this flare-up pain with your usual set-back plan.
…and during an FCE? 
 
Let the person conducting the assessment know about all your health conditions,including whether you have chronic pain, and also discuss the pain managementstrategies you will be using. Remember, if you usually use medications as part of yourpain management plan, you must continue taking these on the day of your assessment.This is to ensure your assessment reflects your usual state of health.An FCE is intended to reflect your usual performance, so attempt all the activities to the
 best of your ability. It’s easy to respond to the testing situation by trying to do more – 
orless
 – 
than you usually do, but
this won’t give you an accurate picture of what you can
manage. Provided you use your active coping strategies you will be able to manage theassessment without undue concern.Remind the person taking the assessment that you will need to stretch, breathe and/ortake short breaks throughout the assessment process, especially if this is a high pain day.It is common to find that your pain is a little higher on the day of an FCE, this is possiblybecause of some anxiety. If this is the case, remind yourself of your active copingstrategies such as breathing, stretching, positive self statements and activity management.
After the FCE 
Stretch, breathe, use your relaxation strategies, and remind yourself that you’ve justcompleted a set of quite demanding activities, so it’s normal to experience a flare
-up of pain. People without chronic pain can feel muscle pain after completing an FCE. Asmentioned above, plan for a less active day on the day following if necessary
 – 
 
 but don’t
completely stop doing what you usually do on a daily basis.If you find your pain is particularly difficult to manage after an FCE, you may find ithelpful to talk with your GP.

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