Functional Capacity is exactly what it appears to be: A person’s ability (or ‘capacity’) to perform tasks (or ‘functions’).
We often find that complex Functional Capacity Assessments, sometimes called Functional Capacity Evaluations (FCA/FCE), highlight areas where a rehabilitation program might be able to improve strength, flexibility and cardiovascular fitness. This allows us to refer patients for a course of physio and rehabilitation with specific goals to help them improve physical capability for their job role.
Detailed Functional capacity Assessments will provide quality information for Occupational Health and HR Teams, which is necessary in more complicated cases where aspects such as long-term restrictions, re-deployment or capability to safely fulfil contracted duties are being considered. These types of cases are most likely to be after a long period of sickness absence following injury or surgery, or when an employee has a progressive problem which is likely to deteriorate over time. However, most cases referred to us simply require a course of physio and rehab to get an employee back to the required level of recovery and capacity needed to fulfil their usual hours and duties for work.
In order to efficiently assess physical work-ability we need to identify three elements:
- The worker’s medical condition.
- The work duties that are restricted by the worker’s medical condition.
- The functional test(s) needed to measure the impact of the restricted duties identified.
There are a range of tests and measures that may be used to evaluate a person’s functional capacity and determining which ones are correct is an important step in the initial set up of an assessment. Some tests are more comprehensive than others and will be used for people in many different job roles.
The Back Performance Scale comprises of 5 short tests of the most common daily movements that require mobility of the back. These are; the sock test, pick-up test, roll-up test, fingertip-to-floor test, and lift test. This is the most common test carried out as back movement affects almost every type of job and is not limited to manual handling or ambulatory roles.
Lifting is divided into two categories, Low and High each with their own tests. Lifting Low is defined as lifting from floor to waist height and Lifting High is waist to shoulder. It is not necessarily true that if one lifting test is required that the other will be; however, it is quite common that they are both carried out so that all levels of lifting are assessed to ensure they are carried out correctly and safely. It is also likely that if someone is lifting that they will be Carrying too, which has its own tests. Strength and stamina are just two of the measures considered during both lifting and carrying.
Timed Stand Test is sometimes referred to as a sit-to-stand test and that is exactly what it is. Changing from an upright standing position to fully seated as fast as possible within a set time (usually 1 minute) assess’ exercise capacity and leg muscle strength. We are all aware we should lift with our legs and not our back, but many other tasks require good leg strength and control, eg pushing and pulling, driving and of course simply standing for long periods.
The Six-minute Walk Test is also used to determine exercise capacity and general fitness. A predetermined distance is measured and marked off on a flat surface and the test it to walk self-paced back and forth between the 2 marked points for 6 minutes. The laps are totalled along with any rests taken to determine the distance walked within the time. This test is used to assess general fitness for most roles, even sedentary.
Grip Strength is measured to determine upper limb strength and usually will use a device called a dynameter. Good upper limb strength is particularly important to manual roles that involve lifting, pushing, pulling etc but may not necessarily be a main factor e.g., carers or cleaners. However, this is still a common test that is carried out during most FCE’s.
Along with Grip Strength, dexterity is commonly tested using a Perdue Pegboard. The involves inserting metal pins into a board in a set time and then attaching washers and collars to the pins. Assessing dexterity can determine capability to carry out tasks including product assembly, typing, writing etc.
We compare the results of physical tests to normative data for their age & gender and to that of the employee’s job demands, to see how well matched the individual’s physical capability is to that of the job role they are contracted to do. FCA’s help put together a comprehensive view of employee’s abilities and allow for bespoke reports with relevant guidance and practical recommendations.