Issue #6: February 20113

The Functional Capacity Evaluation
By: Dustin Martinson, PT, DPT, Cert. MDT.

Functional capacity evaluations (FCEs) have long been used to determine the abilities of an injured or non-injured individual in the relationship to occupation. FCE’s in the beginning, were used in the pre-placement setting (1) as compared to the heavy use in the post injury setting today. The FCEs of modern day have been improved to include consistency, effort, validity, overreaction, symptom magnification and self perceived disability. The modern FCE can provide important information dependent on the situation. The FCE can be job specific, a tool to establish general capabilities or to investigate vocational rehabilitation.

One of the most important aspects of an FCE is that the measurement of capacity is specific to the demands posed by the job. (1) If the FCE can be specific to the injured client’s job or potential job, the information will be more relevant. There are supporters in the belief that a job simulation is more accurate than an FCE when a target job is available. (1) The only way that the results of an FCE and a functional job description can be compared is if they have similar components with minimal deviation. A functional job description that has very specific demands, such as utilizing an impact wrench at waist height for ten minutes, cannot be tested with the general FCE.

Unfortunately a target job is not always available. Does this make the FCE less important in the injury process? It does not. An FCE is a series of standardized tasks with measured weights and distances, and a trained observer. (1) The information that can be gained from an FCE is important in lifting, strength, posture, flexibility, ambulation, maximum force tests and coordination. This information can then be put in comparison to any future job demands. If the comparison is positive then the chance of that person being able to achieve the functional job demands is high. If the comparison is negative or they don’t match, it is most likely that person would not succeed in that specific job.

The development of a vocational rehabilitation program can also occur after a FCE. Similar to when there is not a target job, the FCE information can be used to determine what a client’s potential is. This potential can then be used to determine what specific vocational rehabilitation program is appropriate for the client to pursue.

No matter what the purpose of the FCE, the results need to be valid and reliable. In an article Joseph J. Chen, MD shows that out of 4 common FCE systems. Only one showed predictive validity and inter-rater reliability. (3) This is consistent with “Functional capacity evaluations should be considered behavioral tests influenced by multiple factors, including physical ability, beliefs and perception.” (2) Inappropriate illness behavior, symptom magnification, inconsistencies, invalid effort or in some cases consistently invalid effort that influence FCE restrictions are not appropriate to be used as to established capabilities.


1.) Pranky G. and Dempsey P, Practical Aspects of Functional Capacity Evaluations, Journal of Occupational Rehabilitation. Vol. 14, No. 3, September 2004
2.) Gross D and Battie M, Factors Influencing Results of Functional Capacity Evaluations in Workers’ Compensation Claimants with Low Back Pain, Journal of the American Physical Therapy Association, 85: 315-322, 2005
3.) Chen MD J, Functional Capacity Evaluation and Disability, The Iowa Orthopaedic Journal. Vol 27. 2007
Dustin Martinson is a physical therapist in Gillette, WY who performs FCEs through the WorkWell system. He is also one of three certified McKenzie Method (Cert. MDT) therapists in the state of Wyoming. He owns Rehab Solutions Physical Therapy with his wife who is also a certified McKenzie therapist.

To schedule an FCE or referred a patient to therapy call us at (307) 686-8177 or fax referral at (307) 686-9484
www.rehabsolutionswy.com