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首页> 外文期刊>Occupational and environmental medicine >Does functional capacity evaluation predict recovery in workers' compensation claimants with upper extremity disorders?
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Does functional capacity evaluation predict recovery in workers' compensation claimants with upper extremity disorders?

机译：功能能力评估是否可以预测上肢疾病的工伤索赔人的康复情况？

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OBJECTIVES: Functional capacity evaluations (FCEs) are commonly used to determine return-to-work readiness and guide decision making following work related injury, yet little is known of their validity. The authors examined performance on the Isernhagen Work Systems' FCE as a predictor of timely and sustained recovery in workers' compensation claimants with upper extremity disorders. A secondary objective was to determine whether FCE is more predictive in claimants with specific injuries (that is, fracture) as compared to less specific, pain mediated disorders (that is, myofascial pain). METHODS: The authors performed a longitudinal study of 336 claimants with upper extremity disorders undergoing FCE. FCE indicators were maximum performance during handgrip and lift testing, and the number of tasks where performance was rated below required job demands. Outcomes investigated were days receiving time-loss benefits (a surrogate of return to work or work readiness) in the year following FCE, days until claim closure, and future recurrence defined as whether benefits restarted, the claim reopened, or a new upper extremity claim was filed. Cox and logistic regression were used to determine the prognostic effect of FCE crudely and after controlling for potential confounders. Analysis was performed separately on claimants with specific and pain mediated disorders. RESULTS: Most subjects (95%) experienced time-loss benefit suspension within one year following FCE. The one year recurrence rate was 39%. Higher lifting performance was associated with faster benefit suspension and claim closure, but explained little variation in these outcomes (r2 = 1.2-11%). No FCE indicators were associated with future recurrence after controlling for confounders. Results were similar between specific injury and less specific groups. CONCLUSIONS: Better FCE performance was a weak predictor of faster benefit suspension, and was unrelated to sustained recovery. FCE was no more predictive in claimants with specific pathology and injury than in those with more ambiguous, pain mediated conditions.
机译：目标：功能能力评估（FCE）通常用于确定工作相关伤害后的恢复工作准备并指导决策，但对其有效性的了解甚少。作者检查了Isernhagen工作系统FCE的性能，作为上肢疾病工人赔偿要求者能否及时持续恢复的预测指标。第二个目标是确定与特异性较低的疼痛介导的疾病（即肌筋膜疼痛）相比，FCE在具有特定伤害（即骨折）的索赔人中是否更具预测性。方法：作者对336名患有FCE的上肢疾病索赔人进行了纵向研究。 FCE指标是把手和提升测试期间的最高性能，以及表现被评定为低于要求的工作要求的任务数。被调查的结果是在FCE之后的一年中获得时间损失福利（替代工作或工作准备）的天数，直至索赔终止的天数，以及将来的复发（定义为福利重新开始，索赔重新提出或新的上肢索赔）被提起。在控制潜在的混杂因素后，使用Cox和logistic回归确定FCE的预后效果。对患有特定疾病和疼痛介导的疾病的索赔人分别进行了分析。结果：大多数受试者（95％）在FCE后一年内经历了时效损失暂停。一年复发率为39％。更高的提升性能​​与更快的利益中止和索赔终止相关，但解释了这些结果几乎没有变化（r2 = 1.2-11％）。控制混杂因素后，没有FCE指标与未来复发相关。特定损伤组和较不特定组之间的结果相似。结论：更好的FCE表现是较慢的利益暂停较弱的预测指标，并且与持续恢复无关。对于具有特定病理学和损伤的索赔人，FCE不能比具有更加模棱两可的，由疼痛引起的疾病的索赔人更具预测性。

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