UPDATING THE EVIDENCE ON FCE De Baets, S. Calders, P.; Schalley, - - PowerPoint PPT Presentation

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UPDATING THE EVIDENCE ON FCE De Baets, S. Calders, P.; Schalley, - - PowerPoint PPT Presentation

Sep 26, 2023 18 likes •421 views

DEPARTMENT OF REHABILITATION SCIENCES MASTER OF SCIENCE IN OCCUPATIONAL THERAPY UPDATING THE EVIDENCE ON FCE De Baets, S. Calders, P.; Schalley, N.; Vermeulen, K.; Vertriest, S.; Van Peteghem, L.; Coussens, M.; Malfait, F.; Vanderstraeten, G.;

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UPDATING THE EVIDENCE ON FCE

De Baets, S. Calders, P.; Schalley, N.; Vermeulen, K.; Vertriest, S.; Van Peteghem, L.; Coussens, M.; Malfait, F.; Vanderstraeten, G.; Van Hove, G.; Van de Velde, D.

DEPARTMENT OF REHABILITATION SCIENCES MASTER OF SCIENCE IN OCCUPATIONAL THERAPY

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INTRODUCTION

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INTRODUCTION

̶ Workers leaving the labor market due to health problems or disability  Social and economic impacts  Disability benefits: significant proportion of public expenditure  High social costs ̶ Persons with reduced work capacity are less likely to remain employed. Employment rates of people with a disability are 40% lower

(OECD.; Andrén et al. 2001; Takala et al., 2014; Gouttebarge et al., 2004.)

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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INTRODUCTION

̶ Changes in the labor market ̶ Growing awareness about the return to work theme. ̶ The number of people depending on sickness and disability benefits is still increasing. ̶ The prevalence of occupational disabilities and related costs continue to increase.

(OECD.; Andrén et al. 2001; Takala et al., 2014; Gouttebarge et al., 2004.)

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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INTRODUCTION

̶ Need for increased investment in vocational rehabilitation To increase employment rates (including people with disabilities) ̶ Appropriate measurement tools. FCE instruments could play a key role

(Innes et al., 2012; Soer et al., 2008; Gross et al., 2005; Haglund et al.,1997.)

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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METHODS

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METHODS

̶ A systematic literature review ̶ Web of science, Trip Database, Journal Storage, Pubmed, Embase, PEDro and OTSeeker. ̶ Search string ̶ (FCE) AND (psychometrics OR psychometric properties OR validity OR reliabiilty) AND (return to work OR vocational rehabilitation OR JOB OR work participation) ̶ 2 independent researchers selected the articles based on title and abstract. ̶ Kappa statistics for agreement ̶ Methodological Quality screening ̶ Three level quality appraisal scale (Gouttebarge, 2004)

Updating the evidence on Functional Capacity Evaluation – Stijn De Baets

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RESULTS

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RESULTS

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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RESULTS

Updating the evidence on Functional Capacity Evaluation – Dominique Van de Velde

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RESULTS

Updating the evidence on Functional Capacity Evaluation – Dominique Van de Velde

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RESULTS

̶ 20 Articles ̶ 16  high quality ̶ 3  moderate quality ̶ 1  low quality ̶ Agreement between the two reviewers: ̶ Kappa: 0.96 (SE=0.03; 95% CI 0.91-1.00)

Updating the evidence on Functional Capacity Evaluation – Dominique Van de Velde

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FCE METHODS

Baltimore Therapeutic Equipment (BTE) Ergokit Ergos Work Simulator Blankenship FCE Isernhagen Work – Systems (IWS) The Physical Work Performance evaluation (PWPE) Short – form FCE Work Disability Functional Assessment battery (WD-FAB) Workhab

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BALTIMORE THERAPEUTIC EQUIPMENT (BTE)

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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BALTIMORE THERAPEUTIC EQUIPMENT (BTE)

̶ No studies on reliability ̶ 2 studies on predictive validity (Cheng et al, 2010 & Cheng et al, 2011) ̶ Moderate predictive validity for return-to-work and employment status

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

FCE method Short Description Validity Reliability

Baltimore Therapeutic Equipment (BTE) A device used for evaluation and work hardening as well as regaining specific movements via attachments. +/- Moderate predictive validity /

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ERGOKIT

http://www.youtube.com/watch?v=M0C4OggW654&feature=relmfu http://www.youtube.com/watch?v=c0IrzbEqYf0&feature=relmfu

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ERGOKIT

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

FCE method Short Description Validity Reliability

Ergokit Measures the construct physical work capacity. There are 19 work skills assessed, such as manual testing, strength tests and physical agility. In addition, the consistency in the mutual test results is assessed. + High convergent validity Low to moderate concurrent Validity + High inter- and intra-rater reliability

̶ 1 study on intra & interrator reliability.

(Gouttebarge et al., 2005; Gouttebarge et al., 2006)

̶ 1 study on the discriminant, divergent and convergent validity.

(Gouttebarge et al., 2009)

̶ 1 study on the concurrent validity of the EK & ERGOS.

(Rustenburg et al., 2004)

̶ Moderate variability between outcomes on the lifting tests. ̶ Agreement between & within raters strongly varied for the lifting tests of the EK from low to high, but was mostly high. ̶ Low discriminative abilities (validity) were found for the EK

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ERGOS WORK SIMULATOR

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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ERGOS WORK SIMULATOR

̶ No studies on the reliability. ̶ 1 study on the concurrent validity in comparison with the Ergo-Kit. (Rustenburg et al., 2004)  A low to moderate concurrent validity compared to the EK.

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

FCE method Short Description Validity Reliability

Ergos Work Simulator A ‘work simulator’ that measures whether and to what extent you perform certain actions that are required in your job/line

  • f work.
  • Low to moderate concurrent

validity /

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BLANKENSHIP FCE

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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BLANKENSHIP FCE

̶ No studies were found on the reliability or validity ̶ 1 was found on the sensitivity and specificity

(Brubaker et al., 2007)

̶ Sensitivity of 80.0% and specificity of 84.2% ̶ Indicates good diagnostic abilities

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

FCE method Short Description Validity Reliability

Blankenship FCE Provides the essential components for determining safe working abilities for all musculoskeletal disorders. / /

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ISERNHAGEN

̶ A varying test–retest reliability and reproducibility in the material-handling component.

(Reneman, et al., 2004)

̶ Provides relatively stable outcomes with limited variation.

(Reneman, et al., 2005)

̶ Agreement between raters was moderate for the lifting tests

(Reneman, et al., 2005)

̶ Moderate to high agreement between raters was found for the physical and behavioral scale.

(Tripolini et al., 2014)

̶ Performance in the IWS (number of failed tasks and weight lifted) has no or low predictive value for recovery outcomes.

(Soer et al., 2008)

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

FCE method Short Description Validity Reliability

Isernhagen Work – Systems (IWS) Consists of 28 tests that reflect work-related activities, such as lifting, carrying, bending, etc.

  • Low predictive validity

+ Moderate to high test–retest reliability, inter-reliability and intra-reliability

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PHYSICAL WORK PERFORMANCE EVALUATION

̶ Provides relatively stable outcomes with limited variation.

(Brassard et al., 2006 & Durand et al., 2004)

̶ Agreement between raters was moderate to high for the PWPE sections and high for the overall PWPE score.

(Durand et al., 2008)

̶ Performance in the PWPE has a high predictive value in return to work.

(Lechner et al., 2008)

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

FCE method Short Description Validity Reliability

The physical work Performance evaluation (PWPE) A specialised evaluation of a person’s physical ability to perform work activities. + High predictive validity +/- Moderate test–retest reliability and moderate to high inter-rater reliability.

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SHORT FORM FCE

̶ No studies on the reliability ̶ 1 article on its predictive validity

(Branton et al., 2010)

̶ The performance items in the short-form FCE have a predictive value for recovery outcomes such as timely and sustained return-to-work.

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

FCE method Short Description Validity Reliability

Short – form FCE FCE measures included items in the Isernhagen Work Systems’ FCE. + High predictive validity /

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WORK DISABILITY FUNCT ASSESSMENT BATTERY

̶ No studies on the reliability ̶ 1 study on the discriminant / divergent and convergent

  • validity. (Meterko et al., 2015)

̶ Good discriminative abilities ̶ physical functioning ̶ behavioral health scales.

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

FCE method Short Description Validity Reliability

Work disability functional Assessment battery (WD-FAB) Physical and mental function domain are analysed and compared to the general population.

  • Low discriminative and

convergent validity /

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WORKHAB

̶ Moderate to high agreement between outcomes in the three subtests of the WorkHab manual handling component

(Meterko et al., 2015)

̶ High agreement between outcomes on the overall manual handling score.

(James et al., 2011)

̶ Stable outcomes with little variation.

(James et al., 2010)

̶ Agreement within raters was moderate to high for the subtests and high for the overall manual handling component.

(James et al., 2011)

FCE method Short Description Validity Reliability

Workhab A system of determining functional capabilities for return to work, pre-hire/post-offer, activities of daily living, or medical case management. / + Moderate to high test–retest, inter- and intra-rater reliability

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DISCUSSION

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DISCUSSION

̶ Overall, the psychometric properties of the studied FCE methods somewhat vary between & within methods. ̶ Used to predict, establish or diagnose work abilities, time of recovery & RTW? ̶ Reliability ̶ Validity

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DISCUSSION

̶ Also look at: ̶ Practicality ̶ Utility ̶ Costs ̶ Time spent ̶ User-friendliness ̶ Acceptability

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DISCUSSION

̶ Short-form FCE’s provide a potential answer to many problems. ̶ but the psychometrics need more scientific substantiation. ̶ 2/3 of the experts found FCE useful ̶ Confirm personal judgements ̶ Provide objective information. ̶ Reasons for not finding FCE useful ̶ It did not seem objective ̶ Did not provide any new information.

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DISCUSSION

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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DISCUSSION

̶ Short-form FCE’s provide a potential answer to many problems but the psychometrics need more scientific substantiation. ̶ Provided a more extensive and updated representation of the psychometric qualities of several FCE methods. ̶ Some more ground has been covered on the better known FCE methods ̶ New methods with different approaches are on the rise and gaining scientific support as well.  Need to be further examined.

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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ARTICLE

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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1.

  • OECD. Sickness, disability and work: breaking the barriers. Paris: OECD Publishing.

2. Hakim C. The social consequences of high unemployment. J Soc Policy. 1982;11(4):433–467. 3. Dooley D, Fielding J, Levi L. Health and unemployment. Annu Rev Public Health. 1996;17(1):449–465. 4. Gouttebarge V, Wind H, Kuijer PP, Frings-Dresen MH. Reliability and validity of Functional capacity evaluation methods: a systematic review with reference to Blankenship system, Ergos work simulator, Ergo-Kit and Isernhagen work system. Int Arch Occup Environ Health. 2004;77(8):527–537. 5. Innes E. Reliability and Validity of Functional Capacity Evaluations: An Update. Int J Disabil Manag. 2012;1(1):135–148. 6. Soer R, van der Schans CP, Groothoff JW, Geertzen JH, Reneman MF. Towards consensus in operational definitions in functional capacity evaluation: a Delphi

  • survey. J Occup Rehabil. 2008;18(4):389–400.

7. Gross DP, Battié MC. Functional capacity evaluation performance does not predict sustained return to work in claimants with chronic back pain. J Occup Rehabil. 2005;15(3):285–294. 8. Gouttebarge V, Wind H, Kuijer PP, Sluiter JK, Frings-Dresen MH. Intra- and interrater reliability of the Ergo-Kit functional capacity evaluation method in adults without musculoskeletal complaints. Arch Phys Med Rehabil. 2005;86(12):2354–2360. 9. Gouttebarge V, Wind H, Kuijer PP, Sluiter JK, Frings-Dresen MH. Reliability and agreement of 5 Ergo-Kit functional capacity evaluation lifting tests in subjects with low back pain. Arch Phys Med Rehabil. 006;87(10):1365–1370.

  • 10. Gouttebarge V, Wind H, Kuijer PP, Sluiter JK, Frings-Dresen MH. Construct validity of functional capacity evaluation lifting tests in construction workers on sick

leave as a result of musculoskeletal disorders. Arch Phys Med Rehabil. 2009;90(2):302–308.

  • 11. Rustenburg G, Kuijer PP, Frings-Dresen MH. The concurrent validity of the ERGOS Work Simulator and the Ergo-Kit with respect to maximum lifting capacity. J

Occup Rehabil. 2004;14(2):107–118.

  • 12. Brubaker PN, Fearon FJ, Smith SM, McKibben RJ, Alday J, Andrews SS, et al. Sensitivity and specificity of the Blankenship FCE system’s indicators of

submaximal effort. J Orthop Sports Phys Ther. 007;37(4):161–168.

  • 13. Reneman MF, Brouwer S, Meinema A, Dijkstra PU, Geertzen JH, Groothoff JW. Test-retest reliability of the Isernhagen work systems functional capacity

evaluation in healthy adults. J Occup Rehabil. 2004;14(4):295–305.

  • 14. Reneman MF, Fokkens AS, Dijkstra PU, Geertzen JH, Groothoff JW. Testing lifting capacity: validity of determining effort level by means of observation. Spine.

2005;30(2):E40–E46.

  • 15. James C, Mackenzie L, Capra M. Test-retest reliability of the manual handling component of the WorkHab functional capacity evaluation in healthy adults. Disabil
  • Rehabil. 2010;32(22):1863–1869.
  • 16. Gross DP, Battie MC. Does functional capacity evaluation predict recovery in workers’ compensation claimants with upper extremity disorders? Occup Environ
  • Med. 2006;63(6):404–410.
  • 17. Innes E, Straker L. Validity of work-related assessments. Work. 1999;13(2):125–152.
  • 18. Innes E, Straker L. Reliability of work-related assessments. Work. 1999;13(2):107–124.

REFERENCES

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@stijndebaets https://participationweb.wordpress.com/

Stijn De Baets Occupational Therapist, PhD student Phone +32 9 332 12 18 Mail stijn.debaets@ugent.be Rehabilitation Sciences and physiotherapy Occupational Therapy Program Campus UZ Gent, B3, 2nd floor, room 009, Corneel Heymanslaan 10, B-9000 Gent.

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INTRODUCTION

̶ Bio-psycho social reasoning ̶ Client centeredness ̶ Psychological and social factors concerning labor.

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets

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33 66 99 idem niet voorkeur Vingervaardigheid idem niet voorkeur Hanteren Reiken laag Reiken hoog Kruipen Hurken Knielen Bukken Traplopen Klimmen Wandelen Staan Zitten Overige vaardigheden Tijdsduur in % van een werkdag

Normaal Belastbaarheid

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PSYCHOMETRICS

̶ A reliable measure is one that measures a construct consistently across time, individuals, and situations. ̶ A valid measure is one that measures what it is intended to measure.

Updating the evidence on Functional Capacity Evaluation - Stijn De Baets