Vocational Rehabilitation Perspective.

To the Editor:

Some recent Letters to the Editor (eg, "Functional Capacity Evaluation" by Fishbain[1] in the January 2000 issue) concern measurements of functional capacity and the lack of validity for these measurements. I suggest considering what I believe is a vocational rehabilitation perspective to the problem. That is, to what extent can "physical functional capacity" alone determine vocational success?

There are numerous variables involved in human performance, and, if we view physical functional capacity as one variable, then we can begin to comprehend the complexity of the construct of "functional impairment." In other words, variables such as workplace culture, interpersonal communication, level of trust, group interaction processes, individual and organizational short-term and long-term goals, and other human resource development issues are likely to be equally important or more important. Because such concepts are probably ignored in many functional capacity evaluations (FCEs), it is no wonder that the measurements obtained with many FCEs seem unreliable and invalid for determining vocational success among individuals who have been injured and rehabilitated.

It would be beneficial for physical therapists involved in conducting FCEs to do some research into the vocational rehabilitation counseling literature and to incorporate what they consider to be relevant information into their evaluations. I believe that patients will appreciate the effort, and it will also be beneficial to the physical therapist. In an attempt to make FCEs more useful, I believe it is important to identify and clarify as many confounding variables as possible.

David L Cross, PT, EdD, CRC, CRT, Certified Disability Analyst Director of Physical Therapy & Rehabilitation Indianapolis Rehabilitation Agency 8330 Naab Rd, Suite 311 Indianapolis, IN 46260

References

[1] Fishbain DA. Functional capacity evaluation [letter to the editor]. Phys Ther. 2000;80:110, 112.