Abbreviations
ADR: Alternative Dispute Resolution
AROM: Active range of motion
ADL: Activities of daily living
BWC: Bureau of Workers' Compensation
DOT: Dictionary of Occupational Titles
FCE: Functional Capacity Evaluation
IADL: Instrumental Activities of Daily Living
IME: Independent Medical Evaluation
IRE: Impairment Rating Evaluation
MET level: Metabolic Equivalency Level
PA: Pennsylvania
PPD: Permanent Partial Disability (partial)
ROM: Range of motion
SSDI: Social Security Disability Insurance
SWIF: State Workers' Insurance Fund
TTD: Temporary Total Disability (total)
WC: Workers' Compensation
WCJ: Workers' Compensation Judge
WCOA: Workers' Compensation Office of Adjudication
Glossary of Terms in Functional Capacity Evaluation*
assessment: A series of test and measures; an evaluation; a dynamic process in which the therapist makes clinical judgments based on data gathered during the examination.
AROM: Active range of motion; a joint measurement in degrees. (See ROM)
ADL: Activities of daily living including bed mobility, transfers, dressing, grooming, bathing, eating and toileting. (see IADL)
acute pain: Sudden onset of pain followed by brief course and severe symptoms.
aerobic capacity assessment: A submaximal screening of an individual's ability to sustain exertion at an aerobic level; expressed by MET level.
assistive/adaptive equipment: Devices, products or equipment used by an individual to improve pain management, mobility or independent function.
baseline evaluation: A brief screening of an individual's abilities prior to design of a more in depth evaluation or treatment program.
chronic pain: A persistent pain that is not amenable, as a rule, to treatments based upon scientific remedies, or to the routine methods of pain control such as non-narcotic analgesics (International Association for the Study of Pain); 3 month duration from onset often cited. [Strong J: Pain: A Textbook For Therapists. Brisbane, Australia: Churchill Livingstone, 2002.]
coefficient of variation: A statistical calculation in which the mean of a set of data is divided by the standard deviation; a measure of the proportion of variability of a set of scores that are based on a ratio scale with true zero.
critical physical demands: Those physical activities required of a worker that reflect the needed physical capacity to meet any or all of an essential job function.
cumulative trauma disorder: Also know as repetitive motion disorder, overuse syndrome or repetitive strain injury. Characterized by a slow onset of micro-trauma to muscles, ligaments or other soft tissue through a combination of force, repetitive cycles of motion and/or awkward postures.
>Dictionary of Occupational Titles: DOT; published by U.S. Dept of Labor as a compendium of job titles and job description, a codification of physical demands and surroundings, environ-mental conditions, hazards and aptitudes.
dynamic strength evaluation: The process of testing an individual's strength during functional activities, lifting or in conjunction with evaluative devices; active motion of the extremity joints and/or muscle groups taking place.
evaluation: A dynamic process in which the therapist makes clinical judgments based on data gathered during an examination.
Evaluation Guidelines (NIOSH)
- safety: rigorous adherence to the procedures that are accepted standards of practice.
- reliability: the degree to which the individual performance is considered over time.
- validity: documentation of how a measure of performance is related to a true criterion statistical evaluation and content validation.
- practicality: evaluation must be reasonably easy to administer, accepted by evaluee and of reasonable cost.
- utility: to what end does the data predict future outcome/disposition of the evaluee.
examination: A comprehensive screening and testing process leading to diagnostic classification or referral to another practitioner. Three components: patient/client history, systems review and test/measures.
FCE: Functional Capacity Evaluation; a detailed examination and evaluation that objectively measures the patient/client current level of function primarily within the context of competitive employment; a measurement of ability to perform work related tasks; a prediction of potential to sustain such tasks over a defined period of time. (see Job Specific FCE)
functional tolerance: The physical tolerance needed to dependably sustain a work task.
grip strength: The ability to maintain a forceful grip using gross grasp (closed fist) as measured by a hand dynamometer.
hand dynamometer: Evaluation device used to measure gross grasp expressed in pounds most commonly; grip size may vary across a standard accepted 5 positions from wide to narrow.
heavy work: Exerting 50 to 100 lbs. of force occasionally, and/or up to 25 to 50 lbs. of force frequently, and/or 10-20 lbs. of force constantly to move objects.
IADL: Instrumental Activities of Daily Living; maintaining a home, shopping, cooking, home chores, financial management, driving a car or using public transportation.
isometric contraction: A muscle contraction in which no change in length of the muscle takes place; a force made against a stationary object such as a wall, weighted machine or fixed dynamometer.
job analysis: The process of systematically evaluating a specific work task or tasks including the application of ergonomic principles to measure biomechanical, cardiovascular and metabolic demands; may include worker interaction with data, people, machines, tools or equipment.
Job Specific FCE: FCE that evaluates ability to perform the physical demands of a specific identified job.
kinesiophysical approach: With regard to material handling, FCE format that provides for evaluator to make decisions on force progression to establish maximum function of the client.
light work: Exerting up to 20 lbs. occasionally and/or up to 10 lbs. frequently and/or a negligible amount of force constantly.
malingering: A medico legal term used by physicians, psychiatrists, psychologists and attorneys indicating conscious and willful misrepresentation of illness or symptoms in order to escape work duties and/or for financial compensation. [WorkCover Corporation: Guidelines for FCE. Adelaide, South Australia, 2006.]
materials handling: A subset of FCE measuring the four strength dependent physical requirements for work including lift, carry, push and pull.
maximum function: The greatest safe ability of a client in either repetitions or weight lifted.
maximum voluntary effort: A measured level of performance which is stable in a manner consistent with an individual's biomechanical and metabolic/cardiovascular capacity; data collected for validating the physical capacity of FCE.
medically stable: That state in which primary healing is complete or in which the progression of primary healing is not compromised; having consistent location of symptoms and the presence of signs has reached a plateau; symptom intensity may vary with activity, intervention or treatment but locations or pattern of change of symptoms remains consistent. [Hart DL, Isernhagen SJ, Matheson LN: Guidelines for FCE of People with Medical Conditions. JOSPT 1993; 6:682-686.]
medium work: Exerting 20 to 50 lbs. of force occasionally, and/or 10 to 25 lbs. of force frequently, and/or greater than negligible up to 10 lbs. of force constantly to move objects.
MET level: Abbreviation of Metabolic Equivalency Level; a calculation to quantify the amount of energy expended; a comparative match can be made for the demands of a specific job.
modified job duty: Variation adjustment of regular duties for a temporary period of time toward transitioning a worker with identified health needs back to established work duties
musculoskeletal screening: Tests or measures to include observation of joint motion, muscle strength, flexibility, palpation and neurologic signs
neurologic signs: Accepted examination techniques and test procedures or reports of symptomatology that indicates a change in nerve function or integrity
non-material handling: A subset of FCE including general physical demands of sitting, standing, walking, stooping, kneeling, crouching, reaching, handling, fingering, feeling, climbing, balancing and driving. May include job specific tasks of keyboard use, tool use or other fine motor coordination activities.
non-organic sign: A test procedure designed to identify physical responses of verbalizations of symptoms by a patient. Such responses are compared for consistency to established data in the medical literature. [Waddell G, McCulloch J, Kummel E, Venner RM: Non-Organic Signs in Low Back Pain. Spine 1980; 2: 117-125.]
objective measurement: Test in which the evaluator's personal opinion can't bias the test result
pain: an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage (International Association for the Study of Pain)
pain drawing: An individual is presented with a body outline or part and the individual is able to draw or shade in distribution and type of symtomotology free of language or communication barrier
psychometric test: A test or battery of questions designed to measure a client's psychological status in domains of emotional condition, perceived capability, pain beliefs, pain assessment, or coping skills. [Karol R: Rehabilitation of the Injured Worker, In
Key G: Industrial Therapy. St. Louis, MO: Mosby, 1995.]
>push-pull dynamometer: Evaluation device used to measure force exerted by either pushing or pulling; isometric (static) or dynamic forces may be used
psychophysical approach: With regard to material handling, FCE format that provides for client to determine stopping points in force progression such that client's subjective and objective reports establish maximum function.
ROM: range of motion; the capacity of a joint to move from one position to another; dependent on muscle and ligament, tendon elasticity and distribution of body fat; measured with a device called a goniometer
reliability: A property of a measurement that indicates the level of agreement that can be achieved in a repeat of the test or if done by others with the same technique.
Inter-tester reliability: the measure of results between different testers
Intra-tester reliability: the measure of results done again by the same tester.
repetitive: Activity that occurs frequently or at least one time every two minutes.
sedentary work: Exerting up to 10 lbs of force occasionally and a negligible amount of force frequently to move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods. Jobs are sedentary if walking and standing are required only occasionally and all other criteria are met.
self-efficacy: the belief that one is competent to handle a situation that one considers to be important; an underlying determinant of motivation to put forth effort in the face of obstacles. [Matheson LN: Getting A Handle On Motivation. In Isernhagen S: The Comprehensive Guide to Work Injury Management. Gaithersburg, MD: Aspen, 1995.]
self limiting: A termination point in testing in which a client asks to stop due to pain reports, fear of re-injury, anxiety, poor understanding of instructions or intentional effort to manipulate test results.
Social Security Disability Insurance Program: SSDI benefits are paid if you worked long enough, paid Social Security taxes, and are unable to work because of a medical condition that is expected to last at least one year (or result in death).
standard deviation: An estimate of the distribution or spread of the data; normally used to describe the population being studied.
static strength evaluation: The process of testing and individual's strength in an isometric con-traction. No motion of extremity joints takes place.
subjective report: One in which the evaluator's personal opinions can bias the result.
symptom magnification syndrome: A concept developed by Leonard Matheson, PhD., where-by an individual either consciously or unconsciously magnifies overt symptomatology out of proportion to the organic causative factors contributing to the symptoms; a self destructive pat-tern of behavior learned and maintained through social reinforcement. [Matheson LN: Symptom Magnification Structured
Interview: Rationale and Procedure. Journal of Occupational Rehabilitation 1991; 1:43-56.]
validity: a property of a measurement that indicates the extent to which a performance is related to a true criterion statistical validation and content validation.
criterion validity: the extent to which the measurement is compared to a gold standard.
concurrent validity: the ability to determine current ability.
predictive validity: the ability to predict future ability.
content validity: the extent to which the measures the test covers all domains of the variable.
very heavy work: Exerting in excess of 100 lbs. of force occasionally and/or in excess of 50 lbs. of force frequently, and/or 20 lbs. of force constantly to move objects.
* Published by the PA Labor & Industry - 2008 Workers Compensation Conference
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