Functional Capacity Evaluations (FCE)
MAPS therapists use the Isernhagen method for functional capacity evaluation (FCE) to determine the specific job activities that can be tolerated safely by an injured worker. It is important to assess the physical abilities of a patient who is recovering from musculoskeletal injury in order to provide for an injury-free return to the workplace.
The FCE Process
The Isernhagen FCE is a remarkably safe way to test the physical abilities of a patient who is recovering from any type of musculoskeletal injury. During an FCE, a patient is asked to complete a series of physical tasks such as lifting, pushing, or carrying varying amounts of weight. The patient may also be required to assume different postures, such as sitting or standing for extended periods of time. During the test, a therapist closely observes the patient for signs of straining or poor posture—either of which may indicate that a patient is close to his or her limit for that particular exercise. The Isernhagen method relies on the therapist’s observation of function rather than the patient’s efforts to determine safe stopping points during the test.
The Isernhagen FCE:
- Measures the maximum objective strength of an individual
- Establishes activity levels through clinically objective observations
- Maintains a safe testing environment by having the patient understand and adhere to physiologically safe lifting/moving techniques
- Explains functional deficiencies in terms of physical causes
- Identifies sub-maximal efforts
- Provides comprehensive reports with detailed observations, conclusions, and recommendations
Preventing Re-Injury in the Work Place
A critical feature of the Isernhagen test is that it occurs over a two-day period, which is particularly important for the assessment of work-place injuries. Sometimes a patient is able to work at a relatively high level on the first day of testing, but returns the second day and is unable to complete as much work. It is critical to know a person’s ability to function over time, so that she or he is not returned to a job that will cause fatigue to the point of re-injury. Such measures not only protect the patient, but also save employers from the high medical and indemnity costs associated with workers’ compensation.
A Kinesiophysical Approach
The kinesiophysical approach used in the Isernhagen FCE distinguishes it from other evaluations because it requires the therapist to comment on the reason behind any functional work deficiency. The testing goes beyond simply reporting, “The worker can lift ten pounds from the floor,” by attempting to also determine answers to questions such as, “Could he or she lift more weight with additional training?” and “Can she or he lift ten pounds repetitively?” The Isernhagen approach requires the therapist to explain functional deficits by correlating them to musculoskeletal and physiological functioning.
The criteria used in this approach have been subjected to scientific analysis and were found to be valid, reliable, and consistent. Upon completion of testing, providers are given a very specific and objective report that offers observations, conclusions, and recommendations for case management and closure.