Functional Capacity Evaluation in Upper Limb Reduction Deficiency and Amputation: Development and Pilot Testing

Abstract

Purpose To develop and pilot test a functional capacity evaluation (FCE) for individuals with upper limb absence (ULA) due to reduction deficiency or amputation, and to examine the relationship between FCE results and presence of musculoskeletal complaints (MSC). Method Five tests (overhead lifting, overhead working, repetitive reaching, fingertip dexterity, and handgrip strength) were selected and adapted if necessary. The newly developed FCE, called FCE-One-Handed (FCE-OH), was pilot tested in 20 adults individuals with ULA, and 20 matched controls. MSC were assessed via a questionnaire. Results Adaptations were considered necessary for all tests, except the handgrip strength test. The repetitive overhead lifting test of the non-affected limb was added. On the overhead lifting test, individuals with above-elbow ULA (ten males), performed similar to controls using one hand. When lifting bimanually using the prosthesis, a trend for lower lifting capacity of individuals with below-elbow ULA (seven males, three females) was observed compared to controls. On the overhead working test, individuals with above-elbow ULA performed worse compared to controls. Other tests showed no significant differences between groups. Relationships between FCE results and presence of MSC were non-significant. Conclusion The FCE-OH can be used to test functional capacity of one-handed individuals. Individuals with ULA generally showed similar functional capacity as two-handed individuals. FCE results were not related to MSC. It was discussed that a higher physical load on the non-affected limb might reflect a relative deficit of functional capacity.

Functional capacity of individuals with brachial plexus injury

“…The FCE-OH test results for individuals with BPI were compared to the results of the controls. The participants in the control group had previously participated in a pilot study to assess the functional capacity of individuals with major upper-limb defects [14]. Inclusion criteria for controls were: adults aged between 18 and 67 years, who had a good understanding of Dutch or English and normal hand function in both hands.…”

“…The recently developed functional capacity evaluation one-handed (FCE-OH) can be applied to assess the functional capacity in individuals with BPI. The FCE-OH is a short-form functional capacity evaluation (FCE) adapted for individuals with upper limb absence and wearers of upper limb prostheses [14]. An FCE is used to evaluate the capacity of individuals to perform activities in order to make recommendations regarding their participation in work, while considering their body functions and structures, as well as environmental and personal factors and health status [14].…”

“…The FCE-OH is a short-form functional capacity evaluation (FCE) adapted for individuals with upper limb absence and wearers of upper limb prostheses [14]. An FCE is used to evaluate the capacity of individuals to perform activities in order to make recommendations regarding their participation in work, while considering their body functions and structures, as well as environmental and personal factors and health status [14]. The assessment of the functional capacity can guide return-to-work recommendations, while potentially helping to prevent MSCs caused by overextension by matching functional capacity to physical job demands [15][16][17].…”

“…Secondary aims were to explore differences in the functional capacity of BPIaffected individuals with respect to: those with and without hand function; affected and unaffected sides; with and without MSCs. In light of the finding of a previous study of one-handed individuals [14], we hypothesized that the two-handed functional capacity of individuals with BPI would be lower than that of healthy controls. Furthermore, we hypothesized that in one-handed tests the unaffected side of individuals with BPI would exhibit higher functional capacity relative to the dominant side of healthy controls, because of the adaptation required to carry extra loads.…”

Linking the Spinal Function Sort and Functional Capacity Evaluation Tests to the International Classification of Functioning, Disability and Health Core Set of Vocational Rehabilitation

“…The comprehensive core set for vocational rehabilitation (CSVR) includes 90 categories [1] for use with people of working age that experience limitations in their work-related functional capacity or restricted work participation [2,3]. Functional capacity can be measured by self-report and based on performance [4][5][6][7][8][9][10][11][12] such as the Spinal Function Sort pictorial questionnaire (SFS) and 1 3 Functional Capacity Evaluation (FCE) tests (Complete Minnesota Dexterity Test (CMDT), grip strength test, pushing, pulling, progressive iso-inertial lifting (PILE) and carrying).…”