Is a functional capacity evaluation associated with a more realistic appraisal of patients' self-reported functional capacity? A diagnostic before-after study

Abstract

Purpose Our study analyzed whether self-reported functional capacity is more realistic after a functional capacity evaluation has been carried out, i. e. whether the second self-reported functional capacity after testing corresponds more closely to the tester-observed judgement during the test than the first self-reported functional capacity before testing. Methods Patients with orthopedic trauma were referred for functional capacity evaluation at the end of an inpatient rehabilitation program in Austria and were consecutively recruited for a diagnostic before-after study. We assessed self-reported functional capacity before and after completion of functional capacity evaluation as patient-reported outcome and compared it with tester-observed functional capacity when performing the functional capacity evaluation, i. e. our diagnostic procedure. Self-reported functional capacity was assessed with the Spinal Function Sort. Results In 523 patients, self-reported functional capacity assessed by the Spinal Function Sort increased significantly by 15.4 points after the functional capacity evaluation. This change corresponded to slightly more than 40% of the baseline standard deviation. The frequencies of self-reported moderate and heavy or very heavy work functional capacity increased from 22.2% to 30.4% and 13.6% to 23.5%, respectively, while the frequency of self-reported sedentary functional capacity decreased from 35.2% to 18.9%. The number of patients whose self-reported functional capacity matched the tester-observed functional capacity increased from 19.3% to 34.2% after completion of the functional capacity evaluation. Conclusions After completion of the functional capacity evaluation, the number of patients significantly increased whose rating of functional capacity matched their tester-observed functional capacity.