Presentation T P41

T P41 (Poster Presentation):
Are Performance-Based Functional Assessments Superior to Semi-Structured Interviews for Enhancing Return-To-Work Outcomes in Claimants with Chronic Musculoskeletal Disorders?

Presented by: Douglas Paul Gross

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Authors

Gross DP1,3, Asante AK2, Miciak M1, Battié MC1, Carroll LJ1, Sun A3, Mikalsky M3, Huellstrung R3, Niemeläinen R3

  1. University of Alberta, Edmonton, Canada
  2. Alberta Health Services, Calgary, Canada
  3. WCB-Alberta/Millard Health, Edmonton, Canada

Abstract

Background

Functional capacity evaluations (FCE) are commonly used to identify work abilities and to inform return-to-work (RTW) decisions. FCE results therefore have important consequences. We examined whether performance-based FCE testing enhances RTW assessment of workers’ compensation claimants beyond information gained from self-report measures. We hypothesized that: 1) claimants undergoing performance testing or a functional interview as part of a RTW assessment would have comparable rates of RTW; but 2) claimants undergoing performance testing would RTW at higher levels due to the lower estimations obtained with self-report observed in previous studies.

Methods

A cluster randomised controlled trial was conducted with analysis at level of claimant (registration ISRCTN61284905). The study was conducted at a workers’ compensation rehabilitation facility in Edmonton, Canada. Data were collected on all claimants undergoing RTW assessment for claim closure at the facility for musculoskeletal conditions. Participants were predominantly employed (59%) males (73%) with chronic musculoskeletal conditions (median duration 496 days). Clinicians who were trained and experienced in performing FCE were randomised into two groups. One group included 14 clinicians who were trained to conduct a semi-structured functional interview, while the control group continued to use standard FCE procedures. Outcomes included RTW recommendations following assessment, functional work level at time of assessment and 1, 3, and 6 months after assessment, as well as compensation outcomes. Analysis included Mann-Whitney U, Chi square and t tests.

Results

Participants included 203 claimants of whom 103 were tested with FCE. All outcomes were similar between groups and no statistically or clinically significant differences were observed. Mean differences between groups on functional work levels at assessment and follow-up ranged from 0.1 to 0.3 out of 4 (3% to 8% difference, p>0.05).

Conclusions

Performance-based FCE does not appear to enhance RTW outcomes beyond information gained from semi-structured functional interviewing. Use of functional interviewing has the potential to improve efficiency of RTW assessment without compromising clinical, RTW, or compensation outcomes.

Schedule Details

Tuesday September 30
12:45 - 13:45 Poster Viewing
Session: Work capacity / ability