09-13-2009, 08:58 AM (This post was last modified: 09-13-2009 09:06 AM by Cycler.)
WHile I suppose we are done with this thread and that your experiences with your various FCEs is what any IW can expect, both good and bad, it really is a rehash of an older thread where I cautioned that FCE's have questionable validity issues and are generally held to be unreliable predictors of function by the medical community as a whole. Various courts have also questioned their ability to meet Frye and Daubert standards. Even the large insurance companies have published one the need for a more focused standard.
Consider these excerpts from the FCE literature as each "system" tries to outsell it's competition;
" As functional capacity is influenced by psychosocial as well as physical factors,
it is difficult to determine whether maximal effort is exerted in FCEs.The sensi-
tivity and specificity of a number of tests,including the PILE,were examined for
their ability to determine maximal effort (Lemstra, Olszynski, & Enright, 2004).
While specificity was reasonable, sensitivity was unacceptable as those giving
maximal effort may be incorrectly labeled as exerting submaximal effort (Lemstra
et al.,2004).Caution is therefore urged when labeling the efforts of individuals. "
"When lifting capacity results were compared with job requirements, those
workers who met the physical job demands were found to have significantly lower
injury rates than those workers who did not demonstrate the required physical
capacities (Harbin & Olson,2005).Strength testing alone,however,had no predic-
tive value for determining the incidence of work injuries.Therefore, the ‘physical
evaluation of potential employees is useful for injury prevention only if it can be
related to the physical requirements of the job’(Harbin & Olson,2005,p.306). "
..and yet FCE's of IW in situations such as your, the norm, are job non-specific, just a test with no context.
So the problem with an FCE is really that, with the exception of very narrowly focused job specific testing, the outcome has doubtful medical and legal validity and yet it has become a powerful tool in litigation, generally at the expense of the patient or injured worker. The testing is very expensive and so it's of no surprise that various vendors, usually physical therapists or exercise physiologists, compete vigorously for a place at the insurance industry trough and do not market their services to the patient community at all. Physicians, even Rehab Specialists who are arguably the most highly educated Professionals in the field of medical conditions and human performance are never found to be involved in the FCE industry and have generally disavowed their usefulness - curious.
I would want every patient to understand these issues and to have the knowledge to challenge a skewed or erroneous report as few would have the means to obtain their own competing FCE as you did.
In a nutshell, FCE's are bad science at this stage of their development and testee's and their attorney's should be better informed on the matter for their own protection than is currently the case. Maybe a Sticky topic on what every IW should know about FCE's ?
Wink Wrote:Bad Boy Bad Boy Wrote:So, are we done with this thread now? Or is there anymore that anyone wants to know more, or have more questions?
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RE: FCE - Cycler - 09-13-2009 08:58 AM
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