PTOTPilotJournal of occupational rehabilitation2018

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

S G Postema, R M Bongers, M F Reneman and 1 others

PMID 28397018

WHAT IT FOUND

Adapted functional capacity tests for one-handed adults proved feasible but revealed lower lifting weights than two-handed controls.

The prosthesis often limited performance due to grip safety rather than muscle strength, and no link was found between test scores and current pain.

Key findings

01Adults with above-elbow upper limb absence lifted significantly less weight than two-handed controls, and showed lower endurance on overhead tasks.

02For below-elbow amputees using a prosthesis, the most common reason for stopping the lifting test was unsafe grip with the device, not reaching maximum muscle capacity.

03There was no significant difference in any functional capacity test results between participants with upper limb absence who reported musculoskeletal complaints and those who did not.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study was a pilot with a small sample size (40 total), so definitive conclusions about functional capacity cannot be made. The FCE-OH itself has not yet established reliability or validity, so it should not be used for clinical decisions without further psychometric testing. The sample included very few women (only 6 of 40 participants), limiting generalizability to female patients. Controls were not matched for physical work demands, which may have influenced the comparison of functional capacity.

Declared interests

The research was supported by non-U.S. government funding. The authors declared no specific conflicts of interest related to commercial entities.

The easy way to misread this

Do not assume that low lifting scores in below-elbow amputees indicate muscle weakness. The study found that grip safety with the prosthesis, not muscle capacity, was the primary reason for stopping the test, so these scores may underestimate true physical potential.

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