Repeatability and Safety of the Functional Capacity Evaluation-One-Handed for Individuals with Upper Limb Reduction Deficiency and Amputation.
S G Postema, R M Bongers, C K Van der Sluis and 1 others
PMID 28932940WHAT IT FOUND
Five of eight one-handed functional capacity tests gave stable scores across two sessions in 23 people with upper limb absence; three did not.
The test was safe with precautions, but pain and learning effects mean individual scores need cautious interpretation.
Key findings
01Five of eight FCE-OH test items had acceptable test-retest reliability, and one item was close to acceptable.
02No serious adverse reactions occurred, but one participant had a bruise and eight participants reported a physical response 24 hours after the first session.
03Several FCE-OH tests were performed better during the second session, including overhead lifting with a 2.0 kg weight, repetitive reaching with both limbs, and fingertip dexterity with the unaffected hand.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only 30 people took part, and only 23 completed both sessions, so some test analyses included as few as 9 participants. The gap between sessions was short, with a median of 47.2 hours, which may leave pain or fatigue from session 1 affecting session 2. Seven participants did not complete session 2 for scheduling, unknown decline, or no-show reasons, and it is unknown whether this caused bias. Several tests were better on the second session, and the first reaching trial was slower, so practice effects can change scores. No minimal clinically important change has been established for the one-handed functional capacity evaluation, so limits of agreement cannot yet be interpreted clinically. Some tests were altered from earlier versions, so their agreement cannot be compared with healthy adult data.
Declared interests
Funder named: Bench Fee.
The easy way to misread this
Do not assume the one-handed functional capacity test can reliably measure change for any patient. Five of eight tests were acceptable, but three were not, and several tests were better on session 2, so a single score may reflect practice or fatigue rather than true capacity.