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

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. 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. 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. After completion of the functional capacity evaluation, the number of patients significantly increased whose rating of functional capacity matched their tester-observed functional capacity