Maximal effort during functional capacity evaluations: An examination of psychological factors

Background and Purpose: Patients with low back pain are often administered a Functional Capacity Evaluation (FCE) to determine levels of physical functioning at the conclusion of their rehabilitation program. The purpose of this study was to examine the relationship between psychological factors tie, self-reported disability, anxiety, depression, self-efficacy) and maximal effort exerted during the FCE. Subjects and Methods: Sixty-four patients with low back pain were administered the Oswestry Low Back Disability Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory, and the FCE Self-Efficacy Scales before administration of the FCE. Results: Compared with patients who gave maximal effort during the FCE, patients who did not exert maximal effort reported significantly more anxiety and self-reported disability, and reported lower expectations for both their FCE performance and for returning to work. There was also a trend for these patients to report more depressive symptomatology. Conclusion and Discussion: Results provide evidence for the relationship between self-reported disability, depression, anxiety, self-efficacy, and patients' performance on the FCE. Suggestions for addressing the psychological factors in a comprehensive pain treatment program are provided. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation .