Visual Estimation of Effort May Not Be Best Way to Determine Strength

Reducing Workers Comp Cost Using Rehabilitation Assessments: Visual

As discussed previously, part of assigning an injured worker to transitional duty is the factor of “medical readiness” to assume a modified duty job. Thus, it is important to know an injured worker’s physical capabilities and strengths.

Let’s look at the third area of significant physical assessment.

1. Hand Strength
2. Isometric Leg Lift and Arm Lift
3. Visual Estimation of Effort

What is the Visual Estimation of Effort, and Why Should You Care About It?

During a lifting assessment the so-called visual estimation of effort (VEE) is the most widely used method of classifying validity of effort. So what is this estimation, and how accurate is it? In the VEE, a trained therapist visually monitors a claimant during an functional capacity evaluation (FCE) and attempts to determine, visually, if the claimant is working at a maximum level and if the claimant is cooperating.

Studies nearly 30 years ago found untrained college students in Sweden could determine with accuracy, above the level of chance, as to whether a person was having true difficulty during a lifting task or was “faking” difficulty.

In the United States, one of the rare references to accuracy of the method found maximal performances were correctly identified in 46% to 53% of healthy subjects and in 5% to 7% of chronic back pain patients evaluated in a study published in Spine.

In a current study being submitted for peer review, it was found trained therapists and untrained health care professionals who never did an FCE achieved the same level of accuracy, slightly above the level of chance, in classifying effort as did lay subjects taking part in the study.

In other words, being a trained professional does not quarantee accuracy in classifying effort.

Author: Darrell Schapmire, MS of X-RTS Software Products & Testing Devices develops distraction-based tests for use in functional capacity evaluations. He can be reached at dschapmire@yahoo.com or www.exrts.com

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