FCE Tools & Techniques 2 — Questions and Answers
Question 1: Which dynamometer protocol requires three to five trials with coefficient of variation (CV) below 15% to indicate reliable effort?
- Jamar hand dynamometer rapid exchange grip test (Correct answer)
- EPIC Lift Capacity test
- Isernhagen Work Systems protocol
- Blankenship System sincerity of effort
Correct answer: Jamar hand dynamometer rapid exchange grip test
The Jamar rapid exchange grip test uses 3–5 trials; a CV below 15% across trials indicates consistent, reliable effort.
Question 2: During a positional tolerance assessment, an evaluator documents that a worker can maintain a forward-flexed trunk position for 8 minutes before rest. This primarily measures:
- Static endurance capacity (Correct answer)
- Dynamic material handling
- Aerobic work capacity
- Grip-force production
Correct answer: Static endurance capacity
Timed positional tolerance testing measures static (sustained) endurance of a posture, not dynamic movement or cardiovascular capacity.
Question 3: The WEST Tool Sort assessment is primarily used to evaluate:
- Upper-extremity coordination and dexterity (Correct answer)
- Lumbar range of motion
- Cardiovascular fitness
- Lower-extremity weight-bearing tolerance
Correct answer: Upper-extremity coordination and dexterity
The WEST Tool Sort is a standardized dexterity and coordination task using nuts, bolts, and washers to simulate industrial hand-tool use.
Question 4: An FCE evaluator uses surface EMG biofeedback during a lifting task. The PRIMARY purpose is to:
- Objectively document muscle activation patterns during effort (Correct answer)
- Replace functional capacity observations
- Set vocational rehabilitation goals
- Determine maximum aerobic capacity
Correct answer: Objectively document muscle activation patterns during effort
Surface EMG provides objective data on muscle recruitment timing and amplitude, helping document effort consistency during functional tasks.
Question 5: Which technique is used to estimate whole-body energy expenditure during an FCE lifting task without direct gas analysis?
- Heart rate monitoring with age-predicted maximum heart rate formulas (Correct answer)
- Manual muscle testing
- Goniometric measurement
- Grip dynamometry
Correct answer: Heart rate monitoring with age-predicted maximum heart rate formulas
Heart rate monitoring allows estimation of metabolic demand using percentage of age-predicted maximum heart rate as a proxy for VO2.
Question 6: When a Valpar Component Work Sample is administered during an FCE, the evaluator compares the examinee's performance to:
- Percentile norms derived from industry worker populations (Correct answer)
- The evaluator's own clinical judgment only
- OSHA occupational exposure limits
- DOT physical qualification standards
Correct answer: Percentile norms derived from industry worker populations
Valpar norms are established from samples of workers in relevant industries, allowing percentile comparison of speed and accuracy.
Question 7: A floor-to-waist lift test in an FCE is terminated early due to the evaluator observing 'lumbar flexion reversal' reversal pattern. This refers to:
- The pelvis rotating posteriorly before the lumbar spine begins to extend during the lift (Correct answer)
- Decreased grip force during the lift
- Elevated heart rate above 85% of maximum
- Cervical hyperextension during load acceptance
Correct answer: The pelvis rotating posteriorly before the lumbar spine begins to extend during the lift
Lumbar flexion reversal (also called lumbar-pelvic rhythm disruption) occurs when the pelvis tips back before the lumbar spine extends, indicating poor lifting mechanics or pain-avoidance.
FCE Tools & Techniques 2
Which dynamometer protocol requires three to five trials with coefficient of variation (CV) below 15% to indicate reliable effort?