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STUDY DESIGN: Single-blinded, randomized, posttest only design. OBJECTIVE: To help contribute to the body of evidence in defining the validity of functional capacity evaluations. BACKGROUND: Functional capacity evaluations (FCEs) are tests used to help determine an individual's readiness to return to work. Most FCEs incorporate indicators of effort within the evaluation. Published evidence validating the use of these indicators is limited. METHODS AND MEASURES: Forty-nine injured and noninjured individuals 18 to 65 years of age participated in this study. The participants were randomly assigned to 1 of 2 groups: 100% effort or 50% effort. Raters were blinded to participant group. The Blankenship Version 6.0 software was used to analyze the data and a Blankenship FCE validity profile was scored. A score of 70% or greater was deemed a valid FCE as adopted by the Blankenship protocol. RESULTS: The sensitivity of the FCE components tested was demonstrated to be 80% and specificity was 84.2%. The positive likelihood ratio was 5 and the negative likelihood ratio was 0.2. A receiver operating characteristic (ROC) curve demonstrated the 70% cut-off value for scoring the FCE was optimal. CONCLUSION: Four components of the Blankenship FCE system demonstrated good sensitivity and specificity for detecting submaximal effort. However, clinicians should note that false positives (maximum effort identified as submaximal effort) may occur and scores of 'equivocal' are not scored in the 'criteria passed' category. The rater should be aware that this method of scoring could potentially influence a client's overall FCE score. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of noxious level electrical stimulation on pain, grip strength and functional abilities in subjects with chronic lateral epicondylitis., Design: Randomized, placebo-control, double-blinded study., Setting: Physical Therapy Department, North Georgia College and State University., Subjects: Eighteen subjects with chronic lateral epicondylitis between the ages of 24 and 72 years participated in this study. Subjects were randomly assigned into treatment or placebo groups., Interventions: Subjects received six sessions of low-frequency electrical stimulation over the palpated tender points. The intensity of electrical stimulation was set at 0 in the placebo group., Main Measurements: Grip strength, functional status, pain intensity and limited activity due to pain were assessed before and after treatment. Six-month follow-up data were collected in treatment group only., Results: Both clinically and statistically significant improvements in average grip strength were found (treatment group: 28% increase; placebo group: 2.5% decrease; P=0.04), functional activity (treatment group: 110% increase; placebo group: 22% increase; P= 0.003), pain intensity (treatment group: 3.1 point decrease; placebo group: 0.2 point increase; P=0.01) and activity limitation due to pain (treatment group: 4.1 points increase; placebo group: 1.9 point decrease; P= 0.003) between the treatment and placebo groups. Follow-up data showed that 100% of subjects maintained the improved function, and 83% remained pain-free for at least six months post treatment., Conclusion: The results of this study indicated that symptoms of chronic lateral epicondylitis could be effectively treated by noxious level low-frequency electrical stimulation.

Symptoms of lateral epicondylitis (LE) are attributed to degenerative changes and inflammatory reactions in the common extensor tendon induced by microscopic tears in the tissue after repetitive or overload functions of the wrist and hand extensor muscles. Conventional treatments, provided on the premise of inflammatory basis of LE, have shown 39-80% failure rate. An alternative approach suggests that symptoms of LE could be due to active tender points developed in the origin of hand and wrist extensor muscles after overuse or repetitive movements. Oscillating-energy Manual Therapy (OEMT), also known as V-spread, is a craniosacral manual technique that has been clinically used for treating tender points over the suture lines in the skull. Considering symptoms of LE may result from active tender points, the purpose of this study was to investigate the effect of OEMT on pain, grip strength, and functional abilities of subjects with chronic LE. Twenty-three subjects with chronic LE (>3mo) between ages of 24 and 72 years participated in this study. Before their participation, all subjects were screened to rule out cervical and other pathologies that could possibly contribute to their lateral elbow pain. Subjects who met the inclusion criteria were randomized into treatment and placebo treatment groups by a second (treating) therapist. Subjects were blinded to their group assignment. Subjects in the treatment group received OEMT for six sessions. During each treatment session, first a tender point was located through palpation. After proper hand placement, the therapist focused the direction of the oscillating energy on the localized tender point. Subjects in the placebo group underwent the same procedure, but the direction of the oscillating energy was directed to an area above or below the tender points, not covering the affected area. Jamar Dynamometer, Patient Specific Functional Scale (PSFS), and Numeric Rating Scale (NRS) were used to measure grip strength, functional status, and pain intensity and limited activity due to pain, respectively. The screening therapist who was blinded to the subjects' group assignment performed pretest, posttest, and six-month follow-up measurements. Subjects in the treatment group showed both clinically and statistically significant improvement in grip strength (p=0.03), pain intensity (p=0.006), function (p=0.003), and limited activity due to pain (p=0.025) compared with those in the placebo group. Follow-up data, collected after six months, showed no significant difference between posttest and follow-up measurements in functional activity (p=0.35), pain intensity (p=0.72), and activity limitation due to pain (p=0.34). Of all the subjects contacted for follow-up assessment, 91% maintained improved function and 73% remained pain free for at least six months. OEMT seems to be a viable, effective, and efficient alternative treatment for LE.