There are many variations of functionals depending on the company's needs and the proposed job role of the applicant. Each assessment may include:
Musculoskeletal Screen
Musculoskeletal Screen
taking applicants through a series of range of motion testing and posture observations – Normal or Abnormal; Functional or Not Functional. If any abnormality noted, provide further details.
Grip Strength
Grip Strength
Measured bilaterally with calibrated dynamometer commenced at position 2 (Jamar). Results compared to the norms included on paperwork.
Dynamic Tolerances
Dynamic Tolerances
Kneeling, Squatting, and Romberg Test (to test Proprioception). If the applicant fails the Sharpened Romberg Test (feet inline heel to toe) the consultant must revert to the Standard Romberg (feet side by side) and test repeated.
Functional Lifting & Carrying
Functional Lifting & Carrying
Lifting and carrying weights are as indicated by the paperwork. Always test all the weights outlined, as this testing has a fatigue element. For example, if you are testing what appears to be a large, strong man, do not skip to the highest weight.
However, when progressing testing from Floor-to-Waist &/or Floor-to-Shoulder lifting to Carrying, clinicians MUST reduce weight to approximately 60% of the weight demonstrated before commencing a new task, i.e. if a patient lifts to 15kg during Floor to Waist lifting, the Carrying task must be started at approximately 10kg and progressed accordingly (not started at 15kg).
Please ensure that you:
Monitor their heart rate throughout testing. If HR reaches 85% Max HR then allow 30 secs rest to allow HR to decrease. Cease testing if HR does not decrease to less than 85% Max HR after 30 secs rest.
Always observe the applicant's technique, looking for any signs of significant effort/unsafe technique – correct as necessary. Cease testing if unsafe and applicant unable to respond to cues to improve/modify technique.
Ask the applicant at the end of each weighted task: “Can you perform that task, hypothetically once per hour for 8 to 12 hours per day?” and “Do you feel you can lift a heavier weight right now?”. Record the response to these questions on the paperwork. Cease testing if the applicant reports “No” for either of these questions.
Ask applicant to provide a Perceived Heaviness (PH) rating – Scale from 1 Easy to 10 Maximal effort) **Provide an example of our RPE scales*** at the end of each weighted task, and any corrections or observations (definitions are on paperwork). Cease testing if applicant scores 8/10 or higher for PH on any task.
Cardiovascular Step Test
Cardiovascular Step Test
Most commonly, you will need to apply the YMCA 3-minute step test. This requires a 30.5 cm (12 inch) step and a metronome set to a cadence of 96 bpm (24 step-ups a minute).
Commence testing only when HR is within 5 beats of resting HR.
During testing, monitor the HR and record HR at the end of each level (1 min increments).
At the end of the 3 minutes, have the applicant sit down and rest for 1 minute.
At 1 min post-test, record the "1-minute post-test heart rate".
Using age, gender, and post-test heart rate to determine test result (see testing paperwork)
Cease the test if the applicant HR reaches 85% Max HR at any point during testing.
Watch for uneven weight bearing between left/right legs, use of hands-on thighs for support, forward flexed posture, signs of fatigue etc. If they fail to keep up with the beat, prompt them a few times before ceasing the test.
If the applicant is unable to complete testing (self-determined or clinician instructed), allow applicant to sit and rest, and confirm why the test was not completed as per dropdown options i.e. exceeded 85% HRmax, unable to maintain correct pace etc. The Carelever Form will auto-fill the other results, however if using paperwork please indicate 'Very Poor' cardiovascular fitness as the outcome.
If step test not completed, still record HR 1min post recovery after stopping.
*Note - There may be requests for other variations of the step test, e.g. Queens College or Chester. These will be clarified at the time of booking.
Job Specific Testing
Job Specific Testing
Refer to instructions on the client paperwork for all job-specific testing. Generally, it will involve more comprehensive dynamic positional tolerances, e.g. sustained forward reaching, sustained squat, sustained stoop, ladder climb etc.