PHYSICAL CAPACITY ASSESSMENT

A physical capacity evaluation typically assesses “isolated” parts of the body (or) functional units.

SMITH PHYSICAL CAPACITY EVALUATION

It has 154 performance items and was found to be very accurate in predicting Reemployment of workers with physical disability.

NUMBER OF HOURS CAPABLE OF WORK:

Given the workday, the client can –

Sitting: ½ 1 2 3 4 5 6 7 8(hours)

Standing: ½ 1 2 3 4 5 6 7 8

Walking: ½ 1 2 3 4 5 6 7 8

PHYSICAL DEMANDS:

Lifting strength (0) (1-10) (11-20) (40-over)

Sedentary - 0-10 lbs

Light - 11-20 lbs

Moderate - 21-50 lbs

Heavy - 51-65 lbs

Climbing (stairs / ladders) Balance Crouch Squat

Reach- at shoulder height Reach –below shoulder height

Client can use feet for repetitive movements: Right ---- Left ---- Both ----

Client can use hands for repetitive movements: Right ---- Left ---- Both ----

Simple Grasping: Yes ---- No ----

Fine Manipulation: Yes ---- No ----

Client is restricted by following environmental factors:

Hot / Cold ---- Dust ---- Height ---- Noise ----

Client will be required to use following Assistive Devices (or) Braces:

Additional comments: ----------------------------------------------------------------------------------------------------------------------------------------------------------------

Date: ---------------- Therapist: ----------------------------