Dodson, M., Kyi, M., Percy, T., Wadley, M., Deeker, K., and Matheson, L. (in press). Use of item response theory to develop a return to work measure for acquired brain injury: The Employment Feasibility Checklist. Work, A Journal of Prevention, Assessment, and Productivity in the Workplace. 2022.
BACKGROUND: The 2001 Feasibility Evaluation Checklist (FEC) is an assessment of work readiness for individuals with acquired brain injury (ABI). It establishes the integrity of basic safety, productivity, and interpersonal factors in neurorehabilitation and vocational settings. This study represents an effort to further development the FEC to increase its clinical utility.

OBJECTIVE: To redesign the FEC by conducting Item Response Theory (IRT) analyses on the study’s results and combining those mathematical calibrations with clinical expert judgement. The result will be a new measure for use in clinical ABI neurorehabilitation and vocational settings: the Employment Feasibility Checklist (EFC). METHODS: Seven participants with ABI were administered a situational assessment on multiple occasions by occupational therapists in a community rehabilitation clinic. The FEC was used to assess the participant’s performance across three areas of basic employment feasibility: safety, productivity, and interpersonal factors. Results were analyzed with ITR Rasch analysis and then subjected to clinical expert judgment, resulting in adjustment recommendations for the FEC. RESULTS: In this scale development study, IRT analysis of results from 89 observation trials was combined with expert clinical judgment resulting in a redesigned tool with increased clinical utility for persons with ABI. The EFC is a 12-item observational rating scale for employment feasibility constructs of Productivity and Interpersonal Relations, with an additional six item Workplace Safety subsection. CONCLUSIONS: The EFC is a mathematically calibrated tool designed to gauge feasibility for competitive employment in clients with ABI. The tool may be useful in clinical neurorehabilitation settings and vocational rehabilitation settings.

Kyi, M., Fischer, J. et. al. Physical Effect of Work on Healthy Individuals: Implications for FCE Testing. WORK, June 2012; Volume 42(2), pp. 233-239.
Abstract: The objective of this study was to assess the effect of time of day and job type on performance of 3 functional capacity evaluation measures in healthy (asymptomatic) adults. It was queried whether or not a healthy population of adults would demonstrate a change in physical performance ability, when re-tested at the end of their work day. Setting: A convenience sample of 50 healthy adults (19-62 years, 66% male) was used from 6 work sites in an urban area. Design: Same day pre-test and post-test testing was performed, implementing use of 3 commonly used functional capacity tests; Jamar dynamometer grip strength test; Turning sub-test of the Complete Minnesota Dexterity Test; and the 50-foot walk test. Method: The study compared morning and afternoon test scores using t-tests, assessed the effect of job type (sedentary, light, medium, heavy) on performance using ANOVA. Results: All 3 measures improved from morning to afternoon; differences were statistically significant for 50-foot walk (mean=0.2 sec, p = 0.02) and manual dexterity (mean=5 sec, p<0.001). Job type had a significant effect on dexterity. Conclusions: Late day performance did not show any significant decline in this sample of healthy adults, and in fact tended to improve or stay relatively stable. Therefore, clinicians who perform functional capacity evaluations should consider alternative explanations for late-day functional declines observed in injured clients. These findings, combined with other test results, may assist clinicians with disability determination.
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Makdessian, F., Friars, D., Kyi M.T., Gutteridge, L. Back on the Job. Occupational Health and Safety Magazine, December 1999.
Abstract/Overview: Untangling the complex world of a functional capacity evaluation and a physical demands analysis in helping injured workers return to work.
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Kyi, M.T., Fischer J.A. Understanding the FCE: Objective Evaluation of Work Tolerance. OT Line, April 2001.
Abstract/Overview: Published paper outlining objective techniques used to assist in determining an individuals ability to work full time.
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Kyi, M.T. Shades of Gray: Determining return to work status isn’t always black and white. Advance for Directors in Rehabilitation, April 2001.
Abstract/Overview: Published paper outlining the importance of functional baseline and repeat testing to help determine a clients durable work tolerances, and issues pertaining to part-time versus full-time work suitability.
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Kyi, M.T. Getting Results: How to get the most out of functional capacity testing. Advance for Directors in Rehabilitation, April 2000.
Abstract/Overview: Published paper outlining key questions referral sources should ask when considering application of a Functional Capacity Evaluation, to assist in disability determination.
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Kyi, M.T., Physical Effect and Symptom Magnification: Current Issues in Work Capacity Evaluation. Occupational Therapy Now, January/February 2000.
Abstract: Work Capacity Evaluation (WCE) is used to determine an individuals physical abilities, limitations, and readiness to return to work. In the early 1980s, Dr. Leonard Matheson defined Work Capacity Evaluation as a systematic process to dependably sustain performance in response to broadly defined work demands (Matheson, 1986). As occupational therapists we are aware of the influence that symptom magnification can have on the clients perception of his or her job readiness. Therefore, in order to thoroughly assess an individuals true work capacity, it is important to separate objective findings gathered during physical effort testing, with more subjective findings gathered during symptom magnification testing.
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