“Functional capacity assessment.” “Fitness for duty.” These phrases will strike fear into the heart of even the most intrepid internist. When the subject of functional capacity assessment arises, one generally thinks in terms of musculoskeletal evaluations using instruments such as inclinometers, goniometers, range of motion machines, and strength analyzers.

Depending on the nature of the organ system to be tested, there are a variety of tests to assess physiological competency, for example liver function or renal function tests. Each of these is a functional capacity assessment. They allow us to assess both the basal function of an organ or organ system as well as the capacity of that system when stressed physiologically.

For muscles to move joints, a system must provide nutrients, remove waste products, and conduct nervous impulses. The cardiopulmonary exercise test (CP Ex test) incorporates many...

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