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PubMed2003

Reliabilities of the Groningen Functional Capacity Test.

The purpose of this study was to make a preliminary evaluation of the test-retest reliability of the Groningen Functional Capacity Test, a test developed to assess the functional capacity of people with a chronic disease and/or physical handicap and participating in a recreational sports stimulation program called SCALA, as a way to create homogeneous sport groups. The test includes motor actions typical for the SCALA sports program and has eight subtests, reaching, balancing, ball-catching, picking up objects, ball-kicking, ball-throwing accuracy, tennis, and walking. The subjects were 52 adults aged 46-71 years, randomly selected from the SCALA project. Intraclass correlations ranged from .96 to .58. Two subtests showed significant improvements on retest for walking (total sample and men) and picking up (total sample, men, and women). For most subtests, test-retest reliability was satisfactory and therefore worth being implemented in the SCALA program.

Aged↗
PubMed1999

Comparison of functional capacity in patients with end-stage heart failure following implantation of a left ventricular assist device versus heart transplantation: results of the experience with left ventricular assist device with exercise trial.

BACKGROUND: Use of a permanent left ventricular assist device (LVAD) has been proposed as an alternate treatment of patients with end-stage heart failure. The purpose of this study was to compare the functional capacity of patients following implantation of a LVAD vs heart transplant (HTx). METHODS: Eighteen patients from 6 centers who received an intracorporeal LVAD as a bridge to HTx underwent treadmill testing 1 to 3 months post-LVAD and again post-HTx. Baseline and peak measurements, including oxygen consumption, blood pressures, and respiratory rate were made during each treadmill test. RESULTS: Peak oxygen consumption was 14.5+/-3.9 ml/kg/minute post-LVAD and 17.5+/-5.0 ml/kg/minute post-HTx (p < .005). The percentage of the predicted peak oxygen consumption based on gender, weight, and age was 39.5%+/-5.5% post-LVAD and 47.7%+/-10.9% post-HTx (p < .005). Exercise duration was lower post-LVAD than post-HTx (10.3+/-4.2 minute vs 12.5+/-5.4 minute, p < .05). After LVAD implantation, peak total oxygen consumption correlated with peak LVAD rate and output. Eight patients reached an LVAD rate of 120 beats per minute (bpm) before the conclusion of exercise, the maximum rate for the outpatient electric device. The peak respiratory exchange ratio post-LVAD was 1.15+/-0.22 and post-HTx was 1.15+/-0.18, consistent with a good effort in both groups. CONCLUSIONS: Patients demonstrated a lower functional capacity post-LVAD than post-HTx. For some patients functional capacity post-LVAD may be improved by a higher maximum LVAD rate and output.

Adult↗
PubMed2007

Effects of exercise intervention on patients with stroke with prior coronary artery disease: aerobic capacity, functional ability, and lipid profile: a pilot study.

OBJECTIVE: To assess the effects of exercise intervention on aerobic capacity, functional ability and lipid profile in patients after stroke with prior coronary artery disease. PATIENTS: Fifteen patients after stroke with prior coronary artery disease. METHODS: Patients were enrolled in a moderate-intensity exercise intervention using a graded treadmill for 12 weeks. Before and after the intervention, their aerobic capacity and functional ability were assessed by the exercise testing and Barthel index, respectively. The total cholesterol (TC), lowdensity lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglyceride, and TC/HDL were also evaluated using an enzyme auto-analyser. RESULTS: After training, the patients'absolute peak oxygen consumption (VO2) was increased (p < 0.01); their functional ability was significantly improved (p < 0.01); and their TC, LDL, triglyceride, and TC/HDL levels were significantly reduced (p < 0.01). However, HDL level did not change significantly. In addition, Pearson analysis demonstrated a strong correlation between the increase in peak VO2 and the decrease in TC/HDL (r = -0.72, p < 0.01). CONCLUSION: These results suggest that exercise intervention is beneficial for aerobic capacity, functional ability, and some parts of the lipid profile in patients after stroke with prior coronary artery disease.

Activities of Daily Living↗
PubMed2000

Functional capacity and fertilizing longevity of frozen-thawed scimitar-horned oryx (Oryx dammah) spermatozoa in a heterologous in vitro fertilization system.

This study was conducted to determine if cryopreservation and thawing reduces the quality of scimitar-horned oryx spermatozoa and thus might be responsible for sub-optimal artificial insemination (Al) efficiency. Functional capacity of frozen thawed oryx spermatozoa was compared in a heterologous bovine in vitro fertilization (IVF) system after being prepared by four methods. Fertilizing longevity was also assessed after thawing and pre-incubating spermatozoa for 12 or 24 h before IVF. Sperm characteristics (viability, morphology, acrosomal and capacitation status) were superior for samples prepared by Percoll centrifugation and standard swim-up compared with microdrop swim-up and wash methods. Regardless of variation in sperm characteristics over time, fertilization success and embryo development were high and did not differ among treatments. Fertilization and cleavage success for spermatozoa pre-incubated for 12 h before IVF were comparable with that achieved with non-incubated spermatozoa. Even 24 h after thawing, spermatozoa were capable of fertilizing oocytes, but percentage fertilization and embryo cleavage were significantly lower than for spermatozoa pre-incubated for 12 h. Overall, functional capacity of oryx spermatozoa after thawing appears comparable with that of domestic bull spermatozoa. When used for Al, frozen-thawed oryx spermatozoa should be capable of fertilizing oocytes in females ovulating 12 or even 24 h after insemination, providing sperm transport mechanisms are adequate. The functional capacity and fertilizing longevity of oryx sperm after thawing is high, and therefore unlikely to be responsible for decreased Al efficiency in the scimitar-horned oryx.

Animals↗
PubMed1997

Age and gender interactions in physiological functional capacity: insight from swimming performance.

One experimental approach to studying the effects of aging on physiological functional capacity in humans is to analyze the peak exercise performance of highly trained athletes with increasing age. To gain insight into the relationships among age, gender, and exercise task duration with use of this model, we performed a 5-yr (1991-1995) retrospective analysis of top freestyle performance times from the US Masters Swimming Championships. Regression analysis showed that in both men and women endurance swimming performance (i.e., 1,500 m) declined linearly from peak levels at age 35-40 yr until approximately 70 yr of age, whereupon performance declined exponentially thereafter. In both genders, the variability among the top 10 winning times in each 5-yr age interval increased markedly with advancing age. Compared with the 1,500-m freestyle, performance in the 50-m freestyle (short-duration task) showed only a modest decline until ages 75 and 80 yr in women and men, respectively. The rate and magnitude of the declines in both short- and long-duration swimming performance with age were significantly (P < 0.05) greater in women than in men. In the women, the percent decline in swimming performance over a 50-yr age period from the 19- to 24-yr to the 69- to 74-yr age groups became progressively greater from the shortest distance (50 m) to the two longest distances (800 and 1,500 m), whereas in men, no differences were observed in the magnitude of performance decline with age among the five longest distance events (i.e., 100-1,500 m). The percent gender difference in performance throughout the age range studied became progressively smaller (P < 0.05) with increasing distance from 50 m (19 +/- 1%) to 1,500 m (11 +/- 1%). The findings in this cross-sectional study indicate that from peak levels at age 35-40 yr, physiological functional capacity, as assessed by swimming performance, decreases linearly until approximately 70-80 yr of age, whereupon the decline becomes exponential. Moreover, the rate of decline with advancing age appears to be associated with event duration and gender.

Adolescent↗
PubMed1994

Measuring residual functional capacity in chronic low back pain patients based on the Dictionary of Occupational Titles.

STUDY DESIGN: This study designed and tested a functional battery based on the Dictionary of Occupational Titles (DOT). OBJECTIVES: Such a battery can be used to measure residual functional capacity (RFC) in chronic pain patients (CPP) and results can be matched against the demand minimum functional capacities (DMFC) of DOT jobs. SUMMARY OF BACKGROUND DATA: Physicians have difficulty translating medical impairment into functional limitation and thereby establishing the RFC of CPPs. METHODS: The DOT, a USA government publication, provides information about physical demands of every USA job according to 36 factors and subfactors. The authors defined and developed a functional battery based on these factors/subfactors. This battery was tested on 67 consecutive CPPs to determine the percentage of CPPs able to pass specific job factors and the full battery and return to some DOT job, and evaluated the effects of pain on battery performance. The data were factor analyzed. RESULTS: The battery determined if CPPs could perform DOT job factors and had the necessary RFC to be placed in a DOT job. The vast majority of CPPs could not pass the full battery and the presence of pain and original job classification predicted whether a CPP could perform a job factor. Factor analyses grouped the factors into four independent categories supporting the design of the battery. CONCLUSION: The battery can assess whether CPPs are able to return to work.

Adult↗
PubMed2005

Enhanced maturation and functional capacity of dendritic cells induced by mannosylated L2 domain of ErbB2 receptor.

The nature of antigens and functional state of dendritic cells (DC) are important in antigen presentation. The ability of DC for the induction of T-cell responses is promoted by maturation. It has been confirmed that mannose receptors mediate highly efficient endocytosis and presentation of mannosylated proteins. In the present study, L2 domain of ErbB2 ectodomain was expressed in Escherichia coli, purified and mannosylated. The maturation and functional capacity of DC induced by mannosylated L2 (mL2) protein were investigated. The results showed that L2 protein could induce DC maturation, which was accompanied by elevated expression of MHC and co-stimulatory molecules. The effect of mL2 protein on DC maturation was more remarkable than that of non-mL2 proteins. Uptake of mL2 antigens by DC was more efficient. Furthermore, the T cells can be stimulated to proliferate in vitro and secrete Th1 and Th2 cytokines. Higher levels of both IFN-gamma and IL-10 were detected from the T cells stimulated by mL2-pulsed DC, suggesting a concurrent activation of CD4+ and CD8+ T cells. The results demonstrated that L2 domain of ErbB2 receptor is an immunodominant molecule. The mL2 domain of ErbB2 can induce an enhanced maturation and functional capacity of DC. It may become an effective strategy to induce anti-ErbB2 response.

Antigen Presentation↗
PubMed1980

Functional capacity evaluation: an empirical approach.

This paper presents an empirical approach to selecting activities of daily living (ADL) to assess the functional capacity of noninstitutionalized individuals with polyarticular disability. The results of structural analyses illustrate the feasibility of substantially reducing the task of assessing functional capacity with a subset of ADL items without sacrificing the comprehensiveness of the assessment. The analyses reveal 5 common functional categories: physical mobility, transfers, home chores, kitchen chores, and personal care, which account for over 50% of the variance in the data.

Activities of Daily Living↗
PubMed1975

[Angiological criteria of the functional capacity in arterial occlusive diseases of extremities after vascular surgery].

In order to avoid wrong estimations of the functional capacity of extremities with successfully reconstructed vessels in angioorganopathies, the use of reliable angiological measuring sizes in a broad spectrum is needed. Oscillography and longitudinal rheography as well as determinations of the arterial blood pressure deliver such qualitatively reliable parameters. For the judgment of the postreconstructive functional capacity one must not renounce the occlusion plethysmography of the veins which delivers quantitative measuring sizes. Other disturbances of the organs by the vascular basic disease present and concomitant diseases of middle and older age independent on the basic disease must always be taken into consideration in the general judgment.

Arterial Occlusive Diseases↗
PubMed2003

[Temporary working disability among younger patients with back pain and its interaction with severity of pain, functional capacity, social factors and personality styles].

The relationships between sick absenteeism and clinical measures were studied for a group of younger patients with chronic back pain (mean years of age for women and men were 41.7 and 42.2, respectively) who were sent to a rehabilitation programme. The duration of sick absenteeism during the last year as well as the momentary status of working ability were correlated with different clinical variables and personality styles. At the beginning of the rehabilitation program, the measure of functional capacity (FFbH-R, Kohlmann u. Raspe, 1996) showed the strongest correlation with temporary working disability (r = -.46) and duration of sick absenteeism during the last year (r = -.44). The severity of pain showed a lower but significant correlation with temporary working disability (r =.24) and duration of sick absenteeism (r =.25). In contrast, depression, vitality and age did not show significant correlations with temporary working disability at the beginning of the rehabilitation. In addition, some of the personality styles from the PSSI (Kuhl u. Kazén, 1997) showed significant correlations with temporary working disability and duration of sick absenteeism. When entering the variables into regression analyses, the measure of functional capacity was the most important predictor of sick absenteeism. Severity of pain, depression, vitality and age did not significantly add to the variance accounted for. In contrast, distinct personality styles from the PSSI significantly contributed to an additional proportion of variance in sick absenteeism and temporary working disability. At the end of the rehabilitation program, there were stable relationships between temporary working disability and functional capacity (r = -.45) as well as severity of pain (r =.39). In, correlations between temporary working disability and depression (r =.30) and vitality (r = -.19) were significant. This was due to the stronger improvement during therapy among patients who were able to work compared to patients who were not.

Absenteeism↗
PubMed1997

Radiation tolerance of cirrhotic livers in relation to the preserved functional capacity: analysis of patients with hepatocellular carcinoma treated by focused proton beam radiotherapy.

PURPOSE: To determine the preserved functional capacity of the liver as a probable determinant of radiation tolerance in patients with cirrhosis and hepatocellular carcinoma, who underwent proton beam radiotherapy. MATERIALS AND METHODS: We reviewed computed tomographic (CT) scans of 26 patients with cirrhosis and hepatocellular carcinoma during a period of 12-27 months after proton beam radiotherapy. Tumors were treated with focused proton beams with target doses of 140-186 TDF (time, dose, and fractionation). We measured the degree of hypertrophy of the untreated liver volume by measuring the total liver volume and the treated liver volume which was radiologically identified on contrast-enhanced CT scans. The risk of radiation-induced liver failure was estimated using the prediction score (PS) originally used for estimating posthepatectomy liver failure, substituting the planned treated liver volume for the resection liver volume. RESULTS: The degree of hypertrophy ranged from -19% to 51%, and was significantly positively correlated with the ratio of the planned treated liver volume to the functional liver volume. The PS agreed well with observed radiation tolerance in 21 patients, but underestimated the tolerance in 5. This underestimation was diminished when the PS was recalculated using the identified untreated liver volume in lieu of the planned untreated liver volume. CONCLUSION: As in surgical treatment, radiation tolerance of the cirrhotic liver after focused treatment is closely related to the preserved functional capacity of the identified untreated liver volume, which shows compensatory hypertrophy following radiotherapy.

Aged↗
PubMed1996

Role of exercise ventilation in the limitation of functional capacity in patients with congestive heart failure.

Patients with heart failure have, compared with normal subjects, an increased minute ventilation (VE) at matched workloads. This heightened ventilatory drive may contribute to their limitation of functional capacity through an increase in the work of breathing and further worsening in the lung ventilation-perfusion mismatch. To measure the ventilatory response to exercise, VE should not be assessed in absolute units but be related to one of its main determinants, e.g., carbon dioxide production (VCO2). Particularly, as VE is closely related to VCO2 during exercise, the ventilatory response to exercise has been assessed using the slope of the relation of VE versus VCO2. This slope is significantly increased in heart failure patients compared with normal subjects and is inversely related to other parameters of maximal exercise capacity, namely peak VO2. The mechanisms of exercise hyperpnea in heart failure patients are still unsettled. A first possibility is that it is a compensatory response to the abnormal exercise hemodynamics with secondary increase of the pulmonary dead space to tidal volume ratio. This mechanism should be aimed to maintain constancy of the arterial gas composition and acid-base balance. However, exercise-induced hypoxemia and/or hypercapnia do not generally develop in heart failure patients. This might imply that other mechanisms, such as an increased sensitivity of the arterial chemoreceptors and/or the activation of reflexes by the abnormal skeletal muscles, stimulate the ventilatory response in heart failure patients. Regardless of its mechanisms, exercise hyperpnea may be clinically relevant in the assessment of patients with chronic heart failure. In fact, it is inversely related with peak exercise capacity, and interventions known to improve peak functional capacity such as therapy with ACE inhibitors, physical training and heart transplantation, also tend to normalize exercise hyperpnea.

Exercise↗
PubMed1986

[Preoperative assessment of the functional capacity of patients with a mitral defect].

The functional capacity was tested in 83 patients with mitral heart defect by step-like loading of bicycle ergometric test, making use of the indices of physical capacity for work. A complex of clinical, non-invasive and invasive investigation methods was used for the hemodynamic evaluation of the patients. A comparison was performed of the threshold power of loading with the pressure in the cardiac cavities, pulmonary artery and pulmonary capillaries, the degree of valvular stenosis, degree and duration of cardiac insufficiency, cardiac rhythm. The indices of the physical capacity for work and the pressures in the cardiac cavities were juxtaposed in the patients undergone operations and patients with postponed operations. The patients with mitral defect were established to have considerably lower indices of physical capacity for work than the healthy non-trained subjects of the same age. The correlation of threshold power of loading with the pressures in right cardiac catheterization was low. The correlation with the mean pressure in pulmonary capillaries was moderate only in the patients with mitral stenosis but--considerable (with the degree of valvular stenosis in mitral stenosis, degree of cardiac insufficiency in both patient groups and with the functional class according to NIKA)--in combined mitral defect. The patients with postponed operations had better indices of physical capacity for work and were with lower pressures, determined by right cardiac catheterization.

Adult↗
PubMed1980

Competitive repopulation: a new assay for long-term stem cell functional capacity.

A new assay for the long-term functional capacity of hemopoietic stem cells is reported. Stem cell function in each donor of a particular genotype is assayed by mixing its marrow cells with a constant number of marrow cells from a donor with distinguishable hemoglobin and measuring the relative ability of each donor to populate stem-cell-depleted recipients. For example, cells from many different B6 donors may be assayed by mixing them with a constant number of WBB6F1 cells from a single pool and injecting them into irradiated WBB6F1 recipients. As the ratio of B6 to WBB6F1 marrow cells increases from 0:1 to 3:1 the percentage of B6 hemoglobin increases in a linear fashion. This is also found with WB and WBB6F1 or CBA and B6CBAF1 mixtures. Correlation coefficients between the percentage of hemoglobin of one donor type and the ratio of cells in the mixture of that type ranged from 0.78 to 0.98 in single experiments, and were 0.68 and 0.75 using data pooled from several experiments.

Animals↗
PubMed2002

Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome.

OBJECTIVE: To assess the effect of an isokinetic exercise program on symptoms and functions of patients with patellofemoral pain syndrome. DESIGN: A total of 22 consecutive patients with the complaint of anterior knee pain who met the inclusion criteria were recruited to assess the efficacy of isokinetic exercise on functional capacity, isokinetic parameters, and pain scores in patients with patellofemoral pain syndrome. A total of 37 knees were examined. Six-meter hopping, three-step hopping, and single-limb hopping course tests were performed for each patient with the measurements of the Lysholm scale and visual analog scale. Tested parameters were peak torque, total work, average power, and endurance ratios. RESULTS: Statistical analyses revealed that at the end of the 6-wk treatment period, functional and isokinetic parameters improved significantly, as did pain scores. There was not statistically significant correlation between different groups of parameters. CONCLUSION: The isokinetic exercise treatment program used in this study prevented the extensor power loss due to patellofemoral pain syndrome, but the improvement in the functional capacity was not correlated with the gained power.

Adult↗
PubMed2006

Are functional capacity evaluations affected by the patient's pain?

Functional capacity evaluations (FCE) are comprehensive batteries of performance-based tests used commonly to inform return-to-work decisions for injured workers. As many people undergoing FCE have painful musculoskeletal conditions limiting their work ability, pain becomes a critical factor in the assessment of function. This paper considers the available literature related to the influence of pain on FCE, which clearly indicates FCEs are behavioral assessments influenced by pain intensity and other pain-related constructs. Increasing pain levels are consistently associated with reduced FCE performance levels. As such, for purposes of claims adjudication, FCE should not be considered a purely "objective" indicator of functional impairment independent of subject or evaluator perceptions. FCE may have some value for facilitating return-to-work or re-integrating chronically disabled workers into the workforce, although pain factors must be taken into consideration when making predictions about future work status. Shorter FCEs could potentially be as effective as more lengthy protocols.

Humans↗
PubMed2006

Material handling performance of patients with chronic low back pain during functional capacity evaluation: a comparison between three countries.

PURPOSE: Functional Capacity Evaluations (FCEs) are batteries of tests designed to measure patients' ability to perform work-related activities. Although FCEs are used worldwide, it is unknown how patients' performances compare between countries or settings. This study was performed to explore similarities and differences in FCE performance of patients with chronic low back pain (CLBP) between three international settings that utilize the same FCE protocol. METHODS: Standardized FCEs were performed on three cohorts of patients with CLBP: A sample from an outpatient rehabilitation context in The Netherlands (n = 121), a Canadian sample in a Worker's Compensation context (n = 273), and a Swiss sample in an inpatient rehabilitation context (n = 170). Patients were undergoing FCE as part of their usual clinical care. Means and standard deviations of maximum performance on the FCE material handling items were calculated and differences compared using ANOVA. Multivariable linear regression was used to determine the relationship between country of origin and FCE performance while controlling for potential confounders including, age, sex, duration of back pain problems, and self-reported pain and disability ratings. RESULTS: Compared to the Dutch sample, the mean performance of patients in the Canadian and Swiss samples was consistently lower on all FCE items. This association remained statistically significant after controlling for potential confounders. CONCLUSIONS: Considerable differences were observed between settings in maximum weight handled on the various FCE items. Future FCE research should examine the effects of a number of potentially influential factors, including variability in evaluator judgements across settings, the evaluator-patient interaction and patients' expectations of the influence of FCE results on disability compensation.

Alberta↗