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PubMed2006

Reliability and agreement of 5 Ergo-Kit functional capacity evaluation lifting tests in subjects with low back pain.

OBJECTIVE: To assess interrater reliability and agreement of 5 Ergo-Kit functional capacity evaluation lifting tests in subjects with low back pain (LBP). DESIGN: Within-subjects design, with 2 repeated measurements. SETTING: Academic medical center in The Netherlands. PARTICIPANTS: Twenty-four subjects (10 men, 14 women) with LBP. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Five Ergo-Kit lifting tests (2 isometric, 3 dynamic) were assessed on 2 occasions (t1, t2), by 2 different raters (R1, R2). The interval between the test sessions was 3 days. Interrater reliability level was expressed with the intraclass correlation coefficient (ICC), and the level of agreement between raters with the standard error (SE) of measurement. RESULTS: ICCs means (reliability) of isometric and dynamic Ergo-Kit lifting tests ranged from .94 to .97, and SE of measurement values (agreement) ranged from 1.9 to 8.6 kg. CONCLUSIONS: There was good reliability and agreement between raters of the isometric and dynamic Ergo-Kit lifting tests in subjects with LBP, which supports the use of these tests to assess functional lifting capacity.

Adult↗
PubMed2000

[Value of the ERGOS work simulator as a component of functional capacity assessment in disability evaluation].

The use of assessment instruments in evaluating functional capacity is an important element in the process of social-medical judgement of whether a person will likely be able to reintegrate into working life. Standardized work processes are used in simulating occupational reality over several hours, with all the requirements involved, and the performance found is contrasted with the requirements to be expected at a workplace. Time-tested in the U.S. for more than 20 years and applied throughout Germany for some two years now, the ERGOS work simulation system is presented in the article, using a case example for more detailed description. Using five different work stations, performance data are collected for job tasks such as carrying, working in kneeling position or overhead, and subjected to computer-based comparison with the job requirements information contained in relevant databases. This enables computerized identification of excessive demands, and hence may point to a need for further rehabilitative action. An important feature is objective assessment, as subjective information on the basis of observation or reports of painfulness are raised separately, hence do not influence the findings of the work simulation performed.

Computer Simulation↗
PubMed2000

[Functional capacity after peripheral nerve lesion: significance of pain syndromes].

INTRODUCTION: The loss of functional capacity by peripheral nerve lesion is easy to be estimated: A certain neurologic dysfunction results in a characteristic reduction of the former individual capacity. In contrast, the effect of accompanying pain to every-day life and working ability is not known exactly. In this study, we compared the results of judgement in nerve lesions under the circumstances of additional pain syndromes. METHODS: From January 1994 until December 1998 we saw 57 patients with peripheral nerve lesions, part of them with an additional pain syndrome. Beside conventional neurological examination a detailed pain analysis has been done. RESULTS: Lesions of the median or ulnar nerves showed regularly disturbances in neurological functions (10/14 for the median nerve, 13/16 for the ulnar nerve). Astonishing is the fact, that serious pain after nerve lesion only occurs in cases of partial nerve lesion. We saw neuralgias in 6 patients with ulnar neuropathy, in three cases of median nerve lesions we could see severe neuralgia (causalgia we found in 3 cases of ulnar neuropathy, in 6 cases after Median Nerve lesion). Patients with a lesion of the central plexus brachialis showed in 10 of 11 cases an additional pain syndrome. Other nerves have been affected more rarely. For the judgement of the loss of earning capacity we saw an additional pain related diminuition of at least 10% compared to those patients without pain problems. CONCLUSIONS: The common grading scales for peripheral nerve lesions are not suitable in cases accompanied by an additional pain syndrome. Beside a functional deficit the effect of severe pain in these patients has to be estimated. On an average, patients with additional pain-problems get a 10% extended loss of earning capacity, even more in particular cases.

English Abstract↗
PubMed1982

I. Evaluation of the functional capacity of stroke patients through an activity index.

An evaluation instrument, the Activity Index (AI), has been constructed for measuring the functional capacity of stroke patients from the acute phase of the disease onwards. The Index consists of 16 variables divided into three main parts: mental capacity, motor activity, and ADL function. The maximum score is 92. In a group of 112 stroke patients the Cronbach alpha reliability coefficient for the total AI was 0.94, indicating a high degree of homogeneity of the test. The Spearman rank correlation coefficient between the AI and the Rankin disability scale was -0.94. The results of a bivariate linear regression analysis between the values of the Activity Index on admission (about 48 hours after the stroke) and the scoring on later test occasions, grouped as dead, low score, medium score, high score, respectively, indicated the instrument's high predictive validity. The AI can be used by different categories of trained staff in clinical practice or clinical research.

Activities of Daily Living↗
PubMed1994

Hürthle cell neoplasms of the thyroid gland: reassessment of functional capacity.

We treated a hyperthyroid man and a euthyroid woman who had autonomously functioning Hürthle cell adenomas and demonstrated uptake of radioactive 131I in a woman with recurrent Hürthle cell carcinoma. Since these tumors are thought to be inactive, we reassessed the functional capacity of Hürthle cell neoplasms by reviewing the medical records of all patients operated upon for these tumors at our medical center from 1950 through November, 1993. We also reviewed series of Hürthle cell neoplasms identified from a MEDLINE search of papers published from 1960 to November, 1993. We identified 92 patients with Hürthle cell neoplasms. Thyroid scintigraphy was performed in 28 of 72 patients with benign adenomas and six of 20 patients with Hürthle cell carcinomas. In addition to the two index cases, four euthyroid patients had hot nodules that partially suppressed the extranodular tissue; seven patients had warm nodules. Thyroid scans performed in patients with Hürthle cell carcinomas revealed five cold nodules and one warm nodule. Our index patient with carcinoma displayed elevated serum thyroglobulin levels when the cancer recurred. This patient and another had uptake of 131I by recurrent or metastatic cancer that allowed for treatment with this nuclide. Of 539 patients identified in a literature survey, 489 had benign Hürthle cell adenomas and 50 had Hürthle cell carcinoma. Thyroid scans performed in 282 patients revealed 247 cold nodules, 20 warm nodules, and 8 hot nodules. Our results, added to those published in case series of Hürthle cell neoplasms, indicated that 4.4% of thyroid scans were hot and 8.9% were warm.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1983

Functional capacity and rehabilitation of recipients with a functioning renal allograft for ten years or more.

Forty-nine renal transplant recipients who had a single functioning allograft for ten or more years are reviewed. There were 17 cadaver recipients and 32 living-related recipients. Most patients have enjoyed excellent long-term renal function with stable mean daily dosages of azathioprine and prednisone. Fifty-three percent of patients never experienced a rejection episode, and 24% of patients experienced only one rejection episode. Five recipients (10%) developed malignancy following transplantation. Based on the Karnofsky activity scale, 80% of patients enjoyed unrestricted activity at ten years posttransplant. The two major factors contributing to declining activity were progression of systemic diseases such as atherosclerosis or diabetes, and declining allograft function. Following transplantation, all patients developed renewed interest in sexual activity, all men were potent, and all women experienced regular menses. Nine men achieved fatherhood and five women underwent successful pregnancy. Currently, 46 recipients are alive with a functioning allograft. These data confirm the ability of recipients with a long-term functioning renal allograft to return to the work force, participate in preillness levels of activity, and enjoy sexual activity and parenthood.

Activities of Daily Living↗
PubMed1996

Maximal effort during functional capacity evaluations: an examination of psychological factors.

BACKGROUND AND PURPOSE: Patients with low back pain are often administered a Functional Capacity Evaluation (FCE) to determine levels of physical functioning at the conclusion of their rehabilitation program. The purpose of this study was to examine the relationship between psychological factors (ie, self-reported disability, anxiety, depression, self-efficacy) and maximal effort exerted during the FCE. SUBJECTS AND METHODS: Sixty-four patients with low back pain were administered the the Oswestry Low Back Disability Questionnaire, Beck Depression Inventory, State-Trait Anxiety Inventory, and the FCE Self-Efficacy Scales before administration of the FCE. RESULTS: Compared with patients who gave maximal effort during the FCE, patients who did not exert maximal effort reported significantly more anxiety and self-reported disability, and reported lower expectations for both their FCE performance and for returning to work. There was also a trend for these patients to report more depressive symptomatology. CONCLUSIONS AND DISCUSSION: Results provide evidence for the relationship between self-reported disability, depression, anxiety, self-efficacy, and patients' performance on the FCE. Suggestions for addressing the psychological factors in a comprehensive pain treatment program are provided.

Activities of Daily Living↗
PubMed2003

Psychosocial factors and functional capacity evaluation among persons with chronic pain.

Psychosocial factors have been found to have a significant impact on functional activity, particularly among persons with chronic pain. While various systems have been developed to assess functional limitations through functional capacity evaluation (FCE), assessment of psychosocial factors that may impact function have been largely ignored. This paper examines the existing literature on psychosocial factors and FCE performance. Given that there are few studies that have directly addressed this issue, the paper also examines psychosocial factors that have been found to influence function in persons with pain. The results of the literature review indicate that few psychosocial factors have been found to be directly associated with FCE and functional measures, although many are related to various measures of disability. The strongest evidence that psychosocial factors are related to functional performance is based on the studies examining the association between functional activity and pain-related fear, self-efficacy, and illness behavior. Psychosocial factors have also been shown to influence measures of sincerity of effort often obtained during FCE. Proposals for modifying FCE assessment are given based on the available data, as well as suggestions for future research.

Anxiety↗
PubMed1980

[Conservation of the functional capacity of the isolated liver during its hypothermic perfusion with eryhem: experimental study].

The functional capacity of the dog's isolated liver was studied in experiment during a 3-hour period of conservation by the method of hypothermal (+8 degrees) perfusion with a solution containing free hemoglobin in concentration 1,8--2,0 g% and under conditions of the following normo-thermal artificial circulation of blood in the isolated organ. It was established that the presence of erygem as a component of the perfusate enables oxygen requirements of the preserved liver to be fully satisfied.

Animals↗
PubMed1997

Functional capacity of the liver after two-thirds partial hepatectomy in the rat.

BACKGROUND: Liver cell proliferation after partial hepatectomy in rats has been thoroughly investigated. Although DNA synthesis and morphologic restoration have been studied in this rat model, the functional capacity of the remnant liver during regeneration has not been elucidated. METHODS: We measured the indocyanine green disappearance rate (ICG-k) and serum aminopyrine (CLamp) in rats at various intervals after two-thirds hepatectomy. Morphologic restoration of the liver after hepatectomy was evaluated on the basis of remnant liver weight, proliferating cell nuclear antigen labeling index, and the DNA content of the regenerating liver. Serial changes in ICG-k and CLamp after two-thirds hepatectomy were compared with the degree of morphologic restoration. RESULTS: ICG-k and CLamp were reduced by one third in rats after two-thirds hepatectomy. Although the rate of restoration of remnant liver weight was steady after hepatectomy, ICG-k and CLamp were lowest about 36 hours after hepatectomy. The restoration of ICG-k was comparable to that of liver weight, but the restoration of CLamp was delayed. CONCLUSIONS: Functional liver capacity was minimal during parenchymal cell mitosis in the regenerating liver. Functional restoration after two-thirds hepatectomy was delayed in comparison with morphologic restoration in rat.

Aminopyrine↗
PubMed1977

Functional capacities and the adenylate energy charge in Escherichia coli under conditions of nutritional stress.

Functional capacities in Escherichia coli cells starved for glucose were examined by comparing protein synthesis, utilization of new substrates, and maintenance of viability with the adenylate energy charge of the culture. When growth ceased because of glucose exhaustion in an E. coli culture, the energy charge dropped from 0.90 to about 0.80. During this time, the viable-cell count and the capacity for protein synthesis and for induction of new enzymes were maintained only if other substrates were available in the medium. The culture could be maintained for many hours without growth or death if glucose was added slowly; the energy charge in this case stabilized at about 0.80. A consistent transient decrease in the energy charge to around 0.80, accompanied by a decrease in protein synthesis, was also observed during the adaptation from glucose to other substrates during diauxic growth on glucose and glycerol or lactose.

Acetates↗
PubMed1999

Effects of an antihypertensive medication on functional capacity under simulated flight-typical stress-conditions.

A model to investigate the functional capacity (psychomental performance) under stressful conditions was developed. Twenty eight patients with mild hypertension receiving Nitrendipine (20 mg) for 30 days were tested under hypoxic (16% oxygen) and/or orthostatic (-30 mmHg lower body negative pressure) conditions using a subset of the AGARD battery. The main effect was a decreasing performance of the grammatical reasoning task (GRT) under hypoxia or the combination of hypoxia and orthostasis. A simultaneous application of stressors while performing psychometric test batteries may be useful to reveal pharmaceutical influences on human performance and may help to recommend the use of drugs in occupational medicine.

Aerospace Medicine↗
PubMed1995

[Early physical conditioning of patients surgically treated for myocardial revascularization. Influence on the functional capacity].

PURPOSE: To evaluate the early physical conditioning (PC) effect [initiated 15 days after the myocardial revascularization surgery (MRS)] in the functional capacity. METHODS: Twenty-two male patients (mean-age of 52y-o), divided in two groups (A and B, 11 patients each), were studied. Group A started PC 3 months after MRS (phase III), with a training intensity of about 70% of the maximum heart rate reserve, during three months, three sessions per week with one hour duration. Group B started PC 15 days after the MRS (fase II), with a training intensity up to five metabolic unities, three times a week, 1 hour and 15 duration. The post-MRS period of three months was designated as the time I (beginning of fase III) and six months as time 2. Stress test, Kraus-Weber flexibility test, coxo-femural flexibility test (flexion, elevation and abduction) and scapule-umeral flexibility test (flexion, extension and abduction) were applied. RESULTS: The maximum oxygen uptake and the total work increased significantly from time 1 to time 2 in both groups, but there was no significant difference between the two groups, either in time 1 or 2. Flexibility in the Kraus-Weber test and in the scapule-umeral flexibility test when in flexion, were significantly greater in group B than A, in both times (1 and 2). Other flexibility variables studied show no significant difference, neither between the studied groups nor in the times 1 and 2 of evaluation. CONCLUSION: Early PC after MRS increased the value of two variables that measure flexibility. However, it has not increased other flexibilities variables and the aerobic capacity.

Analysis of Variance↗
PubMed1996

[Measuring functional capacity in backache patients in rehabilitation: a comparison of standardized questionnaires].

In recent years, subjective assessment of functional ability by patients has become an important diagnostic instrument in rehabilitation medicine. We compared three self-administered standardized questionnaires for measuring functional capacity in patients with back pain (the back pain-specific version of the Hannover Functional Ability Questionnaire, the Roland & Morris Scale, and the Measurement of Patient Outcome Scales) with respect to feasibility, reliability, and validity. The sample comprised 119 patients treated for back pain in a rehabilitation clinic in North Germany. Besides measures of functional ability, anamnestic and psychosociological data were collected in addition. Mobility of the spine was assessed by simple clinical tests. The three questionnaires differed only slightly with regard to their psychometric properties and appeared to be equally well suited for measuring functional ability in patients with back pain. The decision for one of the instruments should be based on practical considerations (time for completion, feasibility, availability of reference data).

Activities of Daily Living↗
PubMed1977

Measurement of functional capacity with visual analogue scales.

The value of three visual analogue scales for measuring aspects of functional capacity was assessed in 22 patients with rheumatoid arthritis receiving long-term treatment. A scale in which patients were allowed to choose a function which was a particular problem gave the best results, with more severe initial impairment and greater change with treatment. This scale was as useful as pain in assessing the result of treatment.

Arthritis, Rheumatoid↗
PubMed2003

Construct validity of a kinesiophysical functional capacity evaluation administered within a worker's compensation environment.

The construct validity of a kinesiophysical Functional Capacity Evaluation (FCE) administered within a worker's compensation context was examined. A cross-sectional study design was employed. Clinical and demographic information on workers' compensation claimants was extracted from a rehabilitation facility's database. Measures of interest were the Isernhagen Work Systems' (Duluth, MN) FCE, the Pain Disability Index (PDI), and a pain visual analogue scale (VAS). A multitrait Pearson correlation matrix was created to observe the pattern of relationships between variables. The sample consisted of 321 subjects with work-related, medically stable low back pain of median duration of 307 days. FCE performance was moderately correlated with the PDI (r = -0.44-0.52) and with the pain VAS (r = 0.34-0.45). Pain intensity was correlated highly with the PDI (r = 0.79). The moderate relationship between FCE and the PDI supports the construct validity of FCE as a functional measure. However, kinesiophysical FCE performance was not unrelated to pain severity ratings as purported.

Chronic Disease↗
PubMed1991

Functional capacity in two elderly populations aged 75 or over: comparisons at 10 years' interval.

The functional capacity of two different non-institutionalized elderly populations and the resources available were compared in the same geographical area at 10 years' interval. The study shows that a 1.5-fold increase in the non-institutionalized population aged 75 or over combined with a fixed number of institutional beds in 10 years resulted in more disability among the elderly at home. The nursing home population at the latter point of time was older and showed a higher mortality, indicating increased pressure and selection to the nursing home. The first study comprised 82.8% and the second 89.2% of all community-living persons aged 75 or over. In 1988, the functional status of the aged living at home was significantly lower than in 1978, in 8 out of 12 functional activities of daily living (ADL). The Basic ADL Index decreased significantly both in men and in women, and mobility also deteriorated. The Instrumental ADL Index decreased significantly in men, while the Index was equally poor in women in both interviews. The poor functional status of the elderly in 1988 was accompanied by moving to the town centre and considerably improved housing standards. Home care services had more than doubled, and home nursing visits had also increased.

Activities of Daily Living↗