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Exercise testing in special situations: ER, preoperative and disability evaluation.

In a number of medical centers, exercise testing has proven to be a safe and useful tool in the evaluation of patients presenting chest pain in an emergency room. At these centers, after a period of observation without evidence of acute myocardial infarction, exercise testing is done. If the exercise test result is normal, the patient is discharged from the emergency room, without being admitted to the hospital. Exercise testing is a well-accepted noninvasive method to evaluate at-risk patients being considered for elective noncardiac surgery. Exercise testing is frequently used to determine functional capacity during disability assessment.

Chest Pain↗

Monitoring population disability: evaluation of a new Global Activity Limitation Indicator (GALI).

OBJECTIVE: To evaluate a single item instrument, the Global Activity Limitation Indicator (GALI), to measure long-standing health related activity limitations, against several health indicators: a composite morbidity indicator, instruments measuring mental health (SCL-90R, GHQ-12), physical co-morbidity and physical limitations (ADLs, SF-36). METHODS: Cross-sectional data (n = 9168) of the 2001-National Health Interview Survey in Belgium was used to compare the GALI with other health indicators across gender, age, educational attainment and language. RESULTS: Responses to the GALI were similar to responses to other indicators of physical limitations (Limitations in Activities of Daily Living (by severity or by number of limitations), the SF-36 physical domain), to an indicator of chronic physical comorbidity and to indicators of mental health. The probability of reporting absence of long-standing activity limitation with the GALI was high in subjects without physical limitations or physical or mental conditions. This probability decreased as the severity or number of limitations, the number of physical or mental conditions increased. CONCLUSIONS: The GALI performs appropriately against other health indicators and appears to reflect long-standing activity limitation associated with both mental and physical conditions.

Activities of Daily Living↗