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PubMed1990

Functional capacity and mental status of elderly people in long-term care in west Glasgow.

Functional capacity and mental status were assessed in 821 patients in long-term care in West Glasgow. In geriatric medical long-term care only five (1.3%) out of 387 patients were independent in activities of daily living (walking, transfers from bed and chair, dressing, toileting, urinary and faecal continence) and were not severely mentally impaired (AMT score greater than 6/10); in psychogeriatric care n = 6/143 (4.2%) in private nursing homes n = 6/66 (9.1%) and in residential care n = 100/235 (42.6%). Patients in geriatric medical care had a greater prevalence of immobility and urinary incontinence but less mental impairment than those in psychogeriatric care. Nearly all patients placed in geriatric medical or psychogeriatric care had major functional disability or mental impairment. The level of disability was less in private nursing than in geriatric medical care. Although 57% of those in residential care required some assistance or supervision in activities of daily living or had severe mental impairment, 86% were independent in walking and 83% were continent of urine. The implications of these findings for the provision of care for physically and mentally frail elderly are discussed.

Activities of Daily Living↗

PubMed1988

The effects of pressure-induced cardiac hypertrophy on the functional capacity of the coronary circulation.

Pressure-induced cardiac hypertrophy has many effects on the functional capacity of the coronary circulation. Many studies have been performed in both animal and humans and the major findings are as follows: 1. Most types of myocardial hypertrophy are associated with the decrement in coronary vasodilator reserve; 2. The magnitude of the decrement in coronary reserve in myocardial hypertrophy is usually much more prominent in patients with myocardial hypertrophy than in animal models; 3. Left ventricular hypertrophy secondary to systemic hypertension is associated with altered autoregulation of myocardial perfusion; 4. The perfusion abnormalities associated with hypertension and left ventricular hypertrophy are affected by various factors such as age of onset, ventricular involvement, and the stimulus for hypertrophy; 5. Left ventricular hypertrophy secondary to renal hypertension markedly augments the adverse effects of coronary occlusion. In this setting, coronary occlusion is associated with a three-fold increase in the incidence of lethal ventricular arrhythmias and a 35% increase in infarct size. Thus, pressure-induced hypertrophy profoundly alters the coronary circulation.

Angina Pectoris↗

PubMed1981

Compensation mechanisms for experimental reduction of the functional capacity in the guinea pig placenta. II. Changes in the trophoblast of the labyrinth.

The functional capacity of the placenta of the guinea pig has been reduced in four different ways. It has been investigated whether changes in the trophoblast of the labyrinthine part of the placenta occurred which could be interpreted as a compensation mechanism for the reduction of the capacity. No significant decrease of the thickness of the maternofetal barrier could be measured nor did enlargement by microvilli of the apical and basal surface of the syncytium change significantly. Activities of the enzymes glucose-6-phosphate dehydrogenase, lactate dehydrogenase, glucose-6-phosphatase and adenosine triphosphatase showed a great variation, but no differences in activities could be demonstrated. Further, the number of cytotrophoblastic cells was widely spread and no significant difference could be observed, although sometimes large and apparently newly formed parts of lobulus were observed.

Animals↗

PubMed2005

Functional capacity evaluation performance does not predict sustained return to work in claimants with chronic back pain.

OBJECTIVES: Functional Capacity Evaluation (FCE) is used to determine return-to-work readiness. We investigated the ability of the Isernhagen Work Systems' FCE to predict sustained return-to-work and future pain and disability in workers' compensation claimants with chronic back pain. METHODS: Prospective study of 130 claimants undergoing FCE for chronic back problems. FCE indicators included number of failed tasks and floor-to-waist lift weight. Recovery indicators included days to suspension of time-loss benefits and future recurrence. Subjects were contacted after one year to determine pain intensity and disability. Analysis included Cox and logistic regression. RESULTS: Fewer failed tasks (HRR 0.94 (0.91-0.98) and higher floor-to-waist lift (HRR 1.38 (1.17-1.62) were associated with faster return-to-work. FCE was not associated with future recurrence, or reported pain intensity, or disability in subjects reached for follow-up. CONCLUSIONS: Better FCE performance was mildly associated with indicators of faster return-to-work. However, FCE is not related to recurrent back problems, future pain intensity, or self-reported disability.

Adult↗

PubMed2002

Validating the Functional Capacity Index as a measure of outcome following blunt multiple trauma.

BACKGROUND: The validity of the Functional Capacity Index (FCI) is evaluated by examining its distributional characteristics, its correlation with other well-known measures of outcome and its ability to discriminate among persons with injuries of varying type and severity. METHODS: A telephone survey which included the FCI and the SF-36 was administered 1 year post-injury to 1240 blunt trauma patients discharged from 12 trauma centers. A subsample of 656 patients also completed the Sickness Impact Profile (SIP) by mail. RESULTS: FCI scores correlated well with the physical health subscores of the SIP and SF-36. They also correlated well with self-reported change in health status and return to work. The FCI, when compared to either the SF-36 or the SIP, however, appears to discriminate better among patients according to the presence and severity of head trauma. CONCLUSIONS: While further testing of the FCI is needed, it holds promise as a preference based measure for assessing the physical impact of trauma.

Activities of Daily Living↗

PubMed1991

Associations between functional capacity and work ability among elderly municipal employees.

The relationship between objectively measured physical and mental functional capacity and work ability was studied among 137 workers with a mean age of 55 years. Of the physical capacity tests muscular strength correlated the best with the constructed work ability index. Cardiorespiratory capacity and work ability did not correlate statistically significantly. About 50% of the subjects was classified uniformly, and less than 10% not uniformly, with respect to muscular strength. The correlation between cardiorespiratory capacity and work ability was significant for those without, but not for those with, a musculoskeletal disease. The mental capacity tests had systematically lower correlations with work ability than the tests for physical capacity. The highest statistically significant correlation was found between visuomotor speed and work ability. Objective measurements of muscular strength seem useful for defining work ability, but other tests need to be improved to be more work-related. Furthermore, musculoskeletal diseases should be checked for when cardiorespiratory capacity is assessed.

Aging↗

PubMed2002

Transplantation of adrenal tissue fragments in a murine model: functional capacities of syngeneic and allogeneic grafts.

Oral hormone substitution for the treatment of Addison's disease inadequately replaces the physiologic circadian secretion of corticosteroids. Alternative therapeutic approaches are reimplantation of healthy autologous adrenal tissue and allogeneic transplantation (Tx), respectively. The aim of our study was to evaluate the functional capacity of adrenal grafts and the influence of intercellular adhesion molecule-1 (ICAM-1) on graft survival. Fragmented adrenal glands of wild-type B10.BR (H-2k) and wild-type or ICAM-1-deficient BALB/c (H-2d) mice were transplanted underneath the kidney capsule of adrenalectomized B10.BR mice [complete major histocompatibility complex (MHC) haplotype disparity in the latter]. Postoperatively, the endocrine function of the adrenal grafts was evaluated by the following parameters: (1) survival analysis of the recipients (termination at day 70 after Tx); (2) reverse transcription-polymerase chain reaction expression analysis of aldosterone synthase (zona glomerulosa-specific) and of 11b-hydroxylase (zona fasciculata-specific); and (3) measurement of basal adrenocorticotropic hormone (ACTH) stimulated serum corticosterone levels. Expression of both enzyme-specific mRNAs was detected in the grafts at any time during the post-Tx period. The adrenal grafts of syngeneic and surviving MHC-disparate mice displayed a similar basal hormone secretion, which was about 60% lower than that in sham-operated animals. In the transplanted mice, ACTH-stimulated corticosterone measurement revealed a 5- to 10-fold decreased functional reserve capacity. ICAM-1 deficiency significantly prolonged the survival of adrenal grafts. Fragmented adrenal grafts are able to maintain physiologic basal corticosterone levels but had markedly reduced reserve capacity. Nevertheless, the results give rise to hopes that autologous or MHC-compatible allogeneic transplantation of adrenal grafts may replace oral hormone substitution in humans.

Addison Disease↗

PubMed1981

Functional capacity of suprarenal cortex in patients on long-term dialysis.

The authors have repeatedly examined the functional capacity of suprarenal cortex in patients on long-term dialysis by means of ACTH stimulation test. Out of 148 examinations, normal reaction was found in 111 cases, partially insufficient in 16 cases, and fully insufficient in 21 cases. Primary suprarenal insufficiency is considered for the reason of insufficient production of cortisol which develops due to enforced changes of regulatory mechanism in glucocorticoids production as a reaction on repeated long-term losses of cortisol through semipermeable membrane. According to the authors, the mentioned facts are of great significance since they may result in changes which influence the survival of patients on long-term dialysis in a negative way.

11-Hydroxycorticosteroids↗

PubMed1990

Effects of long-term coenzyme Q10 and captopril treatment on survival and functional capacity in rats with experimentally induced heart infarction.

The effects of coenzyme Q10 (CoQ) and captopril on functional capacity, hemodynamics and survival were studied in 154 rats that recovered after experimental myocardial infarction. Rats were randomized into four groups receiving either CoQ, captopril, a combination of the two drugs or 1 ml of tap water once daily for 12 weeks from the day of coronary artery ligation. CoQ as well as captopril and the combined treatment significantly improved exercise capacity as evaluated by lactate production during a standardized treadmill exercise test. No significant changes in heart rate or mean blood pressure were observed during the study in the captopril-treated group. CoQ treatment increased the maximum heart rate significantly, whereas no effect on mean blood pressure was observed. Both captopril and CoQ decreased pulmonary congestion. Furthermore, the data may suggest that captopril prevents right ventricular hypertrophy seen in placebo-treated rats with large infarcts. This was not observed after CoQ treatment. Captopril treatment improved 3-month probability of survival (93%) as compared with placebo (74%) (P less than .05). CoQ and the combined treatment tended to improve survival, but this was, however, not statistically significant.

Animals↗

PubMed2002

Lochial secretions of Escherichia coli- or Arcanobacterium pyogenes-infected bovine uteri modulate the phenotype and the functional capacity of neutrophilic granulocytes.

It has been suggested that in cases of puerperal endometritis of cattle infected with Escherichia coli and Arcanobacterium pyogenes, the neutrophils are compromised in their defense capacity or downregulated functionally. In addition to direct bacterial effects, contents of lochial secretions and secreted products of locally activated polymorphonuclear neutrophilic granulocytes (PMNs) may also account for changes in function of freshly immigrating neutrophils. In this study, lochial secretions were obtained from healthy cows and from cows infected by E. coli or A. pyogenes. Separated uterine PMN of infected cows displayed an altered phenotype and function which correlated with the degree of bacterial contamination. Concurrently tested circulating PMN showed no such changes. Infected lochial secretions sterilized by filtration also changed the phenotype of blood PMN. Lochial secretions of healthy cows displayed only minor effects. The effects on PMN function in infected cows varied: ingestion was less affected, whereas generation of reactive oxygen species (ROS) was severely depressed. Concurrently tested purified bacterial products (solubles and fragments) of E. coli and A. pyogenes did not induce the phenotypical and functional changes observed in blood PMN. Since infected lochia also contained high numbers of immigrated and probably activated PMN, the influence of supernatants from phorbol myristate acetate-activated PMN were tested on freshly isolated blood PMN. Such supernatants also increased the expression of certain surface molecules and inhibited the ROS generation. Thus, reduced function and altered phenotypes of PMN which immigrate into the uteri of cows with bacterial endometritis is due not only to interactions with bacteria or bacterial products, but is also to the uterine milieu.

Actinomycetaceae↗

PubMed2000

The effect of high intensity exercise on the functional capacity of equine pulmonary alveolar macrophages and BAL-derived lymphocytes.

The effect of strenuous exercise on the functional capacity of pulmonary alveolar macrophages (PAM) and bronchoalveolar lavage-derived lymphocytes was determined in eight horses prior to and after 7 weeks of training. Strenuous exercise had no effect on the total cell count or the percentage of live cells in bronchoalveolar lavage (BAL) samples prior to or following training. However, training was associated with a significant increase in the total cell count of pre-exercise BAL samples and a significant reduction in the percentage of live cells in post-exercise samples. Strenuous exercise was associated with impaired phagocytosis by PAM after 7 weeks of training but had no effect on similar samples obtained from untrained horses. The oxidative burst activity of PAM was significantly increased following strenuous exercise for both untrained and trained horses. BAL -derived lymphocyte oxidative burst was similarly affected following training. These results suggest that strenuous exercise and training may influence pulmonary immune cell function.

Animals↗

PubMed2003

Inhibition of Fas/Fas ligand signaling improves septic survival: differential effects on macrophage apoptotic and functional capacity.

Signaling through the Fas/Fas ligand (FasL) pathway plays a central role in immune-cell response and function; however, under certain pathological conditions such as sepsis, it may contribute to the animal's or patient's morbidity and mortality. To determine the contribution of FasL to mortality, we conducted survival studies by blocking Fas/FasL with Fas receptor fusion protein (FasFP) in vivo. C3H/HeN mice received FasFP or the saline vehicle (veh) immediately (0 h) or delayed (12 h), after sepsis induced by cecal ligation and puncture (CLP). Subsequently, we examined the effect of FasFP treatment (12 h post-CLP) on macrophage apoptosis and functional capacities. Peritoneal and splenic macrophages and Kupffer cells from sham-veh-, CLP-veh-, sham-FasFP-, or CLP-FasFP-treated mice were harvested 24 h after CLP and stimulated with lipopolysaccharide (LPS) for 24 h. The results indicate that only delayed (12 h) but not 0 h administration of FasFP demonstrated a significant increase in survival. The ability of all macrophage populations to release interleukin (IL)-6 was significantly depressed, and IL-10 release was augmented after CLP. FasFP treatment attenuated the increased IL-10 release in Kupffer cells. However, althogh enhanced susceptibility to LPS-induced apoptosis could be suppressed in CLP mouse Kupffer cells by FasFP, FasFP did not change the peritoneal or splenic macrophage response. Furthermore, FasFP attenuated the elevated plasma levels of liver enzymes after sepsis. These data indicate that in vivo inhibition of Fas/FasL signaling has tissue-specific effects on the induction of macrophage apoptosis, functional changes, and liver damage, which may contribute to the host's ability to ward off a septic challenge.

Animals↗

PubMed2002

Functional capacity of the thyroid autograft: an experimental study.

BACKGROUND: The aim of this study was to investigate the functional capacity of thyroid autografts after total thyroidectomy in a rabbit model. MATERIAL AND METHODS: Thirty-eight rabbits underwent total thyroidetomy. One of the two thyroid lobes was cut into 1-mm pieces and was introduced intramuscularly into the right quadriceps muscle (group A, n = 10), the right rectus abdominalis muscle (group B, n = 10), and the right sacrodorsalis muscle (group C, n = 10). Another group of 8 rabbits underwent total thyroidectomy without autologous implantation and served as the control group (group D). The animals were observed for 8 weeks with weekly measurements of thyroid hormones. At the end of the 8th week, a scintigram was performed. The autografts were removed 2 days later. RESULTS: The thyroid hormone levels showed a gradual decrease until the 2nd-5th week after implantation, followed by a gradual increase and establishment of euthyroid levels between the 5th and 8th weeks. Respectively, an increase of thyreotropin hormone was noted with maximal values in the 4th week, followed by a gradual decrease until the end of the 8th week. The scintigram at the end of the 8th week revealed the presence of functional thyroid tissue in all cases. Functional thyroid follicles were found in all animals who survived. In 35.7% of the autografts, we noted the development of fibrous tissue and gigantocytic granulomas in the periphery, which could be interpretated as a "foreign body" reaction. CONCLUSION: Thyroid autografts can completely substitute thyroid function after total thyroidectomy.

Animals↗

PubMed1996

[Centenarians in the county of Funen. Morbidity and functional capacity].

The aim was to examine the feasibility of a study of centenarians and to describe morbidity and functional capacity of centenarians in the County of Funen. A total of 51 out of 58 centenarians on Funen born on May 1, 1894 or before participated. An interview could be carried out almost completely in 80.4% of the 51 participants, cognitive testing (MMSE) in 78.4% and physical performance test (PPT) in 49%. Additional information on morbidity and activities of daily living (ADL) was collected on all 51 centenarians from family members, nursing staff, GP's, hospital registries and the National Cancer Registry. Almost 3/4 were women and 58.8% were in an old people's home. Osteoarthrosis, urinary incontinence, heart failure, dizziness and eye diseases were found to be frequently prevalent, while hypertension, diabetes, cancer and stroke were found to be rare. Based on Katz' ADL index approx. 1/3 could be considered to be independent of help, while almost everybody was dependent on help for the instrumental activities (IADL). A low average score was found at the PPT, especially the walking speed was found to be very slow. Only 32.5% scored over 23 points at the MMSE, but allowing for severe impairment of vision and hearing more than 1/3 were found to be cognitively well-functioning. Severe dementia was found among 15.7%. Dependency on help for the ADL-functions was not found to be associated with health measurement, but strongly associated with visual function, PPT and MMSE (p < 0.001). The characterization of centenarians as described in a number of foreign studies as being an homogeneous, relatively healthy and independent group could therefore not be confirmed. On the contrary, they were found to be very heterogeneous and characterized by multi-morbidity. By far the great part of them were in addition dependent on help in their activities of daily life. Approx. 1/3, however, were found to be relatively independent of help for basic functions, more than 1/3 were cognitively well-functioning, and a very small number could even manage a few outdoor functions by themselves.

Activities of Daily Living↗

PubMed2003

Relation between isokinetic muscle strength and functional capacity in recreational athletes with chondromalacia patellae.

OBJECTIVES: To investigate the effects of isokinetic exercise on pain and functional test scores of recreational athletes with chondromalacia patellae (CMP) and to examine the correlation between isokinetic parameters and functional tests or pain score. METHODS: The functional ability of 30 recreational athletes with unilateral CMP was evaluated using six different tests. Pain scores were assessed during daily activities before and after the treatment protocol. Isokinetic exercise sessions were carried out at angular velocities of 60 degrees /s (25-90 degrees range of flexion) and 180 degrees /s (full range). These sessions were repeated three times a week for six weeks. RESULTS: Quadriceps and hamstring peak torque, total work, and endurance ratios had improved significantly after the treatment, as did the functional parameters and pain scores. There was a poor correlation between the extensor endurance ratio and one leg standing test. A moderate correlation between the visual analogue scale and the extensor endurance ratio or flexion endurance ratio was also found. CONCLUSIONS: The isokinetic exercise programme used in this study had a positive effect on muscle strength, pain score, and functional ability of knees with CMP. The improvement in the functional capacity did not correlate with the isokinetic parameters.

Adult↗

PubMed1993

Maximal functional capacity in patients with endomyocardial fibrosis.

We evaluated objectively the cardiocirculatory dysfunction of patients with EMF, and related the functional class (FC-NYHA) to the data obtained by analysis of maximal functional capacity. We studied 55 subjects, divided into three groups: group 1 (G1) 21 (38.1%) normal persons, group 2 (G2) seven (12.7%) patients with EMF who were in FC I or II, and group 3 (G3) 27 (49%) patients in FC III or IV. Maximal oxygen consumption (VO2max) and O2 pulse index (PO2max) were obtained using a Beckman computerized gas analyser. The mean values were significantly different among the three groups. We conclude that the greater the clinical impairment, the greater the alterations that occur in the indices of cardiac function.

Adult↗

PubMed1976

[The efficacy of Piracetam on the mental functional capacity of chronic alcoholics (author's transl)].

Piracetam, 1-pyrrolidone acetamid, was tested in 40 chronic alcoholics with a more or less marked psycho-organic syndrome by means of psychological tests. It was a double-blind-cross-over study. Statistical analysis of the results showed that Piracetam improves the energo-functional capacity of the cortex i.e. the basal functions of the cortical cells such as activating capacity, vital dynamic, flexibility, intellectual reactivity and stress tolerance. Apart from the overall improvement we also observed an improvement of specific cerebral performances which is however unimportant in comparison with the greneralized effect.

Alcoholism↗

PubMed2000

The effects of physical training of functional capacity in adults. Ages 46 to 90: a meta-analysis.

BACKGROUND: There is a progressive decline in the functional capacity (FC) of the cardiovascular system with aging. This deterioration is reflected in a decrease in the maximal oxygen consumption (VO2max). The purpose of this quantitative review was to determine the effects of various components of the exercise prescription on FC in older individuals (ages 46-90 years). METHODS: This study synthesized the results of 27 studies by meta-analysis, which generated a total of 34 effect sizes. Each effect size represented an independent measure of the impact of physical training on maximal oxygen consumption (VO2max). A total of 720 subjects were included in this review. The studies were coded according to intensity, session duration, length of training and mode of exercise. RESULTS: A significant difference was found (p < 0.001) in FC between studies in which the intensity of exercise was > or = to 80% of VO2max compared to those with training intensities of 60-75% of VO2max. A significant difference was found (p < 0.002) for exercise duration; namely, a duration of > or = 30 minutes produced significantly greater improvements in VO2max when compared to an exercise duration less than 30 minutes. There was no significant difference reported in FC between studies that lasted 15 or more weeks in duration compared to those that lasted less than 15 weeks. Finally, there was no significant difference reported in FC in studies that utilized a walk/jog training mode compared to those which utilized cycle ergometry. CONCLUSIONS: Despite the inevitable decline in VO2max with aging, exercise training imparts favorable adaptations in FC in individuals well into their seventh and eighth decades of life.

Aged↗