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Results for “Physical Functional Performance”

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PubMed1995

The structure underlying physical performance measures for older adults in the community.

A 6-item physical performance test assessing hand strength/speed, mobility, and balance was administered to 678 elderly people from a Japanese community (age 65-89). A second-order covariance structure model applied to the data revealed that three factors in observed variables (Hand Power, Walking, and Balance) had loadings more than 0.8 on a single higher-order factor, Basic Motor Ability (BMA). The BMA score, or "Physical Performance Age (PPA)", of the individual was calculated on the basis of this model as a unidimensional summary score of physical performances. The PPA predicted the self-reported levels of competence and physical activity with greater accuracy than age alone. The PPA also differentiated those at the high end of the functional spectrum, and thereby not identifiable by use of ordinary self-reported functional measures. The results suggest that a short physical performance battery assessing physical functioning is useful in community-based studies of aging.

Aged↗

PubMed1998

Comparing generic and disease-specific measures of physical and role functioning: results from the Veterans Health Study.

OBJECTIVES: This study compared the performance of generic measures of Medical Outcome Study Short Form 36-Item Health Survey physical functioning and role limitations with disease-specific measures of physical functioning and role limitations using specific disease attributions for chronic lung disease, chronic low back pain, and osteoarthritis of the knee. METHODS: Data were analyzed from the Veterans Health Study among patients receiving Veteran's Administration ambulatory care. Patients identified as having one of the three study conditions were included in the study (n = 932). RESULTS: The study revealed that the generic physical functioning and role limitations scales had higher correlations with other generic SF-36 scales, whereas disease-specific attribution measures had larger R2 values in explaining variability in symptom-based disease severity and larger t statistic values in discriminating the impacts of patients taking medications and having surgery. CONCLUSIONS: The generic measures of physical functioning and role limitations were more applicable in assessing a broad array of health-related quality-of-life issues, whereas disease-specific measures of physical functioning and role limitations were more useful in evaluating clinical management and limitations associated with specific disease conditions. The results of the study suggest that the use of disease-specific attribution assessments was more cost-efficient than the development of new disease-specific instruments. Disease-specific attribution could be used to complement generic measures in assessing patient outcomes.

Activities of Daily Living↗

PubMed1978

A study of former patients placed in private proprietary homes.

The authors report on a study of 1999 residents of 26 private proprietary homes for adults in the metropolitan New York City area; 76 per cent of the residents were former psychiatric inpatients. The former patients were compared with the other residents in areas of physical and psychiatric functioning and social performance; the former patients showed more dysfunction due to psychological problems than the other residents, who tended to be older and suffer from physical problems. The former patients were also categorized into three groups according to whether their needs were considered greater than, less than, or consistent with the level of services provided in the homes; the results suggest that a substantial proportion of former patients may be more appropriately placed in other facilities.

Aged↗

PubMed1975

The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance.

A system for evaluation of motor function, balance, some sensation qualities and joint function in hemiplegic patients is described in detail. The system applies a cumulative numerical score. A series of hemiplegic patients has been followed from within one week post-stroke and throughout one year. When initially nearly flaccid hemiparalysis prevails, the motor recovery, if any occur, follows a definable course. The findings in this study substantiate the validity of ontogenetic principles as applicable to the assessment of motor behaviour in hemiplegic patients, and foocus the importance of early therapeutic measures against contractures.

Ankle↗

PubMed1990

Mental performance during submaximal exercise in 13 and 17% oxygen.

Submarine crews live in atmospheres containing variable levels of O2 and CO2. Under these conditions, significant reduction of the O2 may impair mental function during physical exertion. Therefore, psychomotor performance was measured in exercising men during Hours 26 and 57 of exposure to 21, 17, and 13% O2 in a hypobaric chamber (each gas contained 0.9% CO2, balance N1). Sea-level pressure was used except when reduced to 576 Torr at Hour 57 in 17% O2 (hypobaric-17% O2). At Hour 26 the subjects exercised at 35 and 65% of predicted VO2max They were hypoxic during exercise in 17 and 13% O2, as indicated by reduced SaO2 values (P less than 0.05). The psychomotor test (timed arithmetic) was affected by the exposure condition (P less than 0.05) but not by the work rate. At Hour 57, subjects repeated the arithmetic task at rest and at 65% of predicted VO2max. SaO2 was reduced in hypobaric-17 and 13% O2 (P less than 0.05). The math scores were affected by the work rate (P less than 0.05) but not by the exposure condition. From post-hoc analyses we conclude that 17% O2 does not impair the timed arithmetic task during submaximal exercise at normobaric pressures.

Adult↗

PubMed2004

Get up and go test in patients with knee osteoarthritis.

OBJECTIVE: To determine the reliability, minimum detectable change (MDC), and validity of the Get Up and Go (GUG) test. DESIGN: Repeated-measures test-retest for reliability. Correlational study for validity. SETTING: Institutional practice. PARTICIPANTS: Convenience sample of 130 people, 105 with knee osteoarthritis (OA) (80 women; mean age, 62+/-9 y) and 25 healthy controls (21 women; mean age, 57+/-8 y). INTERVENTIONS: Not applicable. Main outcome measures Western Ontario and McMaster Universities Osteoarthritis Index, the Activity of Daily Living Scale of the Knee Outcome Survey, and the 8 scales of the Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS: Intratester and intertester reliability was.95 (95% confidence interval [CI],.72-.98) and.98 (95% CI,.94-.99), respectively. The MDC, based on measurements by a single tester and between testers, was 1.5 and 1.2 seconds, respectively. Time to perform the GUG test was longer for persons with knee OA than it was for the controls (mean difference, 3.3s; 95% CI, 1.8-4.9). Correlations between the GUG test and measures of physical function did not differ significantly from correlations between the GUG test and measures that do not specifically evaluate physical function. CONCLUSIONS: The GUG test is reliable and has an MDC that is adequate for clinical use. Validity of the GUG test as a single measure of physical function was not supported. Further research should include testing a battery of performance-based measures of physical function.

Case-Control Studies↗

PubMedDate not supplied

Peripheral limiting factors during exercise in chronic lung diseases.

In normal subjects the sensation of general fatigue subjectively limits the physical performance, whereas in patients with reduced respiratory function the sensation of breathlessness is the common limiting symptom. Patients with chronic obstructive lung disease may adopt an intermittent exercise pattern (e.g. when climibing stairs), in which the work periods are brief in duration but relatively high in intensity. The immediate ventilatory demand can in that way be reduced. The local metabolism of the working muscles can meet the increased demand, which demonstrates that peripheral factors are unlikely to limit the physical performance in these patients. For evaluating the importance of peripheral factors limiting the exercise tolerance of daily activities, such as stair-climbing or walking uphill, such activities should specifically be studied considerating also the exercise pattern shown by the patient. Even in bronchitic patients with reduced arterial oxygen tension there are no evidence that the skeletal muscles are working under more anaerobic conditions than in normal persons at the same relative work load. The blood lactate as related to the heart rate usually lies within normal limits. In patients with respiratory failure, however, lack of energy supply from the energy rich compounds may develop. Thus, only in extreme situations can the exercise performance of the respiratory patients be expected to be specifically limited by peripheral factors. Physical inactivity leads to changes in the muscle metabolism as in normal persons with reduced aerobic capacity in the muscles. The specific effects of steroid treatment on the muscle function in patients with chronic obstructive disease have not been studied, but may be an important factor limiting muscular performance at certain types of exercises.

Heart↗

PubMed2000

The Croatian Health Survey--SF-36: I. General quality of life assessment.

The objective of the Croatian Health Survey was the assessment of population health related quality of life in the transitional environment of Croatia. Health status measures incorporate dimensions such as physical, psychological, and social functioning, role performance and perception of wellbeing. In order to assess health status, "The medical outcome study 36-item short-form health survey (SF-36) model" was used. A total sample of 5048 inhabitants (1983 males and 3065 females), 18 years and over, represents approximately 1% of the general population of Croatia. Mean scores were as follows: physical functioning (PF) 69.94, role-physical (RP) 63.01, bodily pain (BP) 64.51, general health (GH) 53.40, vitality (VT) 51.85, social functioning (SF) 72.96, role-emotional (RE) 72.42, mental health (MH) 61.71 and health transition (HT) 44.79. Results of the SF-36 health survey in Croatia are very much like the results in other European countries with indication that general quality of life is lower in Croatia.

Adolescent↗

PubMed2006

Cognition during sustained operations: comparison of a laboratory simulation to field studies.

INTRODUCTION: Military operations, especially combat, expose individuals to multiple stressors, including sleep loss, food deprivation, and sustained physical activity. Civilians, such as woodland firefighters, disaster victims, and relief workers, are also exposed to such environments. Our laboratory developed a brief, intense, laboratory-based simulation of a multistressor environment which included sleep loss, continuous physical activity, and food deprivation. METHODS: During this sustained operations (SUSOPS) scenario, and a control period, cognitive performance and mood were measured in 13 volunteers. The scenario included road marches, battle drills, and land navigation. Physical activity and sleep were assessed with actigraphs. RESULTS: Significant decrements in visual vigilance, choice reaction time, and matching-to-sample, a test of short-term memory, were observed. Marksmanship was stable and physical activity significantly increased. Mood states assessed by the Profile of Mood States (POMS: Tension, Depression, Anger, Vigor, Fatigue and Confusion) also significantly deteriorated. DISCUSSION: Cognitive function declined more extensively and rapidly than physical performance. Decrements in cognitive performance were comparable to those in a field study conducted for an equivalent period of time in uncontrolled conditions. This demonstrates that decrements in cognitive function and increased physical activity, similar to those in highly stressful field environments, can be duplicated under controlled conditions. The simulated SUSOPS scenario is an appropriate paradigm for assessment of adverse effects of military and civilian multistressor environments on human performance, physiology, and interventions designed to mitigate them.

Adult↗

PubMed2006

The functional IME: A linkage of expertise across the disability continuum.

Disability assessment remains a significant challenge especially in welfare systems like workers' compensation and disability insurance. Many of today's managed care strategies do not impact on the seminal issue of return to gainful employment. Employers, insurers, attorneys and case managers routinely request independent medical examinations (IMEs) as a means of determining degree of disability, functional limitations, work restrictions and "estimated" physical capacities. However, this approach is limited because physicians are not trained in the functional model of disability assessment. IMEs address pathology and impairments which represent a portion of the disability continuum described by the World Health Organization, Nagi, Guccione and others [e.g. pathology-impairment-disability-handicap]. Functional capacity evaluations or FCEs are often performed by physical and occupational therapists who are trained in a function-based model of disability assessment. Unlike an IME physician who completes "Estimated Physical Capacities", therapists measure actual physical functioning. The value of both IMEs and FCEs can be enhanced through a "functional IME" that combines both models; medical-based examination and a function-based disability evaluation. This combination enhances the assessment of the relationship of pathology to impairment and impairment to disability status especially, in musculoskeletal disorders which tend to drive costs in workers' compensation.

Humans↗

PubMed2006

Giving meaning to measure: linking self-reported fatigue and function to performance of everyday activities.

Fatigue, a common symptom of cancer patients, particularly those on active treatment, is generally evaluated using self-report methods, yet it remains unclear how self-reported fatigue scores relate to performance of daily activities. This study examines the relationships among self-reported and performance-based measures of function in patients receiving chemotherapy (CT) to link self-reported fatigue measures to self-report and performance-based measures of function. Self-reported fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and self-reported physical function using the physical function 10 subscale of the Short Form 36 (SF-36) (PF-10) were measured in 64 patients within 2 weeks of beginning CT (n=64) and after three cycles of CT (n=48). Motor and cognitive functions were captured using five self-reported and seven observed-performance measures at each time point. Significant correlations between self-reported and observed measures ranged from 0.30 to 0.71. Self-reported fatigue correlated (0.30-0.45) with performance-based function. FACIT-F scores in the range of 30 and below and PF-10 scores in the range of 50 and below were related to an increased difficulty performing everyday activities. Observed measures of physical performance correlate moderately with self-reported fatigue and self-reported physical function. These relationships enable one to begin linking fatigue scores directly to a person's ability to perform everyday activities.

Activities of Daily Living↗

PubMed1994

Physical activity epidemiology as applied to elderly populations.

Physical activity epidemiological studies provide one of many types of research evidence that are necessary to assess the importance of physical activity to health. Available epidemiological evidence, when coupled with relevant experimental and clinical research, suggests that physical activity has the potential to favourably influence the development and progression of a variety of chronic diseases and conditions that are a burden to public health. The evidence is only beginning to emerge for elderly populations, however, thereby highlighting an important void in our scientific knowledge. Attempting to increase the level of physical activity of elderly people raises three important issues. First, improving adherence to a physically active life-style requires assistance of behavioural scientists, either through direct intervention, or through research that can help the elderly identify and overcome impediments to physical activity. Second, many elderly people have diseases that can limit their physical ability, but exercise scientists can assist by prescribing exercise that is both efficacious and safe given the level of limitation. Third, the number of injuries may increase with increased physical activity in elderly persons. Epidemiologists and exercise scientists working in the area of injury control can determine which activities are safe at specific levels of physical ability and function. To quote one of the originators of exercise physiology, Per Olaf Astrand (1992), 'As a consequence of diminished exercise tolerance, a large and increasing number of elderly people will be living below, at, or just above "thresholds" of physical ability, needing only a minor intercurrent illness to render them completely dependent'. Physical activity can help to push back that 'threshold of physical ability' and thereby improve physical functioning. As physical function improves, there is a propensity to perform even greater amounts of physical activity that may be essential to the quality and perhaps quantity of life for an elderly person.

Adult↗

PubMed2003

A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS).

OBJECTIVES: To determine the effectiveness of vitamin D and home-based quadriceps resistance exercise on reducing falls and improving the physical health of frail older people after hospital discharge. DESIGN: Multicenter, randomized, controlled trial with a factorial design. SETTING: Five hospitals in Auckland, New Zealand, and Sydney, Australia. PARTICIPANTS: Two hundred forty-three frail older people. INTERVENTIONS: Patients were randomized to receive a single dose of vitamin D (calciferol, 300,000 IU) or placebo tablets and 10 weeks of high-intensity home-based quadriceps resistance exercise or frequency-matched visits. MEASUREMENTS: The primary endpoints were physical health according to the short-form health survey at 3 months and falls over 6 months. Physical performance and self-rated function were secondary endpoints. Assessments took place in the participants' homes at 3 and 6 months after randomization and were performed by blinded assessors. RESULTS: There was no effect of either intervention on physical health or falls, but patients in the exercise group were at increased risk of musculoskeletal injury (risk ratio = 3.6, 95% confidence interval = 1.5-8.0). Vitamin D supplementation did not improve physical performance, even in those who were vitamin D deficient (<12 ng/mL) at baseline. CONCLUSION: Neither vitamin D supplementation nor a home-based program of high-intensity quadriceps resistance exercise improved rehabilitation outcomes in frail older people after hospitalization. There was no effect of vitamin D on physical performance, and the exercises increased the risk of musculoskeletal injury. These findings do not support the routine use of these interventions at these dosages in the rehabilitation of frail older people.

Accidental Falls↗

PubMed1990

[A study of attitudes toward illness and its effect on mortality in patients with Parkinson's disease].

The standardized mortality ratio (SMR), i.e. the ratio of observed to expected deaths, was investigated among 433 patients with Parkinson's disease (172 males and 261 females), who had been visited by public health nurses for a period of more than one year between 1978 and 1987 in Osaka Prefecture. The mean age of the patients was 58.7, and the average duration of the disease was 6.1 years at study entry. The follow-up period averaged 4.1 years during which sixty eight deaths were observed. The SMR of the patients was 2.54 relative to the general population of Osaka Prefecture. The SMR of those who were able to walk without assistance at study entry was 1.73, while that of patients with severe gait disturbance was 3.81. Patients were divided into three groups according to the extent of daily physical exercise performed to maintain their remaining function. Among patients who had been able to walk, those doing daily physical exercise showed the lowest SMR of 1.46. Among those with severe gait disturbance, the SMR of the exercising group was also the lowest at 1.72. These results indicate that daily physical exercise affects the mortality of Parkinsonian patients independently of the grade of disability. Participation in daily exercise was strongly influenced by the patient's will to battle his illness, and was significantly related to the presence of a spouse, economic situation of household, and the number of rooms in their dwelling.

Adult↗

PubMed1999

Improved physical performance after orthotopic liver transplantation.

Orthotopic liver transplantation (OLT) has become a frequently used treatment for end-stage liver disease and acute liver failure, and liver function is markedly improved after transplantation. However, no studies have investigated the development in physical capacity after OLT. On this basis, the aim of the present study is to study the influence of OLT on physical fitness during the first postoperative year. Twenty-three men with a mean age of 45.1 years (range, 24 to 62 years) and 15 women with a mean age of 44.6 years (range, 21 to 62 years) were included in the study. Preoperative maximal oxygen uptake (VO2max) during graded ergometer bicycling, isokinetic knee extension/flexion moments, and functional performance (i.e., 6-minute walking distance and standardized transfers and squats) was measured. Preoperative fitness and strength was 40% to 50% less than expected in the age-matched general population. Post-OLT, all patients underwent a supervised exercise program for 8 to 24 weeks. Follow-up data showed a significant increase in all tested physical performance parameters after OLT. Six months post-OLT, VO2max had increased 43%; knee strength, 60% to 100%; and functional performance, 22% to 27%. One year postsurgery, general health was improved and perceived as excellent or good in all patients. All patients were independent in activities of daily living, and the level of physical activity increased after OLT. No further improvement in either physical performance parameters or self-assessed parameters was seen beyond 6 months after OLT. In conclusion, these findings indicate that OLT combined with a supervised post-OLT exercise program improves physical fitness, muscle strength, and functional performance in individuals with chronic liver disease.

Activities of Daily Living↗

PubMed1999

Mobility-related function in older adults: assessment with a 6-minute walk test.

OBJECTIVE: To determine the usefulness of the 6-minute walk test as an integrated measure of mobility in older adults. DESIGN: Observational study. SETTING: Community centers and retirement homes in the Los Angeles area. PATIENTS: Eighty-six older adults without significant disease. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Assessments included the 6-minute walk, chair stands, standing balance, gait speed, body mass index, and self-reported physical functioning and general health perceptions. RESULTS: One-week test-retest reliability of the 6-minute walk was .95. As hypothesized, the 6-minute walk distance was significantly greater for active than for inactive older adults (p < .0001), moderately correlated with chair stands (r = .67), standing balance (r = .52), and gait speed (r = -.73). It had a low correlation with body mass index (r = -.07). The correlation of the 6-minute walk with self-reported physical functioning was .55, and its correlation with general health perceptions was .39. Self-report and performance measures explained 69% of the variance in 6-minute walk scores. CONCLUSIONS: The 6-minute walk test is reliable and is valid in relation to the performance and self-reported indicators of physical functioning tested in this study. It could serve as a useful integrated measure of mobility.

Activities of Daily Living↗

PubMed2005

Assessing environmentally determined mobility disability: self-report versus observed community mobility.

OBJECTIVES: To examine the test-retest reliability and concurrent validity of a new self-report measure of mobility function by comparing it with observed mobility, self-reported activity of daily living (ADL) function, and performance-based measures of gait and balance. DESIGN: Cross-sectional study involving two groups of older adults. SETTING: Community sites in Seattle, Washington, and Waterloo, Ontario, Canada. PARTICIPANTS: Fifty-four adults aged 70 and older, recruited. MEASUREMENTS: Subjects completed the Environmental Analysis of Mobility Questionnaire (EAMQ), reporting frequency of encounter and avoidance of 24 features of the physical environment, grouped into eight dimensions, on two occasions 1 week apart. Subjects were observed and videotaped during six trips into the community; frequency of encounters with environmental features within the eight dimensions was recorded. EAMQ encounter and avoidance scores were compared with observed environmental encounters, with disability in ADLs and instrumental ADLs (IADLs), and lower extremity functional measures including the Short Physical Performance Battery (SPPB) and the Berg Balance Test. RESULTS: EAMQ test-retest reliability was high for all eight dimensions (intraclass correlation coefficient range=0.81-1.0) and for summary encounter (0.98) and avoidance (0.96) scores. Observed mobility was significantly correlated (Spearman correlation = r) with EAMQ summary encounter (r=0.66) and avoidance (r=-0.58) scores. Moderate correlations were present between the EAMQ (encounter or avoidance) and observed mobility in the distance, temporal, terrain, posture, load, and density dimensions but not in the attention and ambient dimensions. EAMQ encounter/avoidance was significantly associated with ADL and IADL ability and performance on the SPPB and Berg Balance Test. CONCLUSION: Self-reported frequency of encounter and avoidance of specific environmental features appears to be a valid method for determining environmentally specific mobility disability but needs to be confirmed in a larger sample.

Activities of Daily Living↗

PubMed1996

Self-efficacy and pain in disability with osteoarthritis of the knee.

This study examined the relationship between self-efficacy beliefs and pain during the performance of stair climbing and lifting/carrying tasks on speed of movement, ratings of task difficulty, and perceived task ability in a group of patients with osteoarthritis (OA) of the knee. Seventy-nine patients with knee OA completed the tasks in a controlled laboratory setting. Before completing each task, patients' self-efficacy was assessed; following task performance they rated (a) the most intense knee pain experienced, (b) the difficulty of the task, and (c) their perceived ability as they performed each task. Results demonstrated that, even after controlling for physical function, self-efficacy, and knee pain during performance, each contributed significantly to understanding either speed of movement or self-reported ratings of task difficulty and perceived ability.

Activities of Daily Living↗