Clinical Update: Functional Capacity Evaluations and Disability

1998 ◽  
Vol 3 (2) ◽  
pp. 4-5
Author(s):  
Glenn Pransky
Keyword(s):  
Direct Observation ◽  
Functional Capacity ◽  
Work Capacity ◽  
Functional Capacity Evaluation ◽  
Whole Body ◽  
Validity Of Results ◽  
Job Tasks ◽  
Capacity Evaluation ◽  
Physical Abilities ◽  
The Relationship

Abstract According to the AMA Guides to the Evaluation of Permanent Impairment, a functional capacity evaluation (FCE) measures an individual's physical abilities via a set of activities in a structured setting and provides objective data about the relationship between an impairment and maximal ability to perform work activities. A key distinction between FCEs and self-reported activities of daily living is that the former involve direct observation by professional evaluators. Numerous devices can quantify the physical function of a specific part of the musculoskeletal system but do not address the performance of whole body tasks in the workplace, and these devices have not been shown to predict accurately the ability to perform all but the simplest job tasks. Information about reliability has been proposed as a way to identify magnification and malingering, but variability due to pain and poor comprehension of instructions may cause variations in assessments. Structured work capacity evaluations involve a set of activities but likely underestimate the individual's ability to do jobs that involve complex or varying activities. Job simulations involve direct observation of an individual performing actual job tasks, require a skilled and experienced evaluator, and raise questions about expense, time, objectivity and validity of results, and interpretation of results in terms of the ability to perform specific jobs. To understand the barriers to return to work, examiners must supplement FCEs with information regarding workplace environment, accommodations, and demotivators.

Changes in indicators of intonation structure of speech in occupational activity of air traffic control operators

2019 ◽  
pp. 31-37
Author(s):  
K. I. Zasjad’ko ◽  
A. V. Bogomolov ◽  
S. K. Soldatov ◽  
A. P. Vonarshenko ◽  
A. F. Borejchuk ◽  
...  
Keyword(s):  
Functional State ◽  
Traffic Control ◽  
Air Traffic Control ◽  
Work Load ◽  
Work Capacity ◽  
Air Traffic ◽  
Experimental Series ◽  
Occupational Activity ◽  
Average Value ◽  
Control Operators

Introduction.The study is aimed to determine possible use of vocal signal analysis for diagnosis of functional states in air traffic control operators, with justifying selection of informative parameters of intonation structure of speech.Materials and methods.Experiments on semi-natural simulator complex with participation of 16 air traffic male dispatchers modelled occupational activity of air traffic dispatcher with moderate (6 aircrafts controlled) and intense (7–12 aircrafts controlled) work load. Duration of simulated working shiftwas 6 hours. Registration covered characteristics of main vocal tone of the examinees, with calculation of 8 jitter-factors that portrayed mirco-changes of main vocal tone curve and 2 tremor indices disclosing periodic waves of 4–16 Hz in main vocal tone curve. Functional state of the dispatchers was assessed via cardiac rhythm parameters. Reliability and work capacity of the dispatchers corresponded to correct radio traffi c, changes in threshold of reception and transfer of aircrafts in number of allowable dangerous approach of aircrafts, time to detection of input aircraft’s deviation from preset flight line.Results and discussion.According to analysis of the experiments results, some parameters of the main vocal tone carried significant changes both in first (simulated moderate work load) and second (simulated intense work load) experimental series.The data obtained prove lower level of psychic regulation of the dispatchers’ occupational activity during 3rd to 5thhours of “working shift” in the first experimental series and from 2nd to 4thhours of the second experimental series, due to decreased psychophysiologic resources and developing fatigue.Conclusion.Studies of changes in indicators of intonation structure of speech in occupational activity of air traffic dispatchers demonstrated that using such indicators provides adequate diagnosis of the functional state. The most informative indicators are average value, histogram asymmetry and excessive frequency of main vocal tone, duration of pauses between words of the dispatchers’ commands and fi ft h jitter-factor.

Multiple Sclerosis: Treadmill Versus Cycle Ergometry Maximal Exercise Test Responses

2020 ◽  
Vol 9 (3) ◽  
pp. 113-117
Author(s):  
Garett Griffith ◽  
Badeia Saed ◽  
Tracy Baynard
Keyword(s):  
Multiple Sclerosis ◽  
Aerobic Capacity ◽  
Work Capacity ◽  
Cross Sectional Study ◽  
Cycle Ergometer ◽  
Cycle Ergometry ◽  
Cross Sectional ◽  
Complete Test ◽  
Peak Aerobic Capacity ◽  
Predicted Values

ABSTRACT Background: Multiple sclerosis (MS) is an autoimmune disease that impacts the central nervous system. MS generally results in decreased mobility and work capacity. Our objective was to determine exercise testing responses on both a treadmill and cycle ergometer among individuals with MS who were able to ambulate freely. Methods: Twenty-six individuals with MS participated in a cross-sectional study (44 ± 11 years; body mass index 26.8 ± 6.2 kg·m−2; expanded disability scale score 3.1 ± 0.9), with 24 individuals with complete test data for both treadmill and cycle ergometry tests. Peak aerobic capacity (VO2peak) for both treadmill and cycle ergometry tests were measured with indirect calorimetry. Results: Participants safely completed both treadmill and cycle ergometry tests, and treadmill testing yielded higher values (26.7 ± 6.4 mL·kg−1·min−1) compared with cycle ergometry (23.7 ± 5.7 mL·kg−1·min−1), with values ~12% greater for treadmill. When comparing tests to their respected predicted values within modality, treadmill tests were 8% lower and cycle ergometry tests were 10% lower than predicted. Conclusions: While peak aerobic capacity was very low for this population, treadmill tests were still higher than cycle ergometry data, with this difference between modes being similar to that observed in healthy adult populations. Additional research is required to determine if these findings are impacted by participation in physical activity or regular exercise.

Work Capacity and Efficiency of the Autotransplanted Heart

Circulation ◽  
1967 ◽  
Vol 35 (4s1) ◽  
Author(s):  
WILLARD M. DAGGETT ◽  
VALLEE L. WILLMAN ◽  
THEODORE COOPER ◽  
C. ROLLINS HANLON
Keyword(s):  
Work Capacity

Effect of vitamin B12 on work capacity

1955 ◽  
Vol 16 (1) ◽  
pp. 20-24
Author(s):  
Henry J. Montoye ◽  
Donald Kuick ◽  
Paul Robbins ◽  
William Rosenberger
Keyword(s):  
Vitamin B12 ◽  
Work Capacity

scholarly journals Predictors of health-related quality of life in musculoskeletal disease patients: a longitudinal analysis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110340
Author(s):  
Alfredo Madrid-García ◽  
Leticia León-Mateos ◽  
Esperanza Pato ◽  
Juan A Jover ◽  
Benjamín Fernández-Gutiérrez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Musculoskeletal Diseases ◽  
Work Capacity ◽  
Health Related Quality ◽  
Clinical Predictors ◽  
Related Quality ◽  
Health Related ◽  
Classification Index ◽  
San Carlos

Introduction: Rheumatic and musculoskeletal diseases (RMDs) have a significant impact on patients’ health-related quality of life (HRQoL) exacerbating disability, reducing independence and work capacity, among others. Predictors’ identification affecting HRQoL could help to place efforts that minimize the deleterious impact of these conditions on patients’ wellbeing. This study evaluates the influence of demographic and clinical predictors on the HRQoL of a cohort of RMD patients, measured using the Rosser classification index (RCI). Methods: We included patients attending the Hospital Clínico San Carlos (HCSC) rheumatology outpatient clinic from 1 April 2007 to 30 November 2017. The primary outcome was the HRQoL assessed in each of the patient’s visits using the RCI. Demographic and clinical variables extracted from a departmental electronic health record (EHR) were used as predictors: RMD diagnoses, treatments, comorbidities, and averaged HRQoL values from previous periods (for this last variable, values were imputed if no information was available). Association between predictors and HRQoL was analyzed using penalized generalized estimating equations (PGEEs). To account for imputation bias, the PGEE model was repeated excluding averaged HRQoL predictors, and common predictors were considered. Discussion: A total of 18,187 outpatients with 95,960 visits were included. From 410 initial predictors, 19 were independently associated with patients’ HRQoL in both PGEE models. Chronic kidney disease (CKD), an episode of prescription of third level analgesics, monoarthritis, and fibromyalgia diagnoses were associated with worse HRQoL. Conversely, the prescription in the previous visit of acid-lowering medication, colchicine, and third level analgesics was associated with better HRQoL. Conclusion: We have identified several diagnoses, treatments, and comorbidities independently associated with HRQoL in a cohort of outpatients attending a rheumatology clinic.

Six sessions of sprint interval training increases muscle oxidative potential and cycle endurance capacity in humans

2005 ◽  
Vol 98 (6) ◽  
pp. 1985-1990 ◽  
Author(s):  
Kirsten A. Burgomaster ◽  
Scott C. Hughes ◽  
George J. F. Heigenhauser ◽  
Suzanne N. Bradwell ◽  
Martin J. Gibala
Keyword(s):  
Citrate Synthase ◽  
Training Session ◽  
Interval Training ◽  
Maximal Activity ◽  
Work Capacity ◽  
Control Group ◽  
Endurance Capacity ◽  
Sprint Interval Training ◽  
Oxidative Potential ◽  
Cycle Endurance

Parra et al. ( Acta Physiol. Scand 169: 157–165, 2000) showed that 2 wk of daily sprint interval training (SIT) increased citrate synthase (CS) maximal activity but did not change “anaerobic” work capacity, possibly because of chronic fatigue induced by daily training. The effect of fewer SIT sessions on muscle oxidative potential is unknown, and aside from changes in peak oxygen uptake (V̇o2 peak), no study has examined the effect of SIT on “aerobic” exercise capacity. We tested the hypothesis that six sessions of SIT, performed over 2 wk with 1–2 days rest between sessions to promote recovery, would increase CS maximal activity and endurance capacity during cycling at ∼80% V̇o2 peak. Eight recreationally active subjects [age = 22 ± 1 yr; V̇o2 peak = 45 ± 3 ml·kg−1·min−1 (mean ± SE)] were studied before and 3 days after SIT. Each training session consisted of four to seven “all-out” 30-s Wingate tests with 4 min of recovery. After SIT, CS maximal activity increased by 38% (5.5 ± 1.0 vs. 4.0 ± 0.7 mmol·kg protein−1·h−1) and resting muscle glycogen content increased by 26% (614 ± 39 vs. 489 ± 57 mmol/kg dry wt) (both P < 0.05). Most strikingly, cycle endurance capacity increased by 100% after SIT (51 ± 11 vs. 26 ± 5 min; P < 0.05), despite no change in V̇o2 peak. The coefficient of variation for the cycle test was 12.0%, and a control group ( n = 8) showed no change in performance when tested ∼2 wk apart without SIT. We conclude that short sprint interval training (∼15 min of intense exercise over 2 wk) increased muscle oxidative potential and doubled endurance capacity during intense aerobic cycling in recreationally active individuals.

scholarly journals PARE0008 MOBILE APPLICATION “MOJRA” FOR MONITORING PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1290.1-1290 ◽  
Author(s):  
N. Teodorovic ◽  
S. Djordjevic ◽  
L. Vranic
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Care ◽  
Best Practice ◽  
Mobile Apps ◽  
Digital Health ◽  
Work Capacity ◽  
Learning Center ◽  
Approval Procedure ◽  
The Republic

Background:In Serbia, regular examinations with a rheumatologist are scheduled on average every 3 to 4 months. With this in mind, there is a real possibility that many patient data during this period may not be presented to the doctor during the examination, either because the patient forgets them or because they may focus on other issues and may not highlight key factsObjectives:To overcome this problem, the Association of Patients with Rheumatic Diseases of Serbia-ORS in cooperation with an IT firm developed the application “MojRA”, which was presented at the annual rheumatology congress of Serbia held in September 2019. The application “MojRA” is intended for patients suffering from rheumatoid arthritis - RA. The application enables efficient storage and systematization of data, allows doctors to monitor the condition of their patients between two examinations and have a medical history. “MojRA” is available for now from smartphones running the android operating system on the google play store. The privacy of patient information is guaranteed.Methods:Patients with RA will be able to record and store information about important moments during treatment in a simple and transparent way. At each subsequent visit they will be able to describe what happened to their illness in the meantime. The application can create different types of reports and views.At the same time, the doctor can use the app to inform the patient about her/his condition in real time, which will contribute to better and more meaningful communication. All this would improve the quality of health care, preserving work capacity and improving the quality of life.Results:In order to simplify biotherapy committee approval procedure for patients of RA, the “Charger” has been developed in association with ORS and URes. The “Charger” will connect data collected by MojRa to the registry of RA patients, making the whole approval procedure more efficient and transparent.Testing of the second version of this application is underway, meetings are held between the patients using the application and the IT company that created it.Plans are to expand the app to other types of arthritis in the near future, too, and will soon be completed for devices running Apple operating systems.Conclusion:In addition to being of great benefit to patients and doctors, it can in the future be of immeasurable importance for the savings in the overall health care system of the Republic of Serbia.References:[1]Mobile Apps for Rheumatoid Arthritis: Opportunities and Challenges, Mollard E, Michaud K, Rheum Dis Clin, May 2019, Volume 45, Issue 2, Pages 197–209[2]Apps for People With Rheumatoid Arthritis to Monitor Their Disease Activity: A Review of Apps for Best Practice and Quality, Rebecca Grainger, Hutt Hospital, JMIR Publications, Advancing Digital Health Research, Feb 27, 2017.[3]ACR Mobile Apps,https://www.rheumatology.org/Learning-Center/Apps,American College of Reumatology.Disclosure of Interests:None declared

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