scholarly journals Relationships Among Lifting Ability, Grip Force, and Return to Work

2002 ◽  
Vol 82 (3) ◽  
pp. 249-256 ◽  
Author(s):  
Leonard N Matheson ◽  
Susan J Isernhagen ◽  
Dennis L Hart

Abstract Background and Purpose. The relationship between functional capacity evaluation (FCE) data and work disability has not been studied. The validity of FCE testing results in terms of subsequent return to work (RTW) was the focus of this exploratory study. Subjects and Methods. Six hundred fifty adults of working age were evaluated as part of a standardized FCE. Clients were contacted by telephone 6 months after the FCE to determine their work status. Predictor variables were gender, age, time off work, maximum safe loads during 3 dynamic lifts, and isometric grip force. Other variables measured were whether or not the client returned to work (RTW-Y/N) and level of return to work (RTW level). Results. A multivariate logistic regression analysis demonstrated that the more time a worker was away from work, the less likely was RTW. Male subjects were less likely to return to work than female subjects. The more weight lifted from floor to waist, the more likely was RTW. The logistic regression equation correctly classified 80.3% of the subjects who returned to work and 56.6% of the subjects who did not return to work. Each of the 3 lift tests was related to RTW level, whereas the grip force tests were not related to either RTW-Y/N or RTW level. Discussion and Conclusion. Time off work and gender were the strongest predictors of RTW, but certain FCE subtests of lifting were related to RTW and RTW level for people with work-related chronic symptoms. Grip force was not related to RTW.

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0022
Author(s):  
Alexander J. Idarraga ◽  
Adam Wright-Chisem ◽  
Daniel D. Bohl ◽  
Simon Lee ◽  
Johnny Lin ◽  
...  

Category: Hindfoot, Ankle, Midfoot/Forefoot, Injury and Rehabilitation Introduction/Purpose: The functional capacity evaluation (FCE) is used to determine a worker’s physical ability after treatment of a work-related injury. This evaluation is a critical determinant in the administration of benefits and the decision to return to work (RTW). The purpose of this study is to characterize FCE results and ability to RTW among patients treated for work- related orthopaedic injuries to the foot or ankle. Methods: A retrospective medical record review from the practices of four orthopaedic foot and ankle surgeons was conducted. Inclusion criteria were (1) treatment of a work-related injury to the foot or ankle, (2) at least 2 years of follow-up from the injury, and (3) documentation of an associated FCE. The FCE report and clinic notes were used to determine the patient’s pre-injury job requirement (Department of Labor Office category: light, medium, or heavy), post-injury FCE-determined work ability (light, medium, or heavy), specific FCE- or physician-imposed work restrictions, and clearance for RTW. Patients were considered cleared to RTW if their FCE-determined work ability met or exceeded their pre-injury job requirement and if there were no additional restrictions imposed by the FCE or physician that would prevent them from functioning in their pre-injury role. Results: A total of 188 patients met inclusion criteria. Missteps/rotational injuries (44.1%), falls from height (22.3%), and crush injuries (20.7%) were the most common mechanisms. 74.4% of patients had FCE-determined work abilities at or above their pre- injury job requirements, and 63.3% of patients were eventually cleared for RTW. The median time from injury to clearance for RTW was 2.0 ± 1.3 years. Reasons for not being cleared to RTW included failure to meet the pre-injury job requirement (67.2%), specific FCE-imposed limitations (28.3%), or specific physician-imposed limitations (4.5%). Less strenuous pre-injury job requirement was positively associated with both FCE-determined work ability meeting pre-injury job requirement and clearance for RTW (p<0.001 and p=0.034, respectively; Table 1). Conclusion: Approximately two-thirds of patients undergoing FCE after a work-related foot or ankle injury are cleared to RTW. However, it takes a median of two years to achieve this clearance. Patients with jobs that are more physically strenuous are less likely to be able to return to those jobs after injury to the foot or ankle.


1998 ◽  
Vol 3 (2) ◽  
pp. 4-5
Author(s):  
Glenn Pransky

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.


Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Cheng Wang ◽  
Jun Zhang ◽  
Cuicui Li ◽  
Wenyu Gong ◽  
Tanqi Lou

Background: Neural precursor cell expressed developmentally down-regulated 4-like (NEDD4L) is a candidate gene for hypertension, and carriers of an intact NEDD4L C2-domain,encoded by the NEDD4L rs4149601 (G/A) GG genotype, together with the C-allele of the NEDD4L rs2288774 (C/T) polymorphism have been found be associated with hypertension both in African Americans and whites. However, there is no data on the relationship between polymorphism of NEDD4L rs4149601 and rs2288774 and hypertension in Chinese chronic kidney disease (CKD) patients. The purpose of the current study was to investigate the relationship between the variation of NEDD4L rs4149601, rs2288774 and hypertension in CKD patients. Methods: A total of 546 Chines Hans CKD patients were enrolled in our study. The SNPs were genotyped using PCR-based techniques. All patients underwent ambulatory blood pressure monitoring, and clinical data were also collected. Multivariate logistic regression analysis was used to identify the relationship between polymorphisms and hypertension. Results: 506 patients carried GG/GA genotype and 30 carried AA genotype. Rs4149601 AA genotype carriers had significantly higher rate of hypertension (68.3% vs 46.2%, P = 0.022) than GG/GA genotype carriers by Chi-squared test. AA genotype carriers also had a higher day-time and bedtime systolic blood pressure (142±16 vs 135±23, P=0.036; 137±18 vs 127±13, P=0.022, respectively) when compared with GG/GA genotype carriers. AA genotype [OR= 3.08, 95% CI (1.06-9.80)], lowever eGFR [OR=0.98, 95% CI (0.97-0.99)], older age [OR=1.03, 95% CI (1.01-1.05)] were independently associated with hypertension in CKD patients by multivariate logistic regression. However, No difference was found in blood pressure with rs2288774 TT/TC/CC genotypes, and no difference was found in the incidence of hypertension among patients with three genotypes. Conclusions: Our results suggested 4149601AA genotype of NEDD4L may be associated with hypertension in CKD patients, and further genetic and functional studies are required to understand its role in the manifestation of hypertension in Chinese CKD patients.


2019 ◽  
pp. 207-228
Author(s):  
Danny Wong

Rehabilitation and return to work is not a straightforward clinical problem of assessment, diagnosis, and treatment. The chapter explores the concept of worklessness and its impact on life expectancy, what barriers there are in returning to work, why work is good for health, and the relationship between work and health. Common work-related health problems are explored along with disability benefits and most prominent health problems in this area. The chapter details the current UK government system of assessing fitness via the Employment and Support Allowance assessment programme. Models of disability are discussed, focusing on the biopsychosocial model and psychosocial flag system. Workplace management including current UK initiatives of the ‘fit note’ and ‘Fit for Work Scheme’ are further explored. Common workplace adjustments that may assist in a return to work are explored.


Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2209-2209
Author(s):  
Dick Chung ◽  
Lily Ding ◽  
Isabelle Amigues ◽  
Katuna Kadeishvili ◽  
Theresa Lo ◽  
...  

Abstract Background: Low MBL2 concentration and MBL2 genotype variants have been associated with an increased risk of infection in various clinical settings. Pulmonary infection is a major complication of HSCT. We examined the relationship of MBL genotypes with post-engraftment bacterial (B-PNA) and fungal (F-PNA) pneumonia Methods: Retrospective review of 236 non-consecutive, non-selected patients who underwent HSCT at MSKCC from 1/1/2000–4/30/2007. Microbiologically confirmed infections and pneumonias were recorded. Antifungal prophylaxis consisted of fluconazole 400 mg daily. Patients at high risk for mold infection received mold-active prophylaxis. After 1/1/2006 voriconazole was the first line anti-mold prophylaxis. Genotype was determined by PR-Melting Curve Analysis on blood or buccal swab specimens. MBL genotype was classified as wild-type: A/A (MBL-sufficient, MBL-S) or variant-type: A/O, O/O (MBL deficient, MBL-D). Patients were followed for up to 2 years. Statistical analysis: Fisher’s Exact test was used to compare the incidence rate between MBL-S and MBL-D patients. Multivariate logistical regression models were used to investigate the relationship between bacterial or fungal pneumonia and MBL genotype, matched related donor (MRD), myeloablative conditioning (MC) peripheral blood as stem cell source (PBSC), acute GVHD grade 2–4 (aGVHD). The results from Maximum Likelihood Estimates were summarized. Results: Transplant characteristics: 80% MC, 76% PBSC, 48.6% MRD. Incidence of aGVHD: 22.4%. MBL genotypes: One-hundred and forty-two (60%) patients were homozygous for wild-type MBL2 (AA), 85(36%) were heterozygous (A/0) and 9 (3.8%) were homozygous for variant genotypes (OO). Transplant characteristics, rates of GVHD, relapse-free and overall survival were similar between MBL-D and MBL-S. There was higher incidence of overall bacterial infections in MBL-D compared to MBL-S pts (47.87% vs 36.62%, p=0.1049). MBL-D had a higher incidence of B-PNA (12.7% vs 4.9%, p=0.048). In multivariate logistic regression analysis, MBL-D(p=0.04) and aGVHD(p=0.06) were likely associated with B-PNA. Rates of overall fungal infections and F-PNA were similar [among MBL-D and MBL-S pts (12.77% vs 9.86%, p=0.5277) and (8.51% vs 7.75%, p=0.1049) respectively]. In multivariate logistic regression analysis only aGVHD was statistically significantly associated with F-PNA p=0.0002. Conclusions: 1) MBL-D genotype was likely associated with increased risk of bacterial pneumonia. 2) MBL-D and aGVHD were risk factors for B-PNA. 3) Further analyses are in progress to evaluate the effect of MBL-D on fungal pneumonia in patients who received mold prophylaxis versus patients who did not receive mold prophylaxis. 4) Prospective studies are needed to assess the relative contribution of MBL-D genotype on the risk of pulmonary infection in HSCT.


2015 ◽  
Vol 123 (5) ◽  
pp. 1145-1150 ◽  
Author(s):  
Keisuke Takanari ◽  
Yoshio Araki ◽  
Sho Okamoto ◽  
Hideyoshi Sato ◽  
Shunjiro Yagi ◽  
...  

OBJECT Intracranial revascularization surgeries are an effective treatment for moyamoya disease and other intracranial vascular obliterative diseases. However, in some cases, wound-related complications develop after surgery. Although the incidence of wound complication is supposed to be higher than that with a usual craniotomy, this complication has rarely been the focus of studies in the literature that report the outcomes of revascularization surgeries. Here, the relationship between intracranial revascularization surgeries and their complications is statistically assessed. METHODS Between October 2004 and February 2010, 71 patients were treated using cerebral revascularization surgeries on 98 sides of the head. The relationship between wound complications and operative technique was retrospectively assessed. Multivariate logistic regression analysis was performed to identify the risk factors of wound complication, including operative technique, age, sex, diabetes mellitus (DM), hypertension, hyperlipidemia, and smoking history. RESULTS In total, there were 21 (21.4%) operative wound complications. Of these 21 complications, there were 14 (66.7%) minor complications and 7 (33.3%) major complications. No statistically significant relationship was found between wound complications and any surgical procedure. A trend toward severer complications was demonstrated for the procedures that used both STA branches (“double” procedures) in comparison with the procedures that used only 1 STA branch (“single” procedures, p = 0.016, Cochran-Armitage trend test). Multivariate logistic regression analysis also revealed that double procedures demonstrated a significantly higher incidence of wound complications than single procedures (OR 3.087, p = 0.048). DM was found to be a risk factor for wound complication (OR 9.42, p = 0.02), but age, sex, hypertension, and hyperlipidemia were not associated with the incidence of complications. Even though the blood supply to the scalp is abundant due to 5 arteriovenous systems, sometimes cutaneous necrosis develops after intracranial revascularization surgeries. The galeal blood supply is thought to be crucial for preventing wound-related complications. Special care is also thought to be required for DM patients. CONCLUSIONS Revascularization surgeries seemed to demonstrate a higher risk of wound-related complications. Double-type procedures, which use both branches of the STA, and a history of DM were found to be risk factors for wound-related complications. Attention should be paid to the design of the galeal incision and vessel harvest line. Also, special attention should be paid to patients with DM.


2015 ◽  
Vol 39 (1-3) ◽  
pp. 224-229 ◽  
Author(s):  
Sung Jin Moon ◽  
Jung Eun Lee ◽  
Jwa-Kyung Kim ◽  
Soo Young Yoon ◽  
Shin Wook Kang ◽  
...  

Background: Although various modalities of hemodialysis (HD) are presumed to have different effects on insulin resistance (IR), the relationship between hemodiafiltration (HDF) and IR has not been fully evaluated. Methods: In a cross-sectional study, 82 non-diabetic HD patients were enrolled. The patients were divided into two groups according to the median homeostasis model assessment index (HOMA-IR) value of 1.685. Clinical and biochemical data were compared, and multivariate logistic regression analysis was performed to identify the independent factors associated with higher HOMA-IR. Results: The higher HOMA-IR group had increased body mass index (BMI), decreased HDL cholesterol, and lower beta-2 microglobulin reduction rate (β2-MG RR) compared to the lower HOMA-IR group. HOMA-IR was significantly correlated with β2-MG RR. In addition, HDF patients had lower HOMA-IR levels compared with low flux hemodialysis patients. On multivariate logistic regression analysis, BMI and HDF treatment were independent factors associated with higher and lower HOMA-IR, respectively. Conclusion: This study suggests that HDF treatment may reduce IR in non-diabetic HD patients.


2014 ◽  
Vol 0 (0) ◽  
Author(s):  
Geum Joon Cho ◽  
Hye-Ri Hong ◽  
Hyun-Joo Seol ◽  
Bo Hae Koo ◽  
Soon-Cheol Hong ◽  
...  

AbstractTo investigate the relationship between angle of progression (AoP) on ultrasonography at 37–40 weeks’ gestation and delivery within 7 days.This prospective study was conducted between January 2013 and May 2013 at Korea University Guro Hospital, Korea. Nulliparous women between 37/0 and 40/3 weeks’ gestation with a singleton fetus, intact membrane, and cephalic presentation from January 2013 to May 2013 were enrolled. To evaluate the cervical parameters of cervical length and AoP, transvaginal and transperineal ultrasonography were performed, respectively. We then assessed the relationship between cervical parameters and onset of labor within 7 days by multivariate logistic regression analysis.Women who underwent spontaneous onset of labor within 7 days had a significantly shorter cervical length and AoP than those who underwent labor after 7 days. Logistic regression analysis showed that a larger AoP was an independent predictor of spontaneous labor within 7 days.A larger AoP was significantly associated with spontaneous onset of labor within 7 days. These findings may be useful for counseling patients regarding the management of term pregnancies.


2021 ◽  
Vol 31 (2) ◽  
pp. 61-64
Author(s):  
Jurga Indriūnienė ◽  
Indrė Nakutavičiūtė ◽  
Inga Muntianaitė ◽  
Rūta Petravičienė ◽  
Rūta Dadelienė

Medical professionals experience more work-related stress than other specialties, furthermore, many results of different researches have shown that the level of stress continues to grow. When stress persists, it becomes chronic and negatively affects a person’s physical and mental health. Work-related stress is associated not only with burnout, exhaustion, but also with increased morbidity, chronic diseases and especially with cardiovascular disorders. The aim of our research was to determine the relationship between work-related stress, burnout and aerobic capacity among physiotherapists. The research included 30 participants, who completed two questionnaires about stress and burnout and performed two tests for aerobic capacity evaluation. 80 percent of physiotherapists were experiencing low, medium or high level stress. Burnout was found in 23 percent of participants. 64 percent of subjects’ aerobic capacity was evaluated as average and 16 percent of subjects had poor and very poor aerobic capacity. 20 percent of the participants’ tonus of sympathetic part of autonomic nervous system was normal and they were considered healthy, but not physically trained. After statistical analysis there was no statistically significant relationship found between physiotherapists’ stress or burnout and aerobic capacity.


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