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PubMedDate not supplied

[Evaluation and prognosis of the mental work capacity of flight personnel with neuroses].

Features of psychic functions and mental performance of flight personnel suffering from various neuroses were examined by clinical and psychological methods. The most severe and persistent changes in mental performance were found in neurasthenics. Higher mental productivity was detected in 80% of subjects with other neuroses (neurotic states and reactions, asthenic state, emotional-vegetative instability) (P less than 0.001). These findings can be regarded as important diagnostic and prognostic criteria in expertise and performance evaluations.

Aerospace Medicine↗
PubMed1984

Hemoglobin concentration and aerobic work capacity in women following induced erythrocythemia.

The effect of induced erythrocythemia on hemoglobin concentration ([Hb]) and aerobic work capacity was determined for nine women. Cycle tests were performed at prereinfusion (T1), 2 days after a placebo infusion (T2), 2 days postreinfusion of 334 ml of red blood cells (T3), 8 days postreinfusion (T4), and 14 days postreinfusion (T5). T1 and T2 responses did not differ, negating a placebo effect. [Hb] increased from 12.7 g X dl at T1 to 14.7 g X dl at T3 and then remained constant at T4 and T5. Hematocrit increased from 38.1% at T1 to 44.9% at T3 and then remained constant at T4 and T5. Submaximal O2 uptake (VO2) and stroke volume (SV) did not change from T1 through T5. Submaximal cardiac output (Q) and heart rate (HR) decreased from T1 to T3 and then remained constant at T4 and T5. Arteriovenous O2 difference increased from T1 to T3 and then remained constant at T4 and T5. Maximal VO2 was greater at T3 (2.65 l X min-1), T4 (2.66 l X min-1), and T5 (2.60 l X min-1) than at T1 (2.41 l X min-1). Physical work capacity was greater at T3 (10,740 kg X m), T4 (10,980 kg X m), and T5 (10,380 kg X m) than at T1 (8,747 kg X m). Maximal values for Q, HR, and SV were unchanged from T1 through T5. At maximum, arteriovenous O2 difference and Hb flow rate increased from T1 to T3 and then remained constant at T4 and T5. The greater postreinfusion [Hb] improved O2 transport capacity and appeared to regulate circulatory responses.

Adult↗
PubMed2006

Material handling performance of patients with chronic low back pain during functional capacity evaluation: a comparison between three countries.

PURPOSE: Functional Capacity Evaluations (FCEs) are batteries of tests designed to measure patients' ability to perform work-related activities. Although FCEs are used worldwide, it is unknown how patients' performances compare between countries or settings. This study was performed to explore similarities and differences in FCE performance of patients with chronic low back pain (CLBP) between three international settings that utilize the same FCE protocol. METHODS: Standardized FCEs were performed on three cohorts of patients with CLBP: A sample from an outpatient rehabilitation context in The Netherlands (n = 121), a Canadian sample in a Worker's Compensation context (n = 273), and a Swiss sample in an inpatient rehabilitation context (n = 170). Patients were undergoing FCE as part of their usual clinical care. Means and standard deviations of maximum performance on the FCE material handling items were calculated and differences compared using ANOVA. Multivariable linear regression was used to determine the relationship between country of origin and FCE performance while controlling for potential confounders including, age, sex, duration of back pain problems, and self-reported pain and disability ratings. RESULTS: Compared to the Dutch sample, the mean performance of patients in the Canadian and Swiss samples was consistently lower on all FCE items. This association remained statistically significant after controlling for potential confounders. CONCLUSIONS: Considerable differences were observed between settings in maximum weight handled on the various FCE items. Future FCE research should examine the effects of a number of potentially influential factors, including variability in evaluator judgements across settings, the evaluator-patient interaction and patients' expectations of the influence of FCE results on disability compensation.

Alberta↗
PubMedDate not supplied

The adaptability coefficient (AC)--an ergometric test in evaluation of the general functional capacity.

The AC test, based on the relation between the heart rate (fh) and triangular submaximal exercise intensity, was applied for 4 years on over 2000 healthy persons, and patients with cardiac and respiratory disorders. In this work there are presented the results of a reference group, made up of 20 male healthy students. The fh increased on an average with 5.32 beats/min for every 10 W step. The recovery of fh was obtained in 201 +/- 82 s, and the hemirecovery time in 38.5 +/- 15 s. We found the AC using the formula: (see text). The average value of the AC was 131 +/- 26. Together with the AC test, the Vo2 max, was also estimated during submaximum exercise--Astrand test; the average value was 35 +/- 6 ml/kg.min, with a semnificative linear correlation. This pleads, together with other data, for the value of AC test in clinical ergometric investigation.

Adult↗
PubMed1992

Mobility, strength, and fitness after a graded activity program for patients with subacute low back pain. A randomized prospective clinical study with a behavioral therapy approach.

Patients with nonspecific mechanical low back pain (n = 103), examined by an orthopaedic surgeon and a social worker, were randomized to an activity group (n = 51) and a control group (n = 52). Patients with defined orthopaedic, medical, or psychiatric diagnoses were excluded before randomization. No patients were excluded due to place of birth or difficulties in speaking or understanding the Swedish language. The purpose of the study was to compare mobility, strength and fitness after traditional care and after traditional care plus a graded activity program with a behavioral therapy approach. A graded activity program, with a behavioral therapy approach was given under the guidance of a physical therapist. The endpoint of the graded activity program was return to work. This program significantly increased mobility, strength, and fitness more than could be explained by only a time recovery effect, especially in males. The patients in the activity group returned to work earlier than did the patients in the control group. Spinal rotation, abdominal muscle endurance time and lifting capacity were significantly correlated to rate of return to work. Traditional care plus a graded activity program were superior to only traditional care, evaluated in terms of mobility, strength and fitness. The graded activity program proved to be a successful method of restoring occupational function and facilitating return to work in subacute low back pain patients. The patients in the graded activity program learned that it is safe to move, while regaining function.

Back Pain↗
PubMed1989

Disabling backache in France, Switzerland, and The Netherlands: contrasting sociopolitical constraints on clinical judgment.

A century has passed since clinicians assumed a linchpin role in the administration of programs to provide recourse and redress for persons suffering the illness of work incapacity. Medicine was asked to certify whether the illness was an injury in the absence of trauma, to ascertain whether further healing was possible, and to quantify the residual functional capacity. The response has been to force the vagaries of clinical judgment into the programmatic algorithm. No country has abandoned or redirected all three of these charges. Physicians have generally remained passive or intransigent as the society in which they function attempts to compensate for the indeterminate nature of these clinical questions. The current study compares the fashion in which the programs in Holland, Switzerland, and France have evolved in response to the clinical uncertainties. The Dutch have discarded the accident question. The Swiss emphasize the accident issue but consider the work-relatedness of the event to be irrelevant. The French have honed the traditional paradigm and have added a tier of clinical judgment within the program to monitor that without. These and other distinctions should cause all physicians to question their own convictions with regard to the three issues and, further, to question whether the basic paradigm is clinically flawed and therapeutically counterproductive.

Accidents, Occupational↗
PubMedDate not supplied

[Effect of unusual regimens of daily activity and sleep deprivation on the human functional state and work capacity].

Physiological functions, work capacity and sleep characteristics of six healthy test subjects were studied for 30 days. The test subjects adhered to one of the three different regimens (1--sleep from 2.00 a.m. to 10.00 a.m., 2--sleep from 6.00 p.m. to 2.00 a.m., and 3--sleep from 10.00 a.m. to 6.00 p.m.) which were aggravated by 64 hr or 72 hr vigilance during the experiment. The studies demonstrated general and specific changes in physiological functions, work capacity and sleep closely associated with the fact how far work-rest cycles were shifted and how long they were applied. Prolonged vigilance caused similar changes in physiological functions, work capacity and sleep. The test subjects showed very poor tolerance to an alteration in the work-rest cycle combined with sleep deprivation.

Activities of Daily Living↗
PubMed2006

Are functional capacity evaluations affected by the patient's pain?

Functional capacity evaluations (FCE) are comprehensive batteries of performance-based tests used commonly to inform return-to-work decisions for injured workers. As many people undergoing FCE have painful musculoskeletal conditions limiting their work ability, pain becomes a critical factor in the assessment of function. This paper considers the available literature related to the influence of pain on FCE, which clearly indicates FCEs are behavioral assessments influenced by pain intensity and other pain-related constructs. Increasing pain levels are consistently associated with reduced FCE performance levels. As such, for purposes of claims adjudication, FCE should not be considered a purely "objective" indicator of functional impairment independent of subject or evaluator perceptions. FCE may have some value for facilitating return-to-work or re-integrating chronically disabled workers into the workforce, although pain factors must be taken into consideration when making predictions about future work status. Shorter FCEs could potentially be as effective as more lengthy protocols.

Humans↗