[Medical expert evaluation of work capacity and surgical treatment of patients with varicose veins of lower limbs].
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The article deals with results obtained in examination covering miners who faced myocardial infarction and assessing their performance. Spirometry and bicycle ergometry appeared to detect changes in aerobic threshold even in the cases when the effort tolerance is not compromised. The materials obtained bring to a conclusion that the miners after myocardial infarction include subjects with lower functional resources and a higher share of those with reserved aerobic capacity. That necessitates more differentiated approach in occupational placement.
Functional capacity evaluation (FCE) is a systematic, comprehensive, objective measurement of an individual's maximal work abilities. This article describes the uses, objectives, and components of FCEs, the various types of FCEs employed, and their advantages and disadvantages.
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BACKGROUND: Functional capacity evaluations are used to quantify and qualify the physical abilities of an individual in relation to the physical requirements of an occupation. One major observation associated with functional capacity evaluations is a lack of evidence on their psychometric properties. PURPOSE: This article presents the results of a study on the test-retest reliability of a functional capacity evaluation tool: the Physical Work Performance Evaluation (PWPE). The PWPE is an instrument for evaluating the physical work capacities of individuals with physical limitations resulting from a health problem. METHODS: The PWPE was administered twice to a convenience sample of 30 workers in good health. RESULTS: In the section on 'Dynamic Strength', the tasks demonstrate a good test-retest reliability (0.79 < ICC < 0.91). The three sections and the global score of the PWPE demonstrate a moderate stability (0.43 < kappa > 0.52). PRACTICE IMPLICATIONS: The PWPE score should be interpreted with caution and further studies on its psychometric properties will be necessary to clarify its clinical utility.
The purpose was to evaluate the interrater reliability of the Dynamic Strength, Position Tolerance, and Mobility tasks of the Physical Work Performance Evaluation (PWPE), a Functional Capacity Evaluation often used with workers disabled due to back pain. For each worker's evaluation, two raters were preselected among five trained raters. One of the raters administered the PWPE while the other functioned as a silent rater. A convenience sample of 40 workers disabled due to back pain and referred to an occupational rehabilitation center was used. In general, the reliability was "substantial" (0.61 < or = kappa < or = 0.80) to "almost perfect" (0.81 < or = kappa < or = 1.00) for most of the 21 tasks and three sections of the PWPE evaluated with the exception of three tasks in the Mobility section (ladder climbing (kappa = 0.47), repetitive trunk rotation--standing (kappa = 0.54), and repetitive trunk rotation--sitting (kappa = 0.37)) task and the Mobility section itself (kappa = 0.54). Several reasons could explain the lower agreement on the observation of the physical signs associated with these tasks. Since these tasks involve rotation movements or complex neuromuscular integration, it seemed difficult for the raters to define what are the normal physical signs and when physical signs of maximal functional capacity are present. The criteria for establishing the presence of the physical signs in the PWPE should be improved.
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The authors have discussed the new conceptual neurophysiological model of genesis and pathogenesis of fatigue and overstrain in seamen. The complex phase character of the developing changes was revealed. Use of the complex of psychophysiological methods with consideration of neurophysiological nature of the changes detected allowed us to obtain the objective assessment concerning fatigue and overstrain in seamen. It is shown that the existing conceptions about the dynamics of nervous processes developed in seamen during fatigue and overstrain including those described in the corresponding documents of the Navy and their evaluation are too simplified and theoretically incorrect. These incorrect concepts practically prevent the conduction of appropriate medical and prophylactic measures, complicate the standardization of some characteristics of habitability of the Navy ships and submarines, not ensure trouble-free conditions at sea in terms of human factor.