Low-intensity exercise and reduction of the risk for falls among at-risk elders.

Background: Among elderly persons, falls account for 87% of all fractures and are contributing factors in many nursing home admissions. This study evaluated the effect of an easily implemented, low-intensity exercise program on the incidence of falls and the time to first fall among a clinically defined population of elderly men and women.

Methods: This community-based, randomized trial compared the exercise intervention with a no-intervention control.

Physical performance effects of low-intensity exercise among clinically defined high-risk elders.

Background: Falls are among the leading causes of injuries and deaths. Results from a number of studies have suggested that a community-based exercise program may be effective in improving lower body strength, although some have shown only limited improvements. However, the impact of these programs on gait and balance are equivocal.

Validity of the dictionary of occupational titles residual functional capacity battery.

Background Data: The Dictionary of Occupational Titles (DOT) is a U.S. government publication that defines each job in the United States according to 20 job factors.

Detection of a "faked" strength task effort in volunteers using a computerized exercise testing system.

The objective of this study was to develop an experimental method to separate a "faked" strength effort from a "best" effort in volunteers. Thirty-four pain-free volunteers (18 males, 16 females) performed a shoulder press and pull-down on an isokinetic computerized exercise testing system (CETS), giving a best effort followed by a faked effort. Two months later, a randomly selected subgroup (6 males) repeated the experiment to test the predictive validity of the derived variables.

The effect of back injury and load on ability to replicate a novel posture.

The purpose of this study was to investigate the effect of back injury and load on the ability to replicate a target standing posture. Subjects included 16 back-injured males and 16 age-matched controls. Subjects were asked to reproduce a target standing posture and to repeat this task while holding a weight.

"Movement" in work status after pain facility treatment.

Study Design: This was a randomized prospective follow-up study of pain facility treatment of chronic pain patients with low back pain, with return to work and work capacity as the outcome measures.

Objectives: To determine if after pain facility treatment chronic pain patients "move" in and out of work and in their work capacity; to determine the patterns of "movement;" and to determine the post-pain facility treatment follow-up sampling time points that would maximize the number of chronic pain patients correctly classified according to their final work and work capacity status.

Summary Of Background Data: Past research and empiric observation have indicated that chronic pain patients may "move" after pain facility treatment in and out of work and in their job work capacity.

Process analysis of functional capacity assessment.

Researchers and practitioners, as well as vendors, have placed much emphasis on what constitutes a functional capacity testing battery. Statistical, procedural, behavioral, technological, as well as legal issues surrounding this type of human performance evaluation are also continuously being addressed in the literature. In addition, several methods, batteries, equipment, and protocols have been developed for the purpose of evaluating what an injured person can or cannot do.

Physician limitations when assessing work capacity: a review.

Literature evidence indicates that physicians have great difficulty in translating medical impairment into functional limitation and thereby establishing the work capacity or the residual functional capacity (RFC) of the injured worker. This is especially true for the chronic pain patient (CPP). Development of quantitative methods for the measurement of functional capacity (FC), have not improved the problems involved in the measurement of RFC and the translation of RFC into the demand minimum functional capacity (DMFC) of some job or jobs.

Efficacy of physical restoration in the elderly.

Studies of the effects of physical exercise programs have shown that such programs can improve older persons' functional capacity. Research was conducted to determine the efficacy of two different types of physical restoration regimens--active and passive--in improving the performance of elderly persons with chronic pain conditions. Data from elderly persons admitted for back and pain rehabilitation to the Comprehensive Pain and Rehabilitation Center (CPRC) at the University of Miami are presented.

Functional electrical stimulation treatment of postradiculopathy associated muscle weakness.

Eighteen chronic pain patients (CPPs) with postradiculopathy-associated muscle weakness were entered into a nonrandomized functional electrical stimulation (FES) clinical treatment study to determine if FES can improve postradiculopathy associated muscle weakness. Because of the clinical nature of the unit, the CPPs could not be denied treatments other than FES. To control for these other treatments, the CPPs were used as their own controls with two control conditions, ie, where possible, the contralateral probable normal muscle was used as a control (control 1) and; in a subgroup of CPPs (n = 6), FES treatment was initially withheld to the probable weak muscle (control 2).

Measuring residual functional capacity in chronic low back pain patients based on the Dictionary of Occupational Titles.

Study Design: This study designed and tested a functional battery based on the Dictionary of Occupational Titles (DOT).

Objectives: Such a battery can be used to measure residual functional capacity (RFC) in chronic pain patients (CPP) and results can be matched against the demand minimum functional capacities (DMFC) of DOT jobs.

Summary Of Background Data: Physicians have difficulty translating medical impairment into functional limitation and thereby establishing the RFC of CPPs.

Does nonsurgical pain center treatment of chronic pain return patients to work? A review and meta-analysis of the literature.

Evidence in the literature relating to return to work as an outcome variable for nonsurgical treatment for chronic pain was examined. Study selection criteria were as follows: a detailed definition of patient work status, delineation of work status pre-treatment and at follow-up, and documentation of the proportion of patients employed at follow-up. Of 171 studies reviewed, 37 fulfilled these selection criteria.

Functional capacity and residual functional capacity and their utility in measuring work capacity.

Objective: The pain physician is often asked to establish the medical impairment of the chronic pain patient (CPP) and from that determination ascertain the work capacity of the CPP. Functional capacity (FC) testing has recently been introduced as a more objective and accurate way of facilitating the determination of work capacity. However, there are conceptual problems with the measurement of FC.

The prediction of return to the workplace after Multidisciplinary Pain Center treatment.

The prediction of return to the workplace after Multidisciplinary Pain Center (MPC) treatment has become a major research area. To delineate the variables that predict this outcome, the authors reviewed 164 multidisciplinary variables studies. Of these, 79 addressed work as an outcome variable.

Computer-aided design and analysis of the sitting workplace for the disabled.

This paper describes a personal microcomputer model to match the need of the ambulatory disabled to the physical workplace. It is noted that back pain resulting from working from wheelchairs is the most common complaint of many who continue or return to work. The use of computer-aided design in matching the person to his/her workstation is described.

The utility of electromyographic biofeedback in the treatment of conversion paralysis.

Conversion paralysis has a poor prognosis when there is evidence of nonresponse to previous treatment, long duration, and secondary atrophy of the "paralyzed" muscles. The authors present four such cases in which conversion paralysis was treated successfully by means of electromyographic (EMG) biofeedback. Each of the four patients also suffered from a chronic pain condition.

Functional electric stimulation in the reversal of conversion disorder paralysis.

Numerous reports have documented the usefulness of functional electric stimulation (FES) in restoring and/or improving the function of organically diseased or paralyzed muscles. There are few reports related to the use of FES in the treatment of conversion disorder paralysis of the hysterical type. This paper presents a case of hysterically paralyzed muscles where the patient received daily treatment with FES for two weeks.