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On 10/31/99, J. Boone<[log in to unmask]> wrote: <<I am looking for a few simple functional strength tests for sick patients in hospitals? I am beginning to prepare an article on this subject and would like to get some viewpoints from the group.>> ***An important point to remember is that strength and endurance tests depend a great deal on psychological factors such as motivation, concentration and perception of pain and effort. A sick patient is hardly likely to display qualities such as these to any significant degree, so one has to question the relevance, accuracy and repeatability of strength testing someone who is severely debilitated. I know, when I was a seriously ill patient in a clinic, the last thing I felt like doing was exerting any form of strength at all and I am a trained Olympic weightlifter. Later, of course, in the post-acute stages, some mild exertion became acceptable, but not for many months did I feel like exerting anything like maximal strength or something like 5RM (% repetition max) testing, but that was long after discharge. Even a child could see how frail and weak I was - I did not have to try any oppose therapist applied force, lift a miserable little dumbbell or push against some dynamometer. So, one has to examine the entire idea of strength testing ill patients. This would depend on whether by ill you mean "injured", diseased, post surgical cancer or cardiac, etc. Since you stipulated tests to be administered in hospitals, then I assume that this refers to immediate post-acute testing and I have to wonder what practical purpose this sort of testing would serve. Any attending nurse can tell you from the daily rounds how strong or weak a patient is in carrying out basic daily functions. Why should any more accurate quantitative testing be necessary at this early stage of evaluation? Undergoing spirometer and coughing tests alone are already demanding enough for many patients. The ability to sit up in bed and even walk unaided to a bathroom are two basic acts that tell you enough about a patient's strength and coordination for essential daily activities. Dr Mel C Siff Denver, USA [log in to unmask] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%