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
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