Assessment Of Functional Capacity Research Articles

Effects of Osteoporosis Specific Standardized Physical Therapy on Functional Capacity, Bone Mineral Density and Bone Metabolism – a 2-Year Prospective and Randomized Study

Purpose: Patients with osteoporosis inherit a high risk for pathologic fractures as consequence from falling due to deficits in coordination, balance, muscle strength and endurance. It is believed that a specific training can avoid these complications. Therefore the effects of osteoporosis specific physiotherapy (OSP) on functional capacity, bone mineral density (BMD) and bone metabolism were evaluated in a real-life long-term setting. Methods: 42 patients with manifest osteoporosis receiving adequate calcium and vitamin D supplementation and bisphosphonate therapy were included. 25 patients underwent OSP once a week (exercise group – EG) and were compared to 17 patients without OSP (control group – CG). Outcome parameters at baseline and after 1 and 2 years included assessments of functional capacity and pain as well as BMD and specific markers of bone metabolism (serum osteocalcin and crosslaps). Results: Functional capacities improved significantly only in the EG, a significant pain reduction occurred only in the EG as well. Furthermore the EG demonstrated a significant increase in BMD of the right femur after 2 years (0.84±0.10 g/cm²) as compared to baseline (0.81±0.12 g/cm²) (p Conclusions: This is the first study to show that standardized osteoporosis-specific physiotherapy once weekly results in significant protective effects on functional capacity, bone mineral density and bone metabolism, which is accompanied by a reduced risk of falling in patients with osteoporosis under adequate osteoprotective medical treatment. It needs to be emphasized that even a once-weekly exercise is sufficient to sustain these positive effects.

Role of telerehabilitation in patients following total knee arthroplasty: Evidence from a systematic literature review and meta-analysis

Introduction Increased physical activity and functional ability are the goals of total knee replacement surgery. Therefore, adequate rehabilitation is required for the recovery of patients after discharge from hospital following total knee arthroplasty (TKA). This systematic literature review aimed to evaluate the effectiveness of home telerehabilitation in patients who underwent TKA. Methods Studies published in the English language between 2000 and 2014 were retrieved from Embase, PubMed, and Cochrane databases using relevant search strategies. Two researchers independently reviewed the studies as per the Cochrane methodology for systematic literature review. We considered telerehabilitation sessions as those that were conducted by experienced physiotherapists, using videoconferencing to patients’ homes via an internet connection. The outcomes assessed included: knee movement (knee extension and flexion); quadriceps muscle strength; functional assessment (the timed up-and-go test); and assessment of pain, stiffness, and functional capacity using the Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain. Results In total, 160 potentially relevant studies were screened. Following the screening of studies as abstracts and full-text publications, six primary publications (four randomized controlled trials, one non-randomized controlled trial, and one single-arm trial) were included in the review. Patients experienced high levels of satisfaction with the use of telerehabilitation alone. There was no significant difference in change in active knee extension and flexion in the home telerehabilitation group as compared to the control group (mean difference (MD) −0.52, 95% CI −1.39 to 0.35, p = 0.24 and MD 1.14, 95% CI −0.61 to 2.89, p = 0.20, respectively). The patients in the home telerehabilitation group showed improvement in physical activity and functional status similar to patients in the conventional therapy group. Discussion The evidence from this systematic literature review demonstrated that telerehabilitation is a practical alternative to conventional face-to-face rehabilitation therapy in patients who underwent TKA.

Assessing functional exercise capacity using telehealth: Is it valid and reliable in patients with chronic heart failure?

Introduction This study aimed to determine the validity and reliability of video-based telerehabilitation assessments in patients with heart failure. Methods Seventeen consecutive participants (mean age 69 years, SD 12 years and 88% males) undertook assessments of three functional tests via both telerehabilitation and face-to-face approaches, on the same day. The assessment order was randomised and conducted by independent assessors. Outcome measures included functional tests: timed up and go (time), six-minute walk (distance), grip strength (kilograms); system usability scale to rate participant experience with telerehabilitation assessment; and number of technical issues encountered. Validity and inter- and intra-rater reliability of telerehabilitation assessments were examined using limits of agreement, intra-class correlation coefficients (ICC), and paired t-tests. Results The limits of agreement for telerehabilitation assessments were within the clinically acceptable limits for timed up and go and grip strength. Telerehabilitation assessments for all functional tests were strongly associated with face-to-face assessments, with ICCs of between 0.85 and 0.96. Inter- and intra-rater reliability of telerehabilitation assessments for all functional tests were excellent (all ICC > 0.95). The mean (SD) system usability scale score was 85 (15)/100. Some incidences of Internet drop-outs, video freezing and auditory fading occurred. Discussion The use of telehealth for the assessment of functional exercise capacity appears to be valid and reliable in patients with heart failure.

FIELD MEASUREMENTS ON RUNWAY FRICTION DECAY RELATED TO RUBBER DEPOSITS

Surfaces of airport pavements are subject to contamination that can be very dangerous for the movement of aircraft particularly on the runway. A recurrent problem is represented by the deposits of vulcanized rubber of aircraft tires in the touchdown area during landings and lesser during take-offs. This causes a loss of grip that compromises the safety of aircraft movements in take-off and landing operations. This study deals with the surface characteristics decay phenomenon related to contamination from rubber deposits. The experiment was conducted by correlating the pavement surface characteristics, as detected by Grip Tester, to air traffic before and after de-rubberizing operation and two models were constructed for the assessment of functional capacity of the runway before and after the operations de-rubberizing.

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Validation of a Computerized test of Functional Capacity

Regulatory guidance for schizophrenia cognition clinical trials requires that the assessment of cognitive change is accompanied by a functionally meaningful endpoint. However, currently available measures are challenged by resistance to change, psychometric weaknesses, and for interview-based assessments, dependence upon the presence of an informant. The aims of the current study were to: 1) assess the validity, sensitivity, and reliability of the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) as a measure of functional capacity; 2) determine the association between performance on the VRFCAT and performance on the MATRICS Consensus Cognitive Battery (MCCB); and 3) compare the metrics of the VRFCAT with the UCSD Performance-based Skills Assessment (UPSA). 167 patients with schizophrenia and 166 healthy controls completed the VRFCAT, UPSA, and the MCCB at baseline. The VRFCAT and UPSA were completed again at follow-up. The VRFCAT, MCCB, and UPSA were very sensitive to impairment in schizophrenia (d=1.16 to 1.22). High test-retest reliability was demonstrated for VRFCAT total completion time and the UPSA total score in patients (ICC=0.81 and 0.78, respectively). The UPSA demonstrated significant practice effects in patients (d=0.35), while the VRFCAT did not (d=−0.04). VRFCAT total completion time was correlated with both UPSA (r=−0.56, p<0.0001 for patients and −0.58, p<0.0001 for controls) and MCCB Composite (r=−0.57, p<0.0001 for patients and −0.68, p<0.0001 for controls). The VRFCAT is a highly reliable and sensitive measure of functional capacity with associations to the UPSA and MCCB. These results provide encouraging support for a computerized functional capacity assessment for use in schizophrenia.

Moderate agreement between bladder capacity assessed by frequency volume charts and uroflowmetry, in adolescent and adult enuresis patients.

Frequency Volume Charts (FVC) are recommended for the evaluation of enuretic patients. Although this is a good instrument for the assessment of functional bladder capacity, it is known that patient compliance could introduce problems. Therefore, we assessed whether uroflowmetry and post-void residual volume could replace FVC recordings in specific cases, by comparing the bladder capacity as measured by FVC or uroflowmetry. We performed post-hoc analyses using data from a retrospective cohort study, in secondary/tertiary care. This included 907 patients between 2003 and 2013, aged ≥11 years, suffering from enuresis (≥1 wet night/fortnight). Data were collected from the medical files. Bland Altman plots were made to compare the two methods. Agreement between uroflowmetry and FVC was reasonable only when uroflowmetry was between 200 and 450 ml. For individual clinical purposes, uroflowmetry can be used if values are in this range. For future research, we recommend to keep measuring bladder capacity with an FVC. Neurourol. Urodynam. 36:745-747, 2017. © 2016 Wiley Periodicals, Inc.

Respiratory function and functional capacity in chronic stroke patients 1

Abstract Introduction: Cerebrovascular accident (CVA) or stroke results in weakness of the trunk muscles and physical unfitness. Objectives: To evaluate respiratory changes caused by stroke and correlate them with the functional capacity of chronic stroke patients who were treated at the Clinical Center of Physical Therapy of the Pontifical Catholic University of Minas Gerais, Betim. Methods: Fifteen patients were recruited for assessment of respiratory function and functional capacity. We measured maximum inspiratory pressure (MIP), maximal expiratory pressure (MEP), peak expiratory flow (PEF), vital capacity (VC), and functional capacity using the six-minute walk test (6MWT). Test results were compared with reference values using an unpaired Student's t-test or the Mann-Whitney test. Respiratory variables were correlated with the distance walked in the 6MWT using Spearman's correlation test. Results: The sample had a mean age of 58.2 ± 13.4 years, and most patients had a diagnosis of ischemic stroke and left hemiparesis. The following values were obtained: MIP (47.7 ± 22.2 cmH2O); MEP (47.5 ± 20.3 cmH2O); PEF (351.3 ± 90.8 L/min); VC (3.0 ± 0.91 L); and 6MWT (222.4 ± 101.6 m). The MIP, MEP, PEF, and 6MWT values measured in this study were statistically significantly lower (p &lt; 0.001) than the reference values. There was no statistically significant correlation between the distance walked in the 6 MWT and respiratory variables (p &gt; 0.005). Conclusion: Our results suggest that, despite the decrease in respiratory muscle strength, PEF, and VC, these variables did not correlate with the functional capacity of the chronic stroke patients assessed in this study.

Assessment of functional capacity and the risk of falls in the elderly with mild and moderate stage dementia

Assessment of functional capacity and the risk of falls in the elderly with mild and moderate stage dementia

Assessment of functional capacity in patients attending geriatrics outpatient department at Civil Hospital, Ahmedabad

Aims: To access the quality of life in terms of functional capacity and to estimate the prevalence of depression among geriatric patients. Settings and Design: A hospital-based study was conducted in Civil Hospital, Ahmedabad between July and September 2006. The patients aged 65 years and above were included in the geriatrics outpatient department. Methods: The geriatric patients were interviewed during their geriatric clinic visit using a structured questionnaire regarding instrumental activities of daily living (IADL), basic activities of daily living (ADL), Nagi physical disability scale, and short version of the geriatric depression scale. Statistical Analysis Used: Data were analyzed using EPI-Info Statistical Packages. Using a scoring system, mean, standard deviation, and the significance of the results was tested using the Chi-square test and Z-test was used to compare quantitative data. Results: Mean IADL score of males is 4.05 whereas of females is 2.91 which is significant (P < 0.05). Overall scores for ADL showed no statistically significant results between male and female geriatric subjects. The mean scores of restriction of basic activities on the Nagi scale of physical disability were not significant among women. Mean scores of depression were highly significant in IADL, basic ADL, and limitation of basic movement while significant in a greater number of reported symptoms. Conclusions: Depression was due to combined effect of increased scores of IADL, ADL, and Nagi physical disability scale.

Assessment of Pulmonary Function and Functional Capacity in Overweight Young Adults: Correlation with Visceral Fat

Assessment of Pulmonary Function and Functional Capacity in Overweight Young Adults: Correlation with Visceral Fat

The Daily Activity Report (DAR) a Novel Measure of Functional Outcome for Serious Mental Illness.

The assessment of real-world functional outcomes in clinical trials for medications targeting negative symptoms and cognitive impairment is extremely important. We tested the psychometric properties of the Daily Activity Report (DAR), a novel assessment of productive daily activity. We administered the DAR and additional assessments of functional outcome, functional capacity, cognition and symptomatology to 50 individuals with schizophrenia at 2 time points, 1 month apart and to 25 healthy controls. The DAR records a person’s daily activity for 7 consecutive days based upon phone calls made 3 times a day. A total score and scores in 3 domains; instrumental activities (ie, independent living), social and work or school related activities are generated for the DAR. Inter-item consistency was high 0.89–0.94 for each domain and 0.88 overall. Test–retest reliability across 1 month for the total DAR score was 0.67, P < .0001. The total DAR score as well as scores for social activity and nondomestic work/school differed significantly between control and patient participants (P < .0001). DAR domain scores were associated with negative symptoms and functional outcomes, but the primary score related to these measures was the work/school dimension of the DAR. DAR scores were only weakly and nonsignificantly related to positive symptoms. This study provides preliminary support for the reliability and validity of the DAR using interviewer administration. The development of a patient reported version of the DAR using smart phone technology with automatic scoring is the next step.

Peripheral muscle strength and functional capacity in patients with moderate to severe asthma

&#x0D; &#x0D; &#x0D; &#x0D; Background: The adequate control of asthma includes the absence of nocturnal symptoms, minimal use of medication, normal or nearly normal lung function and no limitations to physical activity. The choice of a more sedentary lifestyle can lead to physical de-conditioning, thereby aggravating asthma symptoms and increasing the risk of obesity.&#x0D; Methods: This study aimed at performing a battery of function-related assessments in patients with asthma and comparing them to a healthy control group. A prospective, transversal and case–control study was designed. It was set up at Santa Casa de Misericórdia Hospital – Sao Paulo and Nove de Julho University on a population of outpatients. Subjects of the study were patients affected by moderate to severe asthma. A case–control study was carried out involving 20 patients with moderate to severe asthma and 15 healthy individuals (control group). All participants underwent body composition analysis (BMI and BIA) and a controlled walk test (Shuttle test), resistance muscle test (1RM) and answered a physical activity questionnaire (IPAQ). The group with asthma also answered a questionnaire addressing the clinical control of the illness (ACQ).&#x0D; Results: In comparison to the control group (unpaired Student’s t-test), the patients with asthma had a significantly higher BMI (31.09 ± 5.98 vs. 26.68 ± 7.56 kg/m2) and percentage of body fat (38.40 ± 6.75 vs. 33.28 ± 8.23%) as well as significantly lower values regarding distance traveled on the walk test (369 ± 110 vs. 494 ± 85 meters) and metabolic equivalents (3.74 ± 0.87 vs. 4.72 ± 0.60). A strong correlation was found between the distance completed and peripheral muscle strength (r: 0.57, p &lt; 0.05) and METs (Metabolic equivalents – minutes/week) and peripheral muscle strength of 1RM (r: 0.61, p = 0.009).&#x0D; Conclusions: The individuals with asthma had lower functional capacity and levels of physical activity as well as a higher percentage of body fat compared to healthy individuals. This suggests that such patients have a reduced physical performance stemming from a sedentary lifestyle. Despite the existence of few studies reporting moderate to severe asthmatic patients and functional capacity assessment, it is clear that the assessment presented in the current study is a valid and accessible tool in clinical practice.&#x0D; &#x0D; &#x0D; &#x0D;

Abstract 17341: Comparing the Kansas City Cardiomyopathy Questionnaire and New York Heart Association in Assessing Functional Capacity and Outcomes

Background: The Kansas City Cardiomyopathy Questionnaire (KCCQ) has emerged as a patient-centered, heart failure-specific health status measure. This study examined the correlation between KCCQ and cardiopulmonary exercise testing (CPET) parameters and clinical outcomes, in comparison to the physician-derived New York Heart Association (NYHA) functional class. Methods and Results: We performed a single-centered, observational prospective analysis of 432 outpatients who presented to the Heart Failure Department, completed the KCCQ, and underwent CPET. Outcomes assessed included 30-day heart failure hospitalization and all-cause mortality. Among the KCCQ scores, the physical limitation domain had similar correlations as NYHA with peak oxygen consumption (r = 0.48 for both, p &lt; 0.001) and ventilatory threshold (r = 0.42 versus r = 0.40, respectively, p &lt; 0.001). The KCCQ overall score predicted 30-day hospitalization (OR 0.77, 95% CI 0.66 to 0.88, p &lt; 0.001) and mortality (HR 0.91, 95% CI 0.88 to 0.95, p &lt; 0.0001). NYHA could not differentially predict mortality between functional class II and III patients who comprised the majority of our cohort, although it did predict 30-day heart failure hospitalization in this group. Using model validation, NYHA was the best predictor of peak VO 2 (r 2 = 0.36), KCCQ total symptom score the best predictor of 30-day heart failure hospitalization (AUC = 0.724), and KCCQ physical limitation score the best predictor of mortality (AUC = 0.671). Conclusions: KCCQ and NYHA provide a reasonable assessment of functional capacity, the latter being more predictive. KCCQ is superior to NYHA in its ability to predict clinical outcomes. These findings support its routine use in clinical care, as well as its potential to serve as a measure in clinical trials.

Scales for assessment of patients with traumatic brain injury.

Dear editor We read with great interest the paper by Ślusarz et al1 published in the Patient Preference and Adherence. The functional recovery after traumatic brain injury (TBI) is related to the severity of the brain lesion and the time after TBI. The consequences of brain damage remain beyond the acute phase, extending and modifying for a long period after the traumatic event.2 Knowing the functional recovery after TBI is relevant to evaluating the results of new techniques and treatments to minimize the severity of the disability. As a result, the pathophysiology of disability after TBI and the mechanisms involved in functional recovery are the subject of investigations, which provide the foundation to direct rehabilitation programs and guide the development of individualized therapy after TBI.3 Ślusarz et al’s1 article focused on the role of establishing the relationships between measurements by the Glasgow Coma Scale (GCS) and the scales used for the assessment of functional capacity of TBI patients. Although some studies have described the recovery of patients of TBI after trauma, there are few studies that evaluate the different aspects of functional capacity in the acute phase after brain injury and factors related to outcome. We agree with Ślusarz et al1 that studying the functional capacity and assessing the activities of daily living in patients with TBI facilitate the planning of systematic assistance, implementation of neurological rehabilitation, reintegration of patients in society, and a better warranted quality of life. A strength of the study is to analyze the functional capacity assessed by different scales at admission and at discharge, highlighting the correlation of recovery in both periods with the level of awareness, and the comparison of different scales that assess functional capacity and activities of daily life. Our group has great interest in the assessment of functional recovery of TBI patients analyzed by different scales, in particular, patients with severe diffuse axonal injury (DAI).3,4 As discussed by Ślusarz et al,1 the evaluation of consciousness is a widely used prognostic parameter in the acute phase of trauma and identifies early the outcome of patients with severe TBI, and it is relevant in the face of the impairment of brain functions caused after TBI and the mechanisms involved in the recovery process. Clinical observations of TBI patients have suggested improvement during the first year, particularly during the first 6 months, with stabilizing of the recovery process thereafter.2,5–7 Research to assess the consequences for TBI patients showed that there is an improvement in functionality after trauma; however, how to measure functional recovery after TBI is still a challenge. Analysis of patients with severe TBI showed that advanced age and prolonged hospitalization were independent predictors of poor outcome after trauma.6 The lowest score of the Glasgow Coma Scale on admission is a factor associated with dependence or death of TBI patients, assessed 3 months after the trauma.7 Our research8 carried out with patients of DAI showed that severe DAI stood out as risk factor for mortality and dependence compared to focal injury. The length of hospitalization was identified as a risk factor related to dependence on outcome. In addition, other important scales can be used to assess functional recovery, mainly in severe trauma. We had used Katz scale and the Extended Glasgow Outcome Scale in patients with severe DAI, and we found similar results when assessing recovery at 6 months after DAI compared with results described by Ślusarz et al,1 using correlation results of the functional capacity scale and the functional index “Repty”. The results described by Sĺusarz et al1 showed the importance of studying the recovery of patients with TBI after trauma since it identified greater independence of the patients after hospital discharge and a correlation between the level of awareness and functional capacity. The identification of functional recovery and its correlation with the outcome can guarantee the quality of care provided to patients and provide a better quality of life. However, we believe that functional recovery analysis of TBI patients is a complex issue, presents particularities, and maybe should be stratified according to severity of trauma, including the creation of appropriate scales for mild TBI, separated from moderate and severe TBI.

Long-Term Efficacy and Safety of Repeated Intravescial OnabotulinumtoxinA Injections Plus Hydrodistention in the Treatment of Interstitial Cystitis/Bladder Pain Syndrome.

Intravesical onabotulinumtoxinA (BoNT-A) injection can relieve symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS), but lacks sustainability. Repeated injections have been shown to provide a superior outcome to a single injection, but data on long-term efficacy and safety is limited. In this prospective study, we enrolled patients with refractory IC/BPS, and treated them with 100 U of BoNT-A injection plus hydrodistention followed by repeated injections every six months for up to two years or until the patient wished to discontinue. A “top-up” dose was offered after the fourth injection. Of these 104 participants, 56.7% completed four BoNT-A injections and 34% voluntarily received the fifth injection due to exacerbated IC symptoms. With a follow-up period of up to 79 months, O’Leary-Sant symptom and problem indexes (ICSI, ICPI, OSS), pain visual analogue scale (VAS) functional bladder capacity, frequency episodes, and global response assessment (GRA) all showed significant improvement (p < 0.0001). Those who received repeated injections had a better success rate during the long-term follow-up period. The incidence of adverse events did not rise with the increasing number of BoNT-A injections. A higher pre-treatment ICSI and ICPI score was predictive for successful response to repeated intravesical BoNT-A injections plus hydrodistention.

Diagnostic value of the six-minute walk test (6MWT) in grown-up congenital heart disease (GUCH): Comparison with clinical status and functional exercise capacity

BackgroundExercise testing for the assessment of functional capacity plays an important role in long-term follow-up of GUCH patients. CPX is the favored modality for decision-making recommended in the current guidelines. In contrast to this complex method, the 6MWT is a simple, easy-to-perform, safe, and commonly available exercise test. Although well-established in various cardiopulmonary diseases, the diagnostic impact of the 6MWT in GUCH patients is not known so far. Methods102 GUCH patients were evaluated by 6MWT and CPX simultaneously. Clinical symptoms were assessed, according to the NYHA classification. Additionally, an echocardiography study, and selected cardiac blood tests (N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive Troponin T) were performed. ResultsRanges of six-minute walk distance (6MWD) and peak oxygen consumption (peakVO2) were 116–765m and 6.4–36.2ml/kg/min, respectively. 6MWD and peakVO2 showed a close correlation (r=0.72, 95% CI, 0.63 to 0.79). Patients with a peakVO2 of ≤15.5ml/kg/min were excellently identified by 6MWT (c-value=0.82). A cut-off value of 482m was optimal to predict reduced peakVO2. In multivariate regression analysis, 6MWD and NYHA class were identified as relevant predictors of peakVO2. In subgroup analysis, Eisenmenger patients achieved the shortest 6MWD (280, SD 178m). ConclusionIn our study population of GUCH patients, the 6MWD shows a close correlation to peakVO2, and an excellent prediction of reduced peakVO2. Thus, it seems to be an easy-to-perform and reliable screening parameter to evaluate functional capacity of these patients (Controlled Clinical Trials number, NCT02193243).

Correlation between the body balance and functional capacity from elderly with chronic vestibular disorders

AbstractVestibular disorders are common among the elderly, mainly resulting in dizziness and imbalance - symptoms which can impact daily routine activities. AimTo study the correlation between body balance and functional capacity and a comparison of risk of falls, actual falls and the functional capacity of the elderly with chronic vestibular dysfunctions. Materials and MethodsA cross-sectional, clinical and experimental study with 50 senior citizens - 60 to 86 years, with chronic peripheral vestibular dysfunction. These participants underwent body balance assessment by the Dynamic Gait Index (DGI) and functional capacity assessment by the Functional Independence Measure (FIM). The data was tested using the Spearman correlation and comparison tests, Mann-Whitney and Kruskal- Wallis, being α=5% (0.05). ResultsThere was a significant correlation between the total DGI score and all FIM scores, especially the total score (r=0.447; p<0.001) and loss of functional capacity in elderly patients with the highest risk of falling (p<0.001). ConclusionThere is a positive correlation between body balance and functional capacity in elderly patients with peripheral vestibular disorders, that is: the better the balance, the better the individual's functional capacity. In addition, a worse functional capacity increases the individual's risk of falling.

Clinical Functional Capacity Testing in Patients With Facioscapulohumeral Muscular Dystrophy: Construct Validity and Interrater Reliability of Antigravity Tests

ObjectiveTo evaluate the construct validity and interrater reliability of 4 simple antigravity tests in a small group of patients with facioscapulohumeral muscular dystrophy (FSHD). DesignCase-control study. SettingUniversity medical center. ParticipantsPatients with various severity levels of FSHD (n=9) and healthy control subjects (n=10) were included (N=19). InterventionsNot applicable. Main Outcome MeasuresA 4-point ordinal scale was designed to grade performance on the following 4 antigravity tests: sit to stance, stance to sit, step up, and step down. In addition, the 6-minute walk test, 10-m walking test, Berg Balance Scale, and timed Up and Go test were administered as conventional tests. Construct validity was determined by linear regression analysis using the Clinical Severity Score (CSS) as the dependent variable. Interrater agreement was tested using a κ analysis. ResultsPatients with FSHD performed worse on all 4 antigravity tests compared with the controls. Stronger correlations were found within than between test categories (antigravity vs conventional). The antigravity tests revealed the highest explained variance with regard to the CSS (R2=.86, P=.014). Interrater agreement was generally good. ConclusionsThe results of this exploratory study support the construct validity and interrater reliability of the proposed antigravity tests for the assessment of functional capacity in patients with FSHD taking into account the use of compensatory strategies. Future research should further validate these results in a larger sample of patients with FSHD.

Functional capacity: a new framework for the assessment of everyday functioning in schizophrenia.

Historically, measures of everyday functioning have focused exclusively on real-world performance. Despite the unquestionable value of "real-world functioning", it has become clear that instruments for its assessment might not be as accurate as desirable. Functional capacity is a domain of everyday functioning that can be assessed through performance-based measures. In the last decade, functional capacity has become a cornerstone for the assessment of everyday functioning, since, alongside measures of real-world functioning, it provides a much more comprehensive picture of functional outcomes than any measurement alone. Functional capacity is more stable and less vulnerable to influence from environmental factors than other domains, and its correlation with cognitive functions has encouraged the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) project to suggest that a performance-based measure of functional capacity be included as a co-primary assessment of cognition in clinical trials. Functional capacity assessment instruments may be also useful in the evaluation of remission in schizophrenia. Validation of these instruments in different countries is desirable, and should always include cross-cultural adaptation; within large countries, adjustment for regional variations should be considered.