Physical Performance Outcomes Research Articles

Identifying hospitalized older patients at varying risk for physical performance decline: a new approach.

A classification tree analysis identifies patient groups at varying risk for decline in physical performance 1 year after hospitalization. Prospective cohort study. Tertiary care VAMC. A total of 507 acutely ill hospitalized male veterans aged 65 years and older. Eighteen admission characteristics were considered as potential predictors: demographic data, medical diagnoses, functional status (e.g., ADL and IADL), geriatric conditions (e.g., incontinence, vision impairment, weight change), mental status, depression, and physical functioning (measured by self-report (MOS-PFR) and the Physical Performance and Mobility Examination (PPME)). Outcome measure was change in PPME status at 12-months post-admission. Patients with the greatest risk for decline had both high baseline physical performance (PPME > or = 9) and at least moderate self-report limitations on physical functioning (MOS-PFR < or = 36, mean = 30.8). Patients with the lowest risk of decline had impaired baseline physical performance (PPME < or = 8) but fewer self-report limitations on physical functioning (MOS-PFR > or = 31, mean = 37.4) and two or less geriatric conditions. The predictive role of self-report functioning suggests that perception of the impact of health on one's own physical functioning is associated with future performance. The number of geriatric conditions is also an important predictor of physical performance change. By identifying patient risk groups based on geriatric conditions, physical performance, and self-report physical functioning, future targeting strategies may improve physical performance outcomes for hospitalized older adults.

Improved Physical Performance Outcomes After Functional Restoration Treatment in Patients with Chronic Low-Back Pain

Functional restoration, a medically supervised team treatment approach that addresses deficits that accompany the deconditioning process in patients with chronic low-back pain, has emerged as a viable rehabilitation alternative. While the primary emphasis of this treatment approach has remained unchanged since its inception over 6 years ago, recent rapid advances in quantification technology and understanding of the complexity of the chronic low-back pain (CLBP) syndrome have led to more sophisticated and aggressive rehabilitation efforts. In the current study, the authors examined two groups of patients with CLBP, from the treatment program's initial (n = 45) and most recent years (n = 57) of operation, respectively, to determine if the evolution of the treatment program has resulted in increased gains in physical capacity between these groups of patients. Patients in each group were assessed on measures of isokinetic trunk strength and spinal range of motion at program admission and discharge. Both groups demonstrated improved physical capacity levels, but the recent group also demonstrated considerably higher physical capacity levels than the early group, at both program admission and discharge. It was concluded that functional restoration continues to be successful with CLBP patients, and that increased preprogram training and education may facilitate a more rapid elimination of inhibitory factors (ie, pain, fear of reinjury), which often impede and slow physical training.

Predicting sales performance, job satisfaction, and depression by using the Achievement Strivings and Impatience-Irritability dimensions of Type A behavior.

Recent research suggested that two dimensions of Type A behavior, namely, Achievement Strivings (AS) and Impatience-Irritability (11), differentially predict physical health and performance outcomes. The present study extends this research and examines whether AS and II differentially predict work performance (number of insurance policies sold), work attitudes (job satisfaction), and depression in a sample of 117 life insurance salespersons. As hypothesized, after statistically controlling for relevant biographical variables and II, AS predicted the number of policies sold and job satisfaction but was not related to depression. After partialing out the effect of relevant biographical variables and AS, II was associated with depression but not with the number of policies sold. In addition, controlling for the same variables, 11 was negatively associated with job satisfaction. Implications for the prediction of sales performance, job satisfaction, and depression, and interventions designed to decrease the negative consequences of Type A by reducing II but not AS, are discussed.