Allison S, Harper D, Tinsley S, Vazquez M, Gleason A; Tri-State Physical Therapy, Inc., and Louisiana State University Health Sciences Center, Shreveport, LA. sallison@tristatept.com.

PURPOSE: To evaluate differences in peak heart rate (PHR) responses in subjects with and without injury during common tests used in functional capacity evaluations. SUBJECTS: Subjects were 42 males ranging in age from 20 to 71 years old. Subjects injured consisted of males with physical impairments and functional limitations from an injury or illness who had reached maximum medical improvement. Subjects uninjured consisted of generally healthy males who were seeking employment. METHODS: Age, gender, percent body fat, and resting heart rate were recorded as baseline data on all subjects. Percent body fat was derived using the FUTREX 5000A/WL Body Composition Analyzer. PHR response using Polar Heart Rate monitoring equipment was recorded on all subjects after administration of the following tests using standard and customized Hanoun Focus Evaluation System (HFES) computerized protocols: standard hand grip testing, static push testing, static pull testing, floor to knuckle dynamic lift testing, knuckle to shoulder dynamic lift testing, and shoulder to overhead dynamic lift testing. Between tests, PHR response was allowed to recover to within 10% of the measured resting heart rate for each subject. ANALYSIS: A 2 x 9 multivariate ANOVA (p < 0.05) was used to analyze differences in resting heart rate, age, percent body and the PHR response between the two groups for each of the HFES computerized protocols. RESULTS: Significant differences in PHR responses were found between the two groups for all of the HFES computerized protocols except for standard hand dynamometry. However, there was no significant difference found in resting heart rate, age, or percent body fat between the two groups. CONCLUSIONS: Individuals with physical impairments and functional limitations from an injury or illness may self-limit their performance during common tests used in functional capacity evaluations for a variety of reasons. Individuals may have a fear of re-injury, elevated levels of perceived disability, elevated levels of pain, poor pain coping skills, or secondary gain issues. Individuals with an injury are probably more de-conditioned contributing to their lower performance during functional testing. Further study is needed to evaluate the effect that gender, age range, and aerobic fitness levels have on PHR responses within and between the two groups. Other hystological measures including changes in blood pressure and respiratory rate should also be evaluated. This information could be useful in establishing a standard for minimum levels of expected physiological changes from individuals with injuries during functional capacity evaluation testing. FUNDING SOURCE: None.

Copyright 2004 by the American Physical Therapy Association

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