Fatigue assessment

assessment of fatigue either physical or mental fatigue

1. FATIGUE ASSESSMENT PRESENTED BY : JWANIKA VANSIYA

2. Fatigue is defined as the subjective complain of tiredness or diminished energy level to the point of interfering with normal or usual activities. Fatigue can be menifested as difficulty or inability initiating activity ( perception of generalized weakness) reduced capacity maintaining activity and difficulty with concentration , memory and emotional stability. What is fatigue?

3. TYPES

4. Lack of sleep Long work hours Shift rotation Noise Boring work Too much stress Alcohol Drugs Worries Illness Advancing age etiology

5. . Common conditions causing Fatigue

6. Forgetfulness Poor communication Impaired decision-making skills Lack of alertness Slow reaction time Quick of anger No sense of humor Lack of interest Always tired SIGNS AND SYMPTOMS

7. FATIGUE ASSESSMENT

8. ID : Age, Gender, Nationality, Occupation Chief complain Onset : abrupt or gradual, related to event or illness Course : stable, improving or worsening? Factors that alleviate or exacerbate symptoms Impact on daily life- ability to work History

9. History

10. When the fatigue is started, how long it lasts, and what makes it better or worse? Symptoms or side effects, such as pain, the patient having from the cancer or the treatments. Medicines being taken. Sleeping and resting habits. Eating habits and changes in appetite or weight. Whether the patient has depression, anxiety Questions????

11. Health habits and past illnesses and treatments. How the fatigue affects being able to work. Questions???

12. General appearance Posture patient’s walking Trouble breathing or loss of muscle strength Palpation Analogue scale: describes the fatigue on a scale 1 to 10 1 5 10 Physical examination

13. Anemia: pallor, tachycardia, systolic ejection murmur Goitre or thyroid nodule: dry skin, delayed deep tendon reflexes, peri orbital puffiness, Hyperthyroidism: weight loss, hyper reflexia , fine tremor, atrial fibrillation. Addison’s disease: hypotension, scar, pigmentation in skin creases Heart failure: elevated jugular venous pressure, ankle edema Specific clinical signs of organic disease associated with fatigue include the following:

14. Tests for fatigue assessment

15. Anaerobic fatigue: Assessment of the fatigue during anaerobic power performance when vigorous exercises continues for more than few seconds . Anaerobic fatigue is the percentage decline in the power output during the test. Systemic assessment

16. The various tests which are used for anaerobic fatigue are following: .

17. Katch test

18. Procedure Test scores: Peak power output = force * distance ( num of revolutions*distance per revolution divided by time in minutes)(5secs=o.o83min) Anaerobic fatigue=high power output – low power output divided by high power output* 100 Wingate cycle ergometer test

19. if a man weighing 73.3 kg performs wingate test on a Monark cycle ergometer (6.0 m traveled per pedal revolution) with an applied resistance of 5.5kg (73.3*0.075=5.49 rounded off to 5.5kg), pedal revolution at 5 secs interval is 12,10,8,7,6,5 (48 total revolution in 30 seconds) Peak power output= force*distance divided by time 5.5kg*(12*6)divided by 0.083 min 4753kg.m/min or 776.8 watts Example

20. Anaerobic fatigue=high power output-low power output divided by high power output * 100 High power output is 776.8 W Low power output= force*distance divided by time 5.5 * (5*6) divided by 0.083 1980.8 kg.m /min = 323.7 W Anaerobic fatigue = 776.8-323.7 divided by 776.8*100=58.3% .

21. Fatigue is reached the amount of lactate in the muscle and blood is maximum. Measurement of lactate in blood can give an idea regarding the extent of fatigue. Measurement of blood lactate levels

22. Measurement of aerobic capacity vo2 max = co * arteriovenous o2 diffrence Arteriovenous o2=arterial o2- venous o2 Measurement of energy expanditure Spirometry testing .

23. Assessment procedure which indicate a fall in the strength or firing ability of the muscle fiber can be used to determine fatigue. Local assessment

24. Brief fatigue inventory Fatigue severity scale Piper fatigue inventory Scales

25. Fatigue severity scale

26. Depending on the findings in the history and physical examination, blood tests and other imagine studies may be ordered. CBC (complete blood count) Blood sugar TSH Tests for deficiency in vitamin B12, D,folic acid and iron ESR LABORATORY TESTING

27. Exercise physiology. McArdle , Katch and Katch Physiology of sport and exercise. Jack H. wilmore , W. Lany Kenney. Physiotherapy in neuro -condition. Glady Reference

28. Thank you