Work capacity; its role in the treatment of tuberculosis.

The treatment of tuberculosis, based as it is upon the concept of bed rest, has as its ultimate objective the restoration of the patient to a state of relative well-being and a capacity for participating in a program of work which is consistent with his handicap. For the physician who treats the tuberculous patient, for the others who are interested in the other aspects of his rehabilitation, and for the patient himself, the problem of absolute bed rest has been a vexing one. Countless papers have been written dealing with the factors which prompt patients to leave tuberculosis hospitals against medical advice, and not a few have referred to the inability of patients to adjust to the bed rest regimen. The physician must rely for the most part upon his experience and empirical judgment to determine at what time the patient may begin his activity and how much activity he may undertake. Neither qualitative nor quantitative yardsticks have yet been developed by which the amount of activity in which a tuberculosis patient participates may be measured, with perhaps the possible exception of the time factor. Thus a patient for whom activity is prescribed is told that he may devote a half hour twice each day to reading, studying, occupational therapy, or related work. With the development of rehabilitation programs for tuberculous patients during recent years, it has become increasingly apparent that evaluation of their work capacity constitutes a significant factor in assisting them to evolve vocational readjustment plans consistent with their physical limitations. The ability of the patient to sustain, without untoward effects, an activity program when his pulmonary lesion has become stabilized enters Into the evaluation of his clinical status. Thus the patient