Comparison:
Progressive Isoinertial Life Evaluation (PILE) Protocol vs. EPIC Lift Capacity (ELC) Test Protocol

Introduction

The Progressive Isoinertial Lift Evaluation (PILE) and the EPIC Lift Capacity (ELC) test were both based on the WEST Standard Evaluation (WSE) developed by Leonard N. Matheson, PhD, at Rancho Los Amigos Hospital in Downey, California, in the 1970s.

The PILE was developed by Tom Mayer, MD, and Nancy Kishino, OTR, at the PRIDE clinic in Dallas, Texas, in the mid-1980s.

After several years of experience with the WSE and PILE, the ELC was developed by a team headed by Dr. Matheson to resolve inconsistencies in the earlier tests, take advantage of advances in technology, and address professional standards issues. Collaboration was provided by Vert Mooney, MD, of the University of California San Diego and Rowlin Lichter, MD, of CHART Rehabilitation; Janet Grant, RN, of ERIC, Hamilton Hall, MD, Tony Melles, PT, and Mike Affleck, HBSc, of the Canadian Back Institute; and Scott Leggett, MS, Scott Negri, MD, Bryon Holmes, PT, and Debbie Holmes, EP, of the OrthoMed program at the University of California, San Diego.

Test Configuration

The PILE and ELC are progressive isoinertial tests of lift-lower capacity that use free weights.

The PILE uses a series of progressive loads over two vertical ranges at one frequency.

The ELC uses a series of progressive loads over three vertical ranges at two frequencies with free weights that are masked so that the evaluee does not know the load.

For both the PILE and ELC, the evaluee’s maximum acceptable weight is recorded at each range.

Weight Increments

The PILE begins at 8 pounds for women and 13 pounds for men and progresses in 5-pound increments for women and 10-pound increments for men. The difference in weight increments for males and females creates a disadvantage for women evaluees. In order to reach the same load as a male, more lifting cycles must be completed (for example a female will complete 9 lifting cycles to reach 50 pounds, whereas a male needs only 6 cycles to reach 50 pounds). The evaluee is aware of the starting and incremental loads.

The ELC begins at 10 pounds and progresses in 10-pound increments for both male and female evaluees. The evaluee is not made aware of the starting and incremental loads. The ELC uses masked weight canisters so that the evaluee is unaware of the starting and incremental loads. The masked weights allow re-test confirmation of full effort.

Frequency

The PILE frequency is four lifts per 20-second cycle for each of the two vertical ranges.

The ELC frequency begins at one lift per cycle for each of the three vertical ranges and proceeds to four lifts per cycle for each range if the evaluee is capable.

Normative Data

The ELC references the U.S. Department of Labor Physical Demand Characteristics of Work (PDC) system and both MTM norms and healthy subject norms. The ELC normative data are based on test-retest trials of healthy normal males and females ranging in age from 18 years to 60 years. There are more than 4,500 reference subjects in the normative pool for the ELC, which is updated periodically. Norms are published for males and females of several age groups.

The PILE healthy subject norms are quite limited and have not been tested for reliability.

Safety

Both tests use psychophysical criteria to identify maximum load levels. The High Risk Work Style Guidelines developed for the WSE are applied in simpler form on the ELC. Body mechanics are not evaluated on the PILE.

A “Rating of Perceived Load” system was developed especially for the ELC and is not available on the PILE due to US Patent protection.

The ELC provides a “heart rate window” within which the test is conducted in order to minimize cardiovascular risk, while the PILE does not.

Both tests have peer-reviewed research studies that demonstrate their safe use in populations of persons with physical impairments.

Control and Support

The PILE is not copyrighted or patent-protected and can be used without restriction. The ELC is protected with both copyrights and a United States patent, restricting use to qualified evaluators.

The PILE is not supported by its developers, with no research published for several years. The ELC is supported by Dr. Matheson and his colleagues who also sponsor a training and certification program, ongoing research and frequent peer-reviewed scientific publications. More than 1500 professionals in North America and around the world have been trained and certified on the ELC.

For more information about ELC certification please visit our Certification Page. For more information on the ELC equipment please visit www.mathesondevelopment.com