last phys dis test

what are ADLs?

- require basic skills

- mobility

- self cares

- communication

- adaptive equipment/environmental hardware

what are IADLs?

- require more advanced skills

- home management

- community living

- health and safety management

-environmental hardware

what is the order for teaching ADLs?

1. feeding

2 grooming

3 continence

4 transfer skills

5 toileting

6 undressing

7. dressing

8 bathing

what are skills needed to be safe at home alone?

- independent in toileting

- independent in transfers

- independent in phone use for emergencies

- preparing a simple meal

- employing safety precautions

- taking medications

- obtaining emergency aid

clients and ADLs

- clients should be evaluated and trained in ADLs

- physical dysfunction, psychosocial dysfunction and the DD population

what goes into evaluation and treatment planning of ADLs?

- pt prognosis

- environment

- finances

-goals

what are advantages of ADL training?

- client becomes more independent

- client's self esteem increases

- less time involved for family/caregivers

what are disadvantages of ADL training ?

- time consuming

- inconvenient for staff and caregivers

what are performance skills?

sensorimotor: combination of sensory, neuromusculoskeletal and motor

-cognitive

- psychosocial

what is the evaluation of ADL skills

- current client performance

- performance eval can be formal or informal

how to assess potential for improvement

- assess physical components

- perceptual/cognition

- mobility

- team decision for discharge

how to test ADLs in a real life situation

- test at appropriate time of day

- test in appropriate place

- try to have a consistent schedule

how to score ADL assessments

- interpretation of standardized evals are done by the OTR

- read directions carefully

- document changes of directions made

what are home evaluations?

- used to adapt home environment

-allow sufficient time to complete

- explain purpose

- bring tape measure

- have client demonstrate ADLs

- provide education

what is adaptation?

- modifying the task

- modifying the method

- modifying the environment

- can be temporary or permanent

what to consider during an eval for adaptive devices

- loan, rent or purchase equipment

- pt family values and culture

- pt. family education

- pt. level of performance with equipment

- caregiver's needs

- economic considerations

- the environment the equipment is used in

- propose solutions

- knowledge of resources

what is the process of adaptation?

training: the pt./family/caregiver must be trained in the safe use of the device, method and environment

selection criteria:

- effectiveness

- affordability

- operability

- dependability

use of assistive devices/equipment

1. only use when necessary

2 introduce early on

allow client to participate in the decision making

4 devices will vary based on diagnosis

5 re evaluate devices as needed

6 modify the environment or method

what is the process for adaptation?

- task analysis

-identification of the problem

- knowledge of compensation

- propose solutions

- knowledge of resources

- check out modification

what is the role of the COTA in adaptive equipment?

- dependent on service competency

- entry level COTAs can construct equipment

- selecting, designing and construction of equipment should be a collaborative effort

- the COTA is responsible for documentation/instruction

what are precautions?

- what to do if the item breaks

- how the item will work with other items already being used

- watch for rough edges unfinished surfaces that might cause issues

- use non toxic finishes

- provide clear instruction

what are the characteristics well constructed devices/equipment ?

- simple design

- controlling the size of equipment

- consideration of cost and time

- attractive appearance

- safety in use

- comfort in use

- ease in application and use

- ease in maintenance and cleaning

presenting equipment to client

- review the following information with the client/caregivers

- purpose

- uses

- limitations

- care and maintenance

- precautions

what is documentation follow up?

- follow up is the final step in the process

- make sure the device/equipment is doing what the goals/expectations were

- ask questions

- be sure to document in chart

what is assistive technology?

- any item, piece of equipment or product system whether acquired commercially off the shelf, modified, or customized that is used to increase or improve functional capabilities of those with disabilities

AT legislation

- 1975: IDEA

- section 508 of rehabilitation act of 1998

- tech act

- work force investment act

- Carl Perkins Vocational and Technical Education Act Amendment

assistive technology

- preparatory method used concurrently with occupational performance

- covers low and high tech services

- team approach

-OTs may need additional training

what are assistive tech models?

- international classification of functioning

- person environment occupation model

- human activity assistive tech model

what are AT assessment steps

- gather information

- clarify the problems

- produce a list of goals/outcomes

- identify/describe the generic attributes

- list several intervention options

- restate the preliminary goals

- select the most desirable intervention option

]- make recommendations

what is the process for recommending adaptive equipment?

- assessment - occupational profile

- activity analysis

- examine practical solutions first

- selection of adaptive equipment

- construction of/ purchase of AT

- implementation/ training

- re evaluation

- follow up

what is assessment information?

- personal information

- funding

- diagnosis/medical history

- psychosocial status

- neuromusculoskeletal eval

- skin condition

- sensory function

additional assessment info

- speech, language, communication

- function skill, task performance

- personal mobility

- transportation

- environment

- history of past equipment

- present equipment

what are AT assessments?

-Movement, control site, input method, position, and targeting assessment MSIPT

M: assess movement available movements

S: control site body part

I: input method and equipment used

P: position of input method

T target an individuals ability to access device

how to determine AT assessment

- matching person and technology

- used to determine appropriate AT with the goal of the device

- considers background information such as user's expectations preferences family environment and economic factors

- series of self checklists and question assessment forms

what can AT assessments do?

- student environment task tools

- aids in process of gathering, organizing and analyzing data to inform collaborative problem solvig and decision making

= looks at student abilities and needs

- looks at all aspects of the environment related to education

Functional Capacity Evaluation (FCE)

an evaluation that identifies the client's functional abilities and or limitations to perform sustained work. Can also be used alone to determine maximum capabilities and provide a one time assessment.

Functional Capacity Report

A written report of assessments and evaluations done in the functional capacity evaluation. Provides employer with what to physically expect from a client on the day they return to work.

Maximum Medical Improvement

the state in which an injured employee's healing process ha plateaued and additional medical interventions or therapy is no longer beneficial to that client

Physical Job Description

a written document that identifies the physical requirements necessary to perform a job's essential functions.

Symptom Magnifier

something that causes client's to magnify their pain behaviors consciously or unconsciously for secondary gain.

Work Capacity Evaluation (WCE)

an assessment designed to determine a person's ability to perform specific work tasks especially after injury or illness

Work Conditioning

a program designed to focus on specific physiological issues that make it difficult for client to participate in more work related activities

Work Hardening

uses the client's participation in real work activities to improve their functional abilities. Work rehabilitation refers to programs that emphasize return to work activities

Reach Envelop

The area or volume a person can physically reach while in a specific posture or performing a task.

Ergonomics

the design of tools, systems, environments, or tasks to maximize a client's occupational performance, prevent injury and promote safety and health

Engineering Controls

involves modifying equipment, the workplace or processes to isolate workers from hazards

Administrative Controls

changing the way work is done or how information is conveyed to reduce exposure to hazards

. Lifting Index

A numerical value that estimates the risk of injury especially low back pain during manual lifting tasks

Root cause analysis

identifies the underlaying reasons for problems or inefficiencies in a rehabilitation program.

what goes into the intervention for assistive technology?

- goals for client and AT

- values/beliefs regarding use of AT

-client's and family's wants

what is the criteria for selecting adaptive equipment?

- duration of disability

- client's tolerance

- psychosocial consideration

- age

what physical deficits are addressed with AT?

- limited ROM

- limited strength

- hemiplegia

- paraplegia

- quadriplegia

- low vision

what ADL and IADLs are addressed?

- dressing

- eating

- hygiene/grooming

- community and environmental adaptations

- mobility and transfer skills

- hone management activities

funding for AT

- funding is individualized

- school system model

- medical model

what are the two certifications in AT?

- AOTA: specialty Certification in Environmental Modifications

-RESNA:

Ergonomics

- the scientific study of human work

- fitting workplace conditions and job demands to the capabilities of employees

- dates back to WWII

what are the statistics?

- 90% of all office workers use personal computers

- carpal tunnel syndrome makes up 13% of all workplace injuries

what are emerging areas of ergonomic practice?

- 2004 ergonomics was identified as one of the emerging areas of practice

- work hardening programs

what are common types of injuries?

- tendonitis

- carpal tunnel syndrome

- tennis elbow

- neck and back injuries

- strains and sprains

- bursitis

- thoracic outlet syndrome

- trigger finger

what are the risk factors?

- repetition

- force

- awkward posture

- static posture

- contact stress

- temperature extremes

- vibration

- psycho social

what are goals of ergonomics

- reducing/eliminating risk factors for developing work related injuries

- increased efficiency

- educate clients in workplace safety

principles of ergonomics

- keep everything in easy reach

- work at proper heights

- reduce excessive forces

- work in good postures

- reduce excessive repetition

- minimize fatigue

- improve work organization

how to adjust the work station

- adjust the chair

- adjust reach requirements

- adjust focal requirements

BTE assessment

It helps in recreating realistic work environments for occupational rehab clinics, making the transition back to work smoother

BTE tracks functional recovery of employees following injury or disability, measuring their response to clinical treatment at specific intervals

The BTE Work Simulator II allows for the simulation of various functional tasks, helping patients understand their progress and increase confidence

BTE technology provides quantifiable information on conditions and progress, enabling better clinical decisions regarding rehabilitation

what is the Bennet hand tool?

- tests manual dexterity

- determines skill set for people who want to work with tools

- assessment has people work on screwing bolts into wood while being timed

Valpar screening test

designed to assess an employee's work-related skills and abilities, which can help determine their readiness to return to work after an injury or illness.

It measures various skills, including manual dexterity, size discrimination, and upper extremity range of motion

The test is crucial for ensuring that individuals can perform essential job functions safely and effectively

By evaluating these skills, employers can make informed decisions about whether an employee is fit for duty and can safely return to work

BOT assessment

- the Bruininks-Oseretsky Test of Motor Proficiency (BOT-measures both fine and gross motor skills in children and young adults. It includes subtests that assess various aspects such as:

Fine Manual Control: Activities like drawing, writing, and cutting.

Manual Coordination: Skills requiring coordination between the two hands, such as catching a ball.

Body Coordination: Gross motor skills including balance, jumping, and running.

Strength and Agility: Physical strength and agility through tasks like push-ups and running.

The BOT-2 provides a comprehensive overview of an individual's motor proficiency, helping to identify strengths and weaknesses in motor skills

what does the Barthel index measure?

This index was designed to measure functional levels of self-care and mobility and it rates the ability to feed and groom oneself, bathe, go to the toilet, walk (or propel a wheelchair), climb stairs, and control bowel and bladder. Generally used with post stroke pts.

what does the Katz index of independence in activities of daily living measure?

- assesses the ability to feed

-grooming

- bathing

-dressing

-transfers

- continence

what does the Lawton Brody ADL assessment assess?

- evaluates 8 categories of IADLS to determine a person's independence level

What does the Klein-Bell ADL assessment test?

- 170 item list that assesses 6 categories of IADL scoring from 0-1

-0 = unable to perform

- 1= able to perform

what does the Cleveland scale assess?

- commonly used in patients with dementia to assess ADL independence levels

- 0=independent

- 3 = dependent

What does the Kohlman Evaluation of Living Skills (KELS) assess?

- The KELS assessment was updated in 2016, and updated the bill paying segment (optional online banking) and the safety photos. It covers 17 basic living skills, which not only covers your standard self care BADLs, but also IADLs like money management, home safety, transportation and work/leisure activities.