Functional Assessment - Neuro PM

Identification of patient’s specific functional activities

Functional assessment

A functional assessment will do one or both of the following:

—Aability to do them independently (safely and without assistance)

—How well do they do them (quality)?

Why do we do functional assessment in PT?

• To document work towards?

• 1.

• 2.

To document work towards ultimate goals of rehab

• To return patient to a lifestyle that is as close as possible to the pre-morbid level OR

• Maximize current potential for function and maintain it as long as possible (if neurodegenerative)

What is a functional activity?

All tasks, activities and roles that an individual self-identifies as essential for their ______

What is a functional or activity limitation?

The inability of a patient to perform an action or activity in ______

Usually occurs due to?

Identifying Functional Limitations using ICF Model

—Refers to _______ and structures instead of pathology and impairment

—Refers to _______ instead of disability and handicap

—Takes into ______ factors

—Language of PT now reflects ICF model

Body Functions and Structures

Activity and participation - what 3 functions?

Physical Function - 2 main categories

1. Sensorimotor skills of daily self-care - feeding, dressing, hygiene, physical mobility?

Physical Function - 2 main categories

2. Advanced skills - vital to independent community living - managing personal affairs, shopping, cooking, home chores, driving?

Psychological Function - 2 main categories

1. Refers to intellectual or cognitive abilities?

Psychological Function - 2 main categories

1. Refers to coping mechanisms needed to deal with everyday events and traumatic/stressful happenings in life?

Refers to the individual’s performance of social roles?

• Participation in recreational activities, clubs, social interactions with others (telephoning, visiting relatives/friends), occupational pursuits

Discordance between actual performance of individual in a particular role and community expectations.  (i.e. unable to be a worker, a student, a spouse)?

What must be accounted for when defining “normal” for participation restriction

Cultural & social differences

Environmental Factors

What role do functional tests and measures serve?

A good test is…

What type of test is administered by the PT while watching patient perform an activity?

What type of test is it where Patient is asked either directly by interviewer or using a self-assessment instrument

Performance-based assessments

• Must give?

• ____ assistance beyond safety concerns

• Data gathered under a _____

• ____ success or failure of person’s ability to perform goal-directed activities in natural conditions

• Must look at ____

Self-Assessment Tests

• Based on?

• Should use clearly worded questions and patient-friendly language, without bias

• Must consider?

• Distinguish between?

• GET A _____

Options for Response Formats

• Nominal measures:

• Ordinal measures:

• Summary/additive measures:

• Visual Analog Scales:

• Video recordings

Consider Factors that Influence Functional Testing / Outcomes

• Settings must be?

• Precise instructions:

• Result may be biased by ___ so what must be considered?

• Retesting should be done periodically to document progress and contribute to discharge planning process

What do we do with the information collected from a functional assessment?

Write patient-centered functional goals & outcomes of intervention

Documentation of Function

—See Box 8.1 in OSS PR book

Important Descriptors - what do they tie together?

Choosing Functional Assessments

• explore what properties of the tools being used?

• APTA suggests PT's should only use tools in which what is know?

psychometric properties

reliability/validity/specificity/sensitivity

Neuro CPG- Core Outcome Measures

Neuro CPG - Core Outcome Measures

• what are the 6 selected tests?

Basic principles - Core outcome measures

• Should be done when? at minimum?

• Document what score if pt is not able to achieve score yet?

When is it appropriate to omit a test?

Specifically for ABC scale?

Communication of test results with patients

Should the 6 core tests be the only ones you use?

Choosing additional outcome measures

Provides data on functional status of adults with specific chronic conditions and the well-being of patients experiencing depression compared to subjects with a chronic medical condition

Participation Level Tests