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functional assessments FTP

Terms

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interrater reliability
two people able to get same result in same setting
self assessments
pt. provides information, function on a daily basis, do not ask leading questions
physical therapy diagnosis
impairments, functional problems
fbg dynamic - fair
accepts minimal challenge (turning head or body) while maintaining balance
static test
double limb stance, single limb stance, tandem limb stance, romberg, romberg sharpened
reliability of test
does the test measure the same thing every time
concurrent validity
the degree to which two seperate test agree on results
descriptive instrument parameters
all reading chart would have clear understanding, include qualifiers as necessary, include perceived rate of exertion or pain
FIM level 7
no helper - complete independence
Nagi guidelines
disease, impairment, functional limitation, disability
performanced-based assessments
PT observes, identify level of functioning, may not mimic functional setting
dynamic test
standing up, walking, turning, stopping and starting, functional reach, get up and go
functional balance tests
static, dynamic, standardized
fbg static- normal
maintain balance without hand hold support
KATZ index of ADL
evaluates degree of assistance needed in six catagories
fbg dynamic - good
accepts moderate challenge (pick up item off floor) without loosing balance
FIM level 2
helper - maximal assist (subject 25% or more)
interpreting test results
what do we need to do, should subcomponents of skill be taught, is only one aspect of skill limiting function
fbg static- good
maintain balance without hand hold support, limited sway
SIP - sickness impact profile
detects small impacts of sickness, evaluates ability vs inability to perform skills, perceived changes in function
posture
becomes faulty with age
dynamic
moving, challenge to stability
fbg static- fair
maintain balancxe with hand hold support and accasional minimal assistance
FIM
test physical, psychological, and social function. evaluates level of assistance needed, functional changes in different environments
WHO health
state of complete physical, mental and social well being, and not merely the absence of disease or infirmity
construct validity
can you combine all the different test items to make inferences about physical functioning
fbg dynamic - normal
accepts maximal challenge and easily weight shifts in all directions throughout the full range
strength and flexibilty plus reaction time
decrease with age
FIM level 1
helper - total assist or non-testable
hip strategies
shifting center of mass
OASIS - outcome and assessment information set
collects informatoin related to sociodemographic characteristics, environmental factors, social support, health status, functional status
face validity
does it measure what it promises
FIM catagories assessed
self care, sphincter control, transfers, locomotion, communication, social cognition
quantitative parameters
amount, timed skill completion, only one deminsion of assessment
standardized test
functional reach, berg balance, tinetti, get up and go, three minute walk
predictive validity
indicates the likelihood of something accuring based on the information gathered on the test
test-retest reliability
test must accurately measure change or lack of change that occurs between administrations
often seen descriptors
pain (perceived rate on scale), fluctuations between time of day, medication levels, environmental influences
validity of test
does test measure what it was designed to measure
purposes for functional assessment
baseline data for outlining function oriented goals, pt. initital skill level, progress toward complex skills, placement decisions, level of safety, effectiveness of treatment
medical diagnosis
name of disease
types of assessment instruments
performanced-based, self-assessment, descriptive instrument parameters
fbg dynamic - poor
unable to accept challenge or move without LOB
FIM level 6
no helper - modified independence (device)
qualitative parameters
how well they perform skill, sometimes quality better than quantity
intrarater reliability
same person able to get same result in same setting
stepping strategies
change base of support
fbg static - poor
requires hand hold support and mod - to - max assistance to maintain balance
performanced-based tests
six-minute walk, functional reach, get up and go/timed get up and go, physical performance battery
static
stable, non moving
balance strategies
ankle, hip, stepping
FIM level 5
helper - supervision (subject 100%)
FIM level 3
helper - moderate assist (subject 50% or more)
Barthel index
measures degree of assistance required on 10 items of mobility and self care, independence or assistance not degree
FIM level 4
helper - minimal assist (subject 75% or more)
balance
becomes impaired with age
content validity
does it measure all dimensions of functioning necessary to describe the skill

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