Functional assessments (Fund. Exam 3)
Terms
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- Nagi guidelines
- used mostly in the US; Disease, Impairment, Functional limitation, Disability
- Impairment
- what we treat; abnormalities within various body systems; problems they are having as a result of the disease; ex.) dec. circulation, inc. weight, etc.
- interrater reliability
- two similarly trained individuals would get similar results with the same pt. performing the same skills
- static tests
- romberg, double leg stance, single leg stance, tandem stance
- content validity
- does it measure all dimensions of functioning necessary to describe the skill
- Medical diagnosis
- determined by doctors or physicians ex.) diabetes type II
- intrarater reliability
- the same therapist should get similar results if he/she performed the same test again on the same patient
- general considerations
- PT/PTA are responsible in the team for functional mobility skills assessment, including bed mobility, tranfers, and locomotion; may be carryover btwn professionals on the multidisciplinary team
- quantitative parameters
- amount; timing functional skill completion
- Physical therapy diagnosis
- determined by the PT ex.) dx: decreased strength, shoulder pain, etc.
- dynamic tests
- 3-min. walk, get up and go/ timed, functional reach, turning
- changes seen with age
- dec. strength and flexibility, reaction time, posture, and balance
- Disease
- the underlying problem or interruption of normal cellular processes; diabetes II
- performance-based assessments
- ex.) functional reach, six-min. walk tests, get up and go;PT observing a pt. performing a skill; Benefits: see how well they can perform; limitations: the PT can only evaluate that skill
- dynamic balance
- moving while COM is above base of support
- Disability
- inability to complete roles in society as a result of the disease, impairment, and functional limitations; ex.) going to church, holiday cooking, traveling, etc.
- predictive validity
- indicates the likelihood of something occurring based on the information gathered in the test
- reliability
- does the test measure the same thing everytime
- test-retest reliability
- will the test accurately measure the change that occurs (or lack of change) btwn administrations
- concurrent validity
- the degree to which two separate tests agree on results
- hip strategies
- anytime you shift COM outside base of support; stand on one foot and lean, balance board, single leg hops
- qualitative
- how well they can perform a skill; evaluating the quality of their performance of the skill; qual. is sometimes more important than quant. just b/c they can do it fast, doesn't mean they do it well
- static balance
- maintain COM above BOS and balance w/o moving and hand-hold support
- validity
- does the test measure what it was designed to measure
- purpose of functional assessment
- provides baseline data, initial skill level and progress, supplements criteria for placement decisions, shows pts. level of safety performing skills, assists with determining effectiveness of the treatment interventions
- questions to ask when selecting a test
- what areas of functioning are included?; what level of functioning is being measured?; when can I perform this test?
- World Health Organization (WHO) guidelines
- health is the "state of complete physical, mental and social well-being, and not merely the absence of diseases and infirmity"; developed ICD codes; terminology: health condition, impairment, activity limitation and participation restriction
- Functional limitations
- inability to perform BADLs (basic ADLs: toileting, dressing, washing self) and IADLs (instrumental ADLs: driving, cooking, paying bills)
- functional independence measure (FIM)
- tests physical, psychological, and social function; evaluates level of assistance needed from total assistance to total dependence
- self-assessments
- what the pt tells the PT he/she can do and how well they do it; benefits: functional abilities; limitations: pt. could be exxagerating, having dramatic behaviors
- ankle strategies
- loss of balance within your limit of stability; stand on one foot, unbalanced objects, catching ball on one foot.
- standardized tests
- Romberg, functional reach, get up and go/ timed, 3-min. walk, tinetti perform.
- stepping strategies
- when you make a new base of support; foot work drills, jumping, kicking
- face validity
- does it measure what it says it will measure