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710: Motor Control & Motor Learning > A Conceptual Framework for Clinical Practice > Flashcards

A Conceptual Framework for Clinical Practice Flashcards

1
Q

List the order of APDA’s model of practice from first to last

A

1) Examination
2) Evaluation
3) Diagnosis
4) Prognosis
5) Intervention

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2
Q

Define examination

A

The process of obtaining a history, performing relevant systems reviews, and selecting and administering specific tests and measures to obtain data that is necessary to form a diagnosis, prognosis and a plan of care.

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3
Q

Define evaluation

A

A dynamic process in which the PT makes clinical judgments based on data gathered during the examination

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4
Q

What 2 things does the prognosis include?

A

(1) the patient’s expected level of functional independence to be achieved following treatment
(2) the amount of time needed to reach the expected level

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5
Q

What can be defined as purposeful and skilled interaction of the therapist with the patient

A

Intervention

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6
Q

True or False

Clinical definition of hypothesis is to establish a systematic way to test assumptions about cause of a problem.

A

True

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7
Q

According to Sackett’s definition, evidence-based practice (EBP) is the integration of:

A) Clinical experience and the best available research evidence
B) Integration of clinical training and common sense
C) Clinical experience and patients’ values
D) A and C

A

D

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8
Q

What is a conceptual framework?

A

a logical structure that helps the clinician organize clinical practices into a cohesive and comprehensive plan

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9
Q

What does the conceptual framework provide?

A

a context in which information is gathered and interpreted

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10
Q

Why do we need conceptual frameworks?

A

to guide clinical practice

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11
Q

What are the 5 components of a conceptual framework for clinical practice?

A
  • A model of practice
  • A model of function and disability
  • Hypothesis-driven clinical practice
  • Principles of motor control and learning
  • Evidenced-based practice
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12
Q

What does the model of practice outline?

A

A method for gathering information and developing a plan of care consistent with the goals, problems, and needs of the patient

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13
Q

What does the model of function and disability describe?

A

a framework for examining the effects of a health condition on the individual and enables the clinician to identify the patient’s strengths and limitations critical in developing a plan of care

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14
Q

What does hypothesis-driven clinical practice provide?

A

A means to test assumptions about the nature and cause of motor control problems systematically

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15
Q

What do the principles of motor control and learning help us to understand?

A

Both the cause ad nature of normal and abnormal movement, as well as assumptions about how movement skills are learned or relearned

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16
Q

What does evidence based practice stress the importance of?

A

Integrating best rest research evidence with clinical expertise and patient values

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17
Q

What are 3 models of functioning and disability?

A
  • Nagi Model
  • NCMRR Model
  • ICF Model
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18
Q

What are the 4 levels of the Nagi model?

A

1) pathology
2) impairment
3) functional limitation
4) disability

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19
Q

Define pathology according to the Nagi model

A

It is a cellular/tissue change that is caused by disease, trauma, infection, congenital abnormalities, etc.

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20
Q

Define impairment according to the Nagi model

A

Abnormalities, defects or losses in function of an organ or organ system

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21
Q

True or False

All pathology involves impairment, but impairment may continue once pathology is eliminated.

A

True

For example: Paralysis

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22
Q

Define functional limitation according to the Nagi model

A

Impairment at the level of the organism that can be measured in terms of performance

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23
Q

Define disability according to the Nagi model

A

A limitation of person in performing socially defined roles of tasks

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24
Q

What is different between the Nagi model and the NCMRR model?

A

The NCMRR model added a 5th level, being societal limitation

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25
Q

Which model of functioning and disability provides a standard language and framework to describe how people with a health condition function in daily lives?

A

The International Classification of Functioning, Disability and Health (ICF) Model

26
Q

What are the 2 parts of the ICF model?

A

1) Functioning and Disability

2) Contextual Factors

27
Q

What are the 2 components to part 1 of the ICF model (functioning and disability)?

A
  • body structures/functions

- activities and participation

28
Q

What are the negative aspects of body function and structure called?

A

Impairments

29
Q

What are the negative aspects of activities called?

A

Limitations

30
Q

What are the negative aspects of participation called?

A

Restrictions

31
Q

What are the 2 components to part 2 of the ICF model (contextual factors)?

A
  • environmental factors

- personal factors

32
Q

What is the research definition of a hypothesis?

A

a proposal to explain certain facts or observations

33
Q

What is the clinical definition of a hypothesis?

A

establish a systematic way to test assumptions about the origin and cause of a problem

34
Q

In order to clarify the causes of functional movement problems what must the clinician do?

A

1) generate several alternative hypotheses about the potential causes
2) determine the crucial tests and their expected outcomes that would rule out one or more of the hypotheses
3) carry out the tests
4) continue the process of generating and testing hypotheses, refining one’s understanding of the cause of the problem

35
Q

Which theory of motor control provides a framework of assumptions about the nature and control of movement that guides clinical practice

A

Systems Theory

36
Q

What can be defined as a philosophical approach to clinical practice that integrates clinical expertise, the best available research, and patient’s value?

A

Evidence-Based Practice (EBP)

37
Q

EBP has been proven to be beneficial in the following 4 ways…

A
  • it enables clinicians to routinely upgrade their knowledge base
  • it improves communication with patients’ regarding rationale for intervention & treatment decisions
  • it increases the accountability of healthcare professionals
  • it enhances the quality of patient care
38
Q

What type of approach to clinical practice integrates the ICF model in the examination at a number of different levels?

A

Task-Oriented Approach

39
Q

What does the task-oriented approach also recognize?

A

the importance of environmental and personal features that affects individual’s function and daily life

40
Q

What are the 3 levels on which the task-oriented approach examines behavior?

A
  • functional (what?)
  • strategy (how?)
  • impairment (why?)
41
Q

What types of things are assessed on the functional level?

A

What can the patient do?

What does he/she have difficulty with?

42
Q

What types of things are assessed on the strategy level?

A

What strategies are used to perform the task?

What’s the patients ability to adapt strategy to changing tasks and environmental conditions?

How does he/she move?

43
Q

What types of things are assessed on the impairment level?

A

What prevents him/her from doing what he/she wants to do?

44
Q

What are the 2 ways in which participation can be measured?

A
  • subjectively through patient/caregiver self-reports

- objectively through quantifying the frequency of participation or level of independence in performing ADLs

45
Q

Do objective and subjective measures of participation have a high or low associated rate?
What does this signify?

A

Low

Objective measures of participation must be supplemented by subjective measure that reflect an insider perspective.

46
Q

What are 3 ways of clinically measuring function?

A
  • task-specific tests and measures
  • age-specific tests and measures
  • diagnosis-specific tests and measures
47
Q

Give an example of a task-specific test and measure

A

Berg Balance Scale

48
Q

Give an example of a age-specific test and measure

A

Functional Reach Test

49
Q

Give an example of a diagnosis-specific test and measure

A

unified Parkinson’s disease rating scale (UPDRS)

50
Q

Define content validity

A

The instrument measures what it is supposed to measure

51
Q

Define construct validity

A

the degree to which the instrument behaves as hypothesized

52
Q

Define concurrent validity

A

the degree to which the instrument agrees with other instruments that are measuring the same factors

53
Q

Examination at the strategy level is a _____ approach, why?

A

Qualitative, because it examines the strategies used to perform functional tasks

54
Q

Why is it important for clinicians to examine the strategies a patient uses when performing a functional task?

A

Because the strategies used to perform a task largely determine the level of performance

55
Q

Performance depends on what 4 factors?

A
  • Demands of the task and person’s motivation for particular standards of achievement .
  • Capacities, mental and physical, that a person brings to the task.
  • The strategies that the person uses to meet the demands of the task.
  • The ability to choose the most efficient strategy for a given task.
56
Q

What are the limitations to a strategy examination of function?

A

There limited tools available for measuring sensory, motor and cognitive strategies

57
Q

What is the significance of examining impairments?

A

The clinician can identify impairments that potentially constrain functional movement skills

58
Q

Examining impairments occurs within what 4 systems?

A
  • sensory
  • motor
  • cognitive
59
Q

What are the 3 goals of a task-oriented approach to intervention?

A
  • Resolve, reduce or prevent impairments in body structure and function
  • develop effective and efficient compensatory strategies for accomplishing functional tasks
  • adapt goal-oriented strategies to changing task and environment and the ability to solve motor problem and minimize disablement
60
Q

The goals of a task-oriented approach to intervention should be used in _____.

A

parallel

710: Motor Control & Motor Learning (14 decks)

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