Functional Status and Activity Level Flashcards
(29 cards)
AZ Laws and Rules pertaining to documentation…..
What are they?
look up
objective
By the end of the lecture, the student will be able to:
Identify functional status and discuss purpose and components of a functional assessment
fyi
“Functional activities encompass tasks, activities and roles that identify a person an independent adult or as a child progressing toward adult independence.” Phys Rehab
- Why do we do it?
- What clinic settings include assessment of functional status?
- What things are we assessing?
Assesing Functional status
Functional Status
Goals?
Return pt to lifestyle as close to the lifestyle that they had before (pre-morbid level of function)
OR
Maximize the current potential for function and maintain it
Functional Assessment Conceptual Framework for Examining Functional Status
Remember the Nagi Model……….
Model designed to connect various terms used to describe health status
list them
- Disease
- Impairments
- Functional Limitations
- 3 categories of function
- Disability
3 Categories of Function Components of Functional Assessment Conceptual Framework for Examining Functional Status
- Physical
- Psychological
- Social
Physical- Components of Functional Assessment(some examples)
ADL or BADL
IADL
Psychological-Components of Functional Assessment (what are some examples)
- Mental
- Affective
Social- Components of Functional Assessment (what are some examples)
Performance of social roles
examples of BADLs
- Feeding
- Dressing
- Hygiene
- Physical mobility
IADL
Instrumental Activities of Daily Living
Higher level tasks: managing personal affairs
what are some examples
Cooking
Driving
Home chores
Shopping
Work
Recreational Activities
Examination of Functional Status
Purpose of Exam: Analysis of function (what are some examples?)
- Identify pt’s abilities
- Get baseline of info to set functional goals
- Criteria to place patient at appropriate level of care
- Identify the pt’s level of safety
- Identify the effectiveness of treatment on the pt’s function
Type of Testing
Performance Based Tests
- What can a patient do under a specific set of circumstances?
- Assessing current function and/or projected maximum level of function
Examples of performanc based tests you will see in therapy:
TUG (Timed Up and Go p258),
Berg Balance Scale (p257) ,
POMA (Performance-Oriented Mobility Assessment p258) Tinetti (p258 & 270-271)
Type of testing: self reports. (what are some ways)
- Clear, direct questions
- Distinguish habitual performance and pt’s perceived ability to perform a task
Needs to be descriptive enough to gauge change:Example;
- patient requires max assist of 2 for transfers may improve to mod assist of 1
- If the tests only asks for assist or no assist, there was no change
Response Formats Ordinal Measures:Ranks in order
- Novice to Entry-level (sound familiar??)
- Pain scales also
Response Formats Ordinal Measures:Summary or Additive Measures
Measures with awarding of points
50/60 or 6/24
Response Formats Visual Analog Scale
10cm long line
Typically has hash marks
Descriptive terms on the endpoints and in between
considered an Ordinal Measure (rank-order scale)
Response Formats Video recordings:
Validates effectiveness of a treatment
Interpreting Test Result When impairments or limitations are found
- What functional deficits does the patient have?
- What normal movements are necessary for the function?
- What impairments inhibit performance?
- Is impaired communication, perception, vision hearing or cognition involved?
Functional Assessment Instruments
- Barthel Index
- Katz Index of ADL:
- Functional Independence Measure
- Sickness Impact Profile
- SF-36
- OASIS
measures assistance needed on items of mobility and self-care
- Individual differences may be masked (test looks at independence or needing assistance)
Barthel Index
focuses on patient performance and degree of assistance required. Uses direct observation and pt self-report
Katz Index of ADL
