Test 1 Flashcards by Megan Hilgers

Another person is not required for the activity

Independent

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The patient safely performs all the tasks described as making up the activity within a reasonable amount of time, and does so without modification, assistive devices, or aids

FIM 7, complete independence

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One or more of the following may be true: the activity requires an assitive device or aid, the activity takes more than reasonable time, or the activity involves safety (risk) considerations

FIM 6, modified independence

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Patient requires another person for either supervision or physical assistance in order to perform the activity, or it is not performed, requires helper

Dependent

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Patient expends half or more of the effort

Modified dependence

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Patient requires no more help than standby, cuing or coaxing, without physical contact; alternately, the helper sets up needed items or applies orthoses or assitive/adaptive devices

FIM 5, supervision or setup

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Patient requires no more help than touching, and expends 75% or more of the effort

FIM 4, minimal contact assistance

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Contact guard assist, can do at least 75% of task

FIM 4

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Helper just sets something up

FIM 5, supervision or setup

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Helper just assists verbally

FIM 5, supervision or setup

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Patient can do all dressing except buttons

FIM 4, minimal contact assistance

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Patient requires more help than touching, or expends between 50 and 74% of the effort

FIM 3, moderate assistance

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The patient expends less than half of the effort. Maximal or total assistance is required

Complete dependence

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The patient expends between 25 to 49% of the effort

FIM 2, maximal assistance

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The patient expends less than 25% of the effort

FIM 1, total assistance

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Activity does not occur

FIM 0

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Why is theory important?

To validate practice, guide practice, justify reimbursement, clarify specialization issues, enhance the growth of the profession, educate competent practitioners, unify practice and profession

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Provides philosophy, values and ethics and knowledge for practice

Paradigm

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Example of paradigm

OTPF

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Explains the relationship between person, environment, and occupational performance

Occupational behavior models

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Provide practice guidelines for specific domains

FORs/practice models

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4 examples of occupational behavioral models

OA, MOHO, COPM, ecological model

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Model that emphasizes adaptation

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Model that highlights occupational engagement

MOHO

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Model that emphasizes client collaboration/client- centered therapy

COPM

Model that pays attention to contextual variables and interdisciplinary communication

Ecological model

Physical disabilities frames of references

rehabilitation, biomechanical, traditional motor control approaches, contemporary motor control approach

Phys Dys FOR that looks at adaptation/compensation

Rehabilitation

Phys Dys FOR that focuses on restoration

Biomechanical and traditional motor control approaches

Phys Dys FOR that looks at a mix of adaptation, compensation, and restoration

contemporary motor control approach

4 traditional motor control approaches

Bobaths' Neurodevelopmental Treatment (NDT), Brunnstrom's movement therapy, the Rood Approach, Proprioceptive Neuromuscular Facilittion

What is NDT used for?

neurological problems, associated with hemiplegia

Purpose of NDT?

remediate foundation skills that make normal skill acquisition possible

What does NDT start with?

postural control

What do manual techniques in NDT do?

Facilitate or inhibit primitive reflexes

What is the overall point of NDT?

Normalize muscle tone

Examples of normal movement in NDT?

clasped hands, weight bearing on affected extended arm, bilateral hand activities, free arm movement, compression/traction, tapping

Use of sensory stimulation to elicit motor response, consideration of mobility and stability, sensory techniques to facilitate hypotonic muscle activation in order to elicit movement, sensory technique to normalize hyperactive muscle tone, tactile/thermal/ proprioceptive stimuli

The Rood Approach

Used with neurological problems, move client through different reflective stages

Brunstrom

Reflexes and primitive movement patterns are normal stages of development and can be used to facilitate recovery of volunteer movement post-stroke

Brunstrom

Diagonal and rotational movement patterns

PNF

How does PNF treatment start?

by bringing attention to breathing and other vitals

What is the purpose of the body movements in PNF?

Improve proprioception

Rehabilitation focuses on what?

ADLs and functional abilities

What FOR looks at adaptive devices, orthotics, environmental modifications, WC modifications, ambulatory devices, adapted procedures, and safety education?

Rehabilitative

Focuses on strength, ROM, endurance, edema management, use of PAMs

Biomechanical

Equipment biomechanical FOR?

UBEs, theraband, weights

Model that usually doesn't stand alone for reimbursement, need to correlate with function (usually rehab approach also)

Biomechanical

_________________ determines need for evaluation

Screening

_________ are sued to gather inf for an evaluation

assessments

Sames 9 steps in evaluation

1. Synthesizing info from the occ profile 2. Selecting appropriate OT theories 3. Observation of occ performance and info gathering 4. Selecting and measuring contexts, activity demands, and client factors 5. Interpretation of assessment data 6. Generating hypothesis 7. Goal setting 8. Confirming outcome measures 9. Delineating intervention approaches

Critical pieces in an evaluation

Prior level of function, reason for referral to OT, assessment tools used, precautions and contraindications, accurate treatment diagnosis, occupational profile, analysis of occupational performance

Type of goal used for the client that used to be able to do something, but can't now.

Restorative

Type of goal that teaches new skills, skills the client never had.

Habilitative

Type of goal used to maintain a level of function, despite influence of disease process. May not be covered by insurance

Maintenance goals

Type of goal written to change the activity demand, rather than the client's abilities

Modification goals

Type of goal used for at-risk individuals

Preventative goals

Type of goal written for clients that do not have a disability, but are interested in enhancing occupational performance

Health promotion goals

Steps to goal writing

Developing a problem list and behavioral indicators, prioritize list with patient assets, frame of reference, treatment goals

What is always placed first on a problem list?

Safety, in order of importance

In general, activities where seem to be reimbursable?

In the home

Areas of reimbursable goals

ADLs, some IADLs, transfers/mobility, health promotion

Non-reimbursable goal categories

social participation, leisure, education, work, play/recreation

R in RHUMBA

Relevant, goal needs to relate to something important to client

H in RHUMBA

How long? When will goal be met?

U in RHUMBA

Understandable, does the goal make sense?

M in RHUMBA

Measurable, how will you know when the goal is met?

B in RHUMBA

Behavioral, outcome must be seen or heard

A in RHUMBA

Achievable, must be realistic for client to achieve

A in ABCD model

Audience (such as patient)

B in ABCD model

Behavior (such as will bathe)

C in ABCD model

Condition (such as using adaptive equipment)

D in ABCD model

Degree (such as independently in less than 15 mins)

ABCD model doesn't include what but should?

Timeline

What is not noted in COAST format but should be considered

Relevance

F in FEAST

function

E in FEAST

expectation

A in FEAST

Action

S in FEAST

Specific conditions

T in FEAST

Timeline

What is not included in FEAST but should be?

A subject should be identified

S in SMART

Significant

M in SMART

measurable

A in SMART

Achievable

R in SMART

T in SMART

Time-limited

What do STGs address?

performance skill, pattern, or step needed to complete LTG

What do LTGs address?

Occupational problem

Goals should focus on what 5 things?

function/occupation, underlying causes, progress, safety, state expectations to progress

Client-driven daily life activities that match goals

Occupations

Actions that support development of skills and patterns to meet occupational goals

Activities

Modalities, devices, and techniques to prepare for occupational performance

Preparatory

A plan that maintains the functional gains of skilled therapy

Maintenance Program

Who can create a maintenance program?

Skilled OT

Learning activities designed to assist people who are having experience with illness or disease in making changes in their behavior conductive to health

Patient education

3 caregiver needs?

information, assistance, respite care

Test 1 Flashcards

(96 cards)