Assessment Introduction Flashcards
What is an assessment?
The evaluation or estimation of the nature, quality, or ability of someone or something.
What are the four pillars of assessment?
Purpose
Validity
Reliability
Value
If you can say why you are choosing an assessment for a specific client, and trust its validity and reliability, then you have chosen it correctly.
Evidence Based Practice (EBP)
A process for integrating scientific and practical knowledge to best serve the needs of the client.
Leads to a client centered approach.
Kinesiology is a blend of the foundational science and the art of working with people.
We want to compare research to who the client is and what is best for them.
Research says what the best tests are, but they are not always clinically relevant.
What are the five steps of EBP integration into clinical practice?
Ask a question.
Find best evidence.
Evaluate evidence.
Apply information in combination with clinical experience and patient values.
Evaluate outcomes.
Validity
The extent to which an assessment measures what it was designed to measure.
Reliability
Whether an assessment instrument gives the same results each time it is used in the same setting.
Gold Standard Assessment
Test against which new tests are compared to gauge their validity, and it is used to evaluate the efficacy of treatments.
What we want in the assessment unless not clinically relevant.
Why do we assess?
To find health or safety concerns for physical activity.
-Pre-screening (ie. typically for personal trainers, not as common for kin’s in clinical settings).
-Contraindications to exercise.
Identify where people are for their fitness level and functional ability.
Figure out a client’s baseline or start point to accurately prescribe exercise and have something to compare to later on.
-gives a chance for education, goal setting, motivation/behaviour change.
Initial Assessments in Clinic
Informed consent, pre-screening, and identifying any contraindications to exercise.
Typically longer sessions for the first session.
-want to use a way to connect with clients.
-focus on subjective interview, goal setting, and building rapport
Assessments include…
-pick objective measures that are the most relevant.
-be mindful of time; want to make sure that you send client home with something to work on.
-can do assessments that can also prescribe as exercise
Initial vs Subsequent Assessments
Subsequent sessions can focus on exercise prescription, continued education, and health behaviour.
-updating or progressing exercise programs
-identify barriers that are coming up.
Can re-assess measures you completed in the initial to compare and see progress.
-this includes updating goals
Pre-Screening Assessments
Helps identify risks, initial goals, medical or injury history, or if further medical clearance is needed.
-PAR-Q and PAR-MedX
-Get Active Questionnaire
-Custom intake form
Goal Setting
Typically done in an initial assessment, but good to review and update whenever.
-don’t have to do an update every time unless don’t see them very often.
-want to always check-in on the goals to maintain client-centered approach
Will help you choose objective assessments and exercise prescription.
SMART goals.
It is an art form to create realistic and efficient goals with clients.
SOAP Notes
Subjective
Objective
Assessment
Plan
Subjective
Subjective information the client provides
Objective
Factual information or metrics the client provides
Assessment (or action)
Clinical interpretations based on the information provided thus far.
What we did
Plan
What is the treatment plan and next steps
Subjective Measures
Can take up as much time as is needed.
Anything the client says/share to you.
-goals, reasons for attending, how they rate their health/fitness, what they do for work, their past medical history, medications, etc.
-description of their pain, barriers to goals, MOI, self-efficacy, etc.
Initial subjective interviews can take up the whole session if needed.
-important to understand the client (best practice) and build rapport.
-helps identify objective measures to use.
Objective Measures
Anything you observe or test.
-the raw data (no interpretation)
-pain scales, results from questionnaires
Must be clinically relevant to the client (best practice).
-use the best, most up to date evidence to choose your tests
-integrate client values, goals, and functional ability to help pick tests
Mash two potatoes with one fork = pick tests that you can use for exercises too.
Assessment/Interpretation
Refers to the objective measures you have decided to use, but also the interpretation of those measures (or the assessment of the client overall).
-comparing objective measures to norms or to past results
-should incorporate your objective and subjective information
-best practice is to use client values and objective measures combined to interpret.
Norms = based on data for specific age groups.
Risk assessment = gives a high/low risk assessment of a certain likelihood of disease or injury.
-very few assessments have a risk factor associated with it.
Other Assessment Forms
Forms that help identify current health behaviours and identify goals.
-intake forms, PASB-Q
Any forms that you can use to facilitate MI or conversations around behaviour change.
-self-efficacy scales or questionnaires
-transtheoretical model
-barriers to physical activity or goals
-relapse planning worksheet
Contraindications to Exercise
Reasons to not exercise.
Normally highlighted or determined in pre-screening or initial assessment.
Can have different CI’s for health conditions.
-relative and absolute
If not comfortable or unsure then don’t work with them or refer to doctor or someone else.
Relative CI
A condition where the risks of exercising may be greater than the benefits.
Case by case scenario.
Absolute CI
A condition that prevents exercise under any circumstances until the condition is treated or managed.
Referral back to doctor for medical clearance and treatment.
