Lecture 1 - Introduction to Assessment

Question 1

International Classification of Functioning (ICF) Model

Answer 1

Question 2

Health

Answer 2

State of complete physical, mental, and social well-being

Question 3

Health Condition (ICF)

Answer 3

Disease, disorder, or injury

Question 4

Body Functions (ICF)

Answer 4

Physiological functions of body systems

Question 5

Body Structures (ICF)

Answer 5

Anatomical parts of the body eg. organs, limbs

Question 6

Impairments

Answer 6

Problems an individual may have in body function or structure

Question 7

Changes in body function defines the

Answer 7

magnitude of the impairment

Question 8

Changes in body structures defines the

Answer 8

magnitude of impairment, nature of change, and localization (could see on observation or X-Ray)

Question 9

Eg. a person comes in for physiotherapy with a sore hip but upon observation of the X-Rays you notice there is a fracture, what would happen?

Answer 9

The patient would have to stop seeing physiotherapy and instead go see a doctor for casting or surgery

Question 10

Activity

Answer 10

Functioning at the level of the person (Everybody has to do every day)

Question 11

List Basic Activities of Daily Living (BADLs)

Answer 11

Toileting, walking, dressing, eating,t alking, learning

Question 12

Activity Limitations

Answer 12

Difficulty an individual may have in executing tasks or actions

Question 13

Participation

Answer 13

Persons individual involvement in life situations/social interactions within the context of their environment (Specific activities to your preference)

Question 14

Participation Restrictions

Answer 14

Problems an individual experiences in personal life situations/social interactions

Question 15

Instrumental Activities of Daily Living (IADLs)

Answer 15

House/school work, play/leisure, parenting, driving (not required life activities)

Question 16

Performance

Answer 16

What an individual does in their current environment eg. use of assistive devices to walk

Question 17

Performance Qualifiers

Answer 17

Extent of participation restriction in performing tasks eg. had stroke and cant dab a bingo marker to play bingo

Question 18

Capacity

Answer 18

Individuals ability to execute a task or action

Question 19

Capacity Qualifiers

Answer 19

Extent of activity limitation eg. individual had stroke and needs cane to walk around house

Question 20

Contextual Factors

Answer 20

Entire background of individuals life and living situations

Question 21

Contextual factors are made up of:

Answer 21

1.Environmental Factors
2. Personal Factors

Question 22

Examples of Environmental Factors

Answer 22

• Cultural/social norms
  -Physical/built environment
  -Political Factors
  Products/Technology
  -Transportation

Question 23

Examples of Personal Factors

Answer 23

-Age
-Gender
-Co-morbidities
-Sociocultural Background
- Education/profession
-Past experience
-Personality/character/coping style

Question 24

Barriers

Answer 24

Factors in individuals environment that limit functioning and create disability eg. having diabetes may cause longer healing times for fractured hip

Question 25

Facilitators

Answer 25

Factors in individuals environments that improve functioning and remove disability eg. supportive friend or spouse to drive individual with broken hip around for socialization

Question 26

Steps of patient management

Answer 26

1) Examination of patient 2) evaluation of data and identification of problems 3) Diagnosis and prognosis 4) Plan of care 5) Intervention 6) Reexamination and evaluation of treatment outcomes

Question 27

Steps to identify relevant information to develop problem lists, goals, and expectations/prognosis

Answer 27

1) Use information gathered from ICF model (impairments, limitations, restrictions, barriers/facilitators) 2) Use patient centered care to adapt to clients wishes

Question 28

List 3 modes of information gathering and the order you should gather them in to prevent repetition with client

Answer 28

1. Chart Review 2. Consultation 3. Client Interview

Question 29

Step 1: Examination

Answer 29

Identify patients impairments, limitations and restrictions in participation and resources to determine appropriate intervention

Question 30

What 4 components make up the examination

Answer 30

1. Patient History 2. Systemic Review 3. Tests and Measures 4. Task Analysis

Question 31

History is obtained by

Answer 31

Medical chart review and patient interview

Question 32

Systemic Review is obtained by

Answer 32

Scanning the patients body systems to determine areas of intact function and dysfunction

Question 33

6 Types of body systems used in scanning (systemic review)

Answer 33

1. Muscoloskeletal: range of motion and strength 2. Neuromuscular: Coordinated movements (eg. balance) and motor function 3. Cardiovascular/Pulmonary: Assessment of heart/respiratory rate and blood pressure 4. Communication Ability: Produce and understand language, feelings 5. Integumentary: Skin integrity 6. Cognitive Ability: Assessment of consciousness

Question 34

Systemic review helps with what 4 things:

Answer 34

1. Confirm need for further more detailed examination 2. Rule out specific system involvement 3. Determine if referral to other health professional is needed 4. Identify specific area of body from symptoms

Question 35

15 items that would be found in a chart

Answer 35

1. Demographic information (eg. age, gender) 2. HPI (History of Presenting Illness 3. Physician Report (treatment plans) 4. Surgery 5. Additional illnesses (eg. diabetes) 6. Medications (important to determine if symptoms caused by medication or ailment) 7. Dietary/Fluid Restrictions (Dont give water to individual who cant have fluids) 8. Imaging Results (CT scan, Xray) 9. Lab Values (eg. hematocrit, pulmonary stress test, etc) 10. Vital signs (eg. heart rate, resp rate, blood pressure) 11. Nursing assessment (eg. medical status, pain level, discharge plans,etc) 12. Patient Self Report Outcome Measures 13. Occupational Therapy Assessment 14. Speech Language Pathology Assessment 15. Psychology assessment

Question 36

REVIEW PG. 9 of Physical Rehab Textbook

Answer 36

SAMPLE INTERVIEW QUESTIONS

Question 37

When looking at a chart what are 3 things to consider

Answer 37

1. Define acronyms unfamiliar with 2. Create a problem list and prioritize afterwards 3. Learn roles and responsibilities to identify issues related only to PT

Question 38

3 steps to create a prioritized problem list

Answer 38

1. List problems from chart reviews, consultations and interviews 2. Categorize problems based on ICF model (impairment, limitation, restriction, modifiable/nonmodifiable contextual factor) 3. Identify whether problem is within scope of PT practice

Question 39

Where can you find physiotherapy scope of practice

Answer 39

Googling The Physiotherapy Act

Question 40

Where can you find role clarifications

Answer 40

Googling national competencies for other healthcare professionals

Question 41

4 reasons why its important to make a prioritization list

Answer 41

1. Determine assessment/intervention needs 2. Determines if need for referral to another healthcare provider 3. Determines prognosis expectations 4. Supports goal setting and communication with client

Question 42

Example: Run through the ICF model for an individual with hip arthritis that wants to play pickle ball

Answer 42

Question 43

Importance of Goals and Outcomes

Answer 43

Goals should be measurable and set by the individual and provider and should include conditions that need to change to achieve goals, behaviour/activity to reach goals and the time it will take to reach the goal to give expected outcomes (improvement after rehab)