Lecture 8 - Assessment of Function Flashcards
What is health?
A state of. complete physical, mental, and social well-being, and not merely the absence of diseases and infirmity
International classification of functioning, disability, and health (ICF)
The ICF attempts to provide a meaningful description of the components of health and its relationship to a s person with the health condition
Function
The construct of function encompasses all those tasks, activities, and roles that identify a person as an independent adult or as a child progressing toward adult independence
Disability
Encompasses impairment in body functions and structures, activity limitations, and participation restrictions
Body functions
Body functions are defined by the ICF as the physiological functions of body systems (Vision, motor coordination, bladder control)
Body structures
Body structures are parts of the body such as organs, limbs, and their components
(joints, muscles, bones)
Activity
ICF defines activity as the execution of a task or action by an individual (walking, running, opening a door, studying)
Participation
Involvement in a life situation (taking part in a marathon, going to work, having dinner with your family)
Contextual factors
considered as either barriers or facilitators to function from the perspective of individual whose situation is being described
Contextual factors - environmental factors
External to the individual and can have a positive or negative influence on performance
Contextual factors - personal factors
Features of the individual such as age, gender, and a race that are not part of a health condition or health state
Activities of daily living (ADL)
Fundamental skills that are required to independently care for oneself
- ADL is used as an indicator of a person’s functional status
Categories of ADLs
- Ambulating
- Feeding
- Dressing
- Personal hygiene
- Continence
- toileting
Instrumental activities of daily living (IADL)
Activities that allow an individual to live independently in a community
Categories of IADLs
- Transporting and shopping
- Managing finances
- Shopping and meal preparation
- Housecleaning and home maintenance
- Managing communication with others
Managing medication
Cognition
the act to process of knowing, including awareness, reasoning, judgment, intuition, and memory
Clinical indicators of cognitive impairment
- Inability to do simple tasks independently or safely
- Difficulty in initiating or completing task
- difficulty in switching from one task to the next
- Diminished capacity to locate visually or to identify objects that seem obviously necessary for task completion
Components of a Clinical Assessment of Cognition - 1. Orientation
procedure: patient is asked person, place and time
positive: unable to recall all information
Components of a Clinical Assessment of Cognition - 2. Attention/Level of Alertness
Procedure: patient is asked to spell a simple word backward. Patient can be asked to repeat a string of integers forward and back
Positive: forward normal is 6 words, backwards normal is 4 words
Components of a Clinical Assessment of Cognition - 3. Memory
Recent memory: ask a patient to recall 3 items after 3-5 minutes
Remote memory: ask a patient about a verifiable historical event
Components of a Clinical Assessment of Cognition - 4. Apraxia
Procedure: examiner asks patient to perform complex task (use a pair of scissors to cut out an image)
Positive: unable to follow the motor command
Short form (36) health survey
questionnaire is made up of 36 items that assess the following 8 HRQL dimensions or sub scales: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health
The barthel index
Is a sum score across ten domains of ADL’s - includes: feeding, transfer, grooming, toilet use, bathing, mobility, stair climbing, dressing, bowel function, and bladder function
Functional independence measure (FIM)
Estimates the level of assistance needed for patients to complete ADLs
Gait speed
Has been used a predictor of functional decline
- Time on takes to walk a specified distance on alveoli surface over a short distance ( 3-10 meters with 2 meters acceleration and 2 meters deceleration
Timed-up and go (TUG)
the time taken to stand up from a standard arm chair (~46cm seat height, ~65cm arm height) walk a distance of 3m, turn around, walk back to the chair and sit down
