Measurement of Function and Activity

Question 1

What parts of the ICF model are we looking at now?

Answer 1

Activity and participation

Question 2

what is The Who’s definition of activity

Answer 2

 The execution of a task or action be an individual (WHO, 2001)
 Learning and applying knowledge, General daily tasks and demands (single/simple or multiple/complex), Communication, Mobility, Self-care

Question 3

4 characteristics of activity

Answer 3

 Usually performed alone
 May be performed out of context
 Essential to support physical, social, and psychological well-being
 Essential to create a personal sense of meaningful living

Question 4

Basic Activities of Daily Living

Answer 4

 Routine activities that people typically do without assistance
 Bathing
 Dressing
 Feeding
 Toileting
 In-home mobility
 Transfers

Question 5

Instrumental Activities of Daily Living

Answer 5

 Cooking/Cleaning
 Shopping
 Driving
 Taking public transportation
 Community mobility
 Social activities/recreation (sport, hobby, leisure activities)

Question 6

What is participation

Answer 6

 Involvement in a life situation
 Domestic life, Interpersonal interactions and relationships, Major life areas, Community/social/civic life

Question 7

What does participation reflect?

Answer 7

 Participation reflects the extent of engagement in the full range of activities that accomplish a larger goal
 Artistic, creative, cultural, active physical, education, civic, sports, play, social, skill-based, work, medical

Question 8

2 Key elements/themes of participation

Answer 8

 Attendance - “Being there”
 Involvement –“In the moment”

Question 9

Benefits of Participation

Answer 9

• improved physical health and fitness
• increased psychosocial and emotional wellbeing
• enhanced academic achievement and attainment
• reduced risk-taking and problem behaviors

Question 10

Factors affecting participation

Answer 10

 Gross Motor Function
 Cognitive/Communication skills
 Age
 Gender
 Environment

Question 11

Interrelated factors of participation

Answer 11

• child, family, environmental barriers/supports

Question 12

How to measure participation

Answer 12

• Nominal: yes/no
• Ordinal: easy, medium, hard
  Interval: award points; true interval data, points equidistant from one another; can add/subtract
• ration: endpoint is zero; scores equidistance; can multiply, divide, add, subtract

Question 13

WeeFIM Levels is an example of:

Answer 13

ordinal

Question 14

Other methods to quantify participation

Answer 14

 Event recording –> Tally each occurrence (Sit-to-Stand)
 Duration recording –> How long can performance task (walk 60 seconds)
 Rate recording –> Frequency of task/time (i.e. 15 steps/30 seconds)
 Time sample recording –> How often within time interval (i.e. # LOB during 5 min of recess)
 Functional consequence –> Presence of pain in hip after walk 30 feet

Question 15

Things to consider when selecting standardized assessments

Answer 15

 How do they rate?
 What do they assess?
 Who are they intended for?
 How can we use the information they provide
clinically?
 Do they measure impairment, activity limitation,
participation?

Question 16

Gross Motor Function Measure

Answer 16

 Clinical measure developed to evaluate change in gross motor function in children with cerebral palsy
 There is evidence that the GMFM 88 is also valid with children who have Down syndrome
 For children from 5 months to 16 years of age with a disability
 Responsive to therapeutic intervention: Measures change in performance; Clinical relevance

Question 17

Activities examined in GMFM

Answer 17

 Lying and Rolling
 Sitting
 Crawling and Kneeling
 Standing
 Walking, Running, and Jumping
88 or 66

Question 18

GMFM Scoring

Answer 18

 0=does not initiate –child is requested to attempt an item, but is unable to commence any part of the activity
 1=initiates- less than 10% of task completion
 2=Partially completes –10% to less than 100% of task completion
 3=Completes –100% task completion
 NT=not tested –item has not been administered or child refuses to attempt the item and you have reason to believe they may be able to at least partially complete the item

Question 19

Ability to cross busy street at light

Answer 19

 Walk 100 feet unassisted
 Time test –walks across street in 30 seconds
 Event recording –# times have loss of balance when descending curb
 Measuring impairment, functional limitation, or participation restriction

Question 20

Additional factors to consider with participation

Answer 20

 Diversity (the number of activities done)
 Intensity (frequency of participation in various activities)
 Enjoyment of activities
 With whom and where do they participate in these
activities?
 Preference for individual activities
Choice (how
many activities
and which ones)
Meaning
Satisfaction
Control
Desire for Change
Belonging

Question 21

Canadian Occupational Performance Measure

Answer 21

 Designed to capture a client’s self-perception of
performance in everyday living, over time
 Broad focus on occupational performance in self-care, leisure and productivity
 Takes into account development throughout the
lifespan and personal life circumstances

Question 22

Children’s Assessment of Participation
and Enjoyment AND Preference for
Activities in Children (CAPE/PAC)

Answer 22

 An evaluation of recreational and leisure activities outside mandated school activities
 Perspective of the child and amount of parental assistance
 5 Domains (Recreational, Active physical, Social, Skill-based, and Self-improvement)
 Formal and Informal activities

Question 23

Who is CAPE/PAC targets for?

Answer 23

 Targeted for individuals with/without disabilities from 6-21 years
 Both measures contain 55 items
 Self-administered and interviewer-assisted version
 Takes approximately 45-65 minutes to complete both: 30-45 CAPE; 15-20 PAC

Question 24

Participation and Environment
Measure for Children and Youth
(PEM-CY)

Answer 24

 Measurement tool designed to help parents, service providers and researchers better understand the
participation of children and youth, 5-17 years
 Parent-report measure asking about participation in home, school and community
 Considers environmental factors affecting participation in each setting

Question 25

Settings of PEM-CY

Answer 25

• Home: 10
• School: 5
• Community: 10

Question 26

PEM-CY Scales

Answer 26

 Frequency (How often?)
 Involvement (very –minimally)
 Desire for change (yes/no and what type)
 Environmental supports/barriers
(e.g. layout, social supports, attitudes, resources,
service/policy)

Question 27

PEM-CY Classroom Participation

Answer 27

1. Classroom Activities (e.g. group work, classroom
   discussions, tests, in-class assignments)
2. Filed Trips and School Events (e.g. going to a museum, the school fair, spring concert or play, dances, fundraisers)
3. School-sponsored teams, clubs and organizations (e.g. groups, clubs, teams, student council)
4. Getting together with peers outside of class (e.g. hanging out during lunch, at recess, or other breaks during the school day)
5. Special roles at school (e.g. lunch room supervisor, student mentor)

Question 28

Emerging Trend: Patient-Reported Outcomes Measurement Information System (PROMIS)

Answer 28

 A new paradigm for how clinical research information is collected, used, and reported.
 Uses recent advances in information technology,
psychometrics and qualitative, cognitive, and health
survey research to measure PROs including:
 Pain
 Fatigue
 Physical functioning
 Emotion distress
 Social role participation