phys dis module 1 Flashcards
what are performance skills ?
- Motor skills- reaching, manipulating, pacing, rolling, standing sitting
- Process skills-sequencing steps, staying on task, modifying performance when there is a problem
- Communication/interaction skills- conversations, gestures, inhibiting behaviors, displaying emotions
what are the examples of ways to assess performance skills?
Observations during tasks
Jebsen hand function test
Test of visual motor skills
Assessment of motor process skills (AMPS)
What are performance patterns ?
Habits
Routines
Roles
what are the examples of ways to assess performance patterns?
Interview
Role checklist
Structured questions
National institutes of health activity record
Example of Barrier
“Physical environment:
an elevated home with no ramp or elevator for the wheelchair user
2019)
Example of Barrier
“Social environment:
living alone with no family or friends to help with transfers as needed
Example of Barrier
“Cultural context:
inability to speak the same language, including body language
Example of Barrier
“Personal context:
lacking high school education and/or living without insurance
Example of Barrier
“Temporal context:
Alzheimer’s disease at the end of a long day (“sundowning”)
Example of Barrier
“Virtual context
: lacking internet access necessary to view one’s electronic health record”
activity domains
Objects used and their properties
Space
Social
Sequencing and timing
Required actions
Required body functions (for specific activity)
Required body structures (for specific activity)
Client factors
Body functions
Body structures
Values, beliefs and
spirituality-
What is Rehabilitation model?
After WWII
Aligned with the medical model
Rehabilitation of disability
Patient is a passive participant
What is social model?
Social model
Disability rights movement
Self-advocacy-Client is at the center of the model = expert
Disability due to environment not function
Participating in life roles brings a sense of self-efficacy and self-esteem
occupational functioning model ( OFM)
what is goal of OFM ?
Goal of OFM is engagement in life roles
what is top down approach
(observation of performance)
Evaluation (activity analysis)
Intervention
Adaptive therapy- balance between goals and abilities
Optimize abilities and capacities
Occupational activities and adjunct therapies are used
Environment can promote or hinder functioning
Biomechanical FOR
Improvement of occupational performance
Restore function
Strengthening, exercises, splinting etc.
Rehabilitation FOR
Return to the fullest function possible
Modification strategies
Use of adaptive devices, equipment, technology etc.
Sensorimotor FOR
CNS insult
Interventions to help reorganization of sensory and motor cortices of the brain
Proprioceptive neuromuscular facilitation (PNF)
Neurodevelopmental treatment (NDT)
Community-based settings
Residential care (months to years) Assistive living setting (months to years (consultation)) Home health (weeks to months)
Outpatient settings
Outpatient clinics (weeks to months) Day treatment (months to years) Work site (weeks to months (consultation))
what’s skilled terminology
Assess Analyze Interpret Modify Facilitate Inhibit Fabricate Adapt Establish Determine Instruct in (techniques, compensatory strategies)
what’s unskilled terminology
Maintain Help Watch Observe Practice Monitor
what is CGA
Contact guard/standby assistance (CG)- hands on assistance is necessary for safety or caregiver must be within arms length for safet
SMART
Significant, Measureable, Achievable, Related, Time
ABCDE
Audience, Behavior, Condition, Degree, Expected time
RHUMBA
Relates, How long, Understandable, Measureable, Behavioral, Achievable
COAST
Client, Occupation, Assistance level, Specific condition, Time
Includes information reported from the patient, family or caregiver. Information the patient reports about their goals, health, response to treat Should be relevant to treatment Be careful of statements that could be misinterpreted
Subjective
Contains observations, results of assessments and measurements Factual information Data is not interpreted or analyzed in this section Emphasis is on results of interventions (not just a list of interventions
objective
Data is interpreted Analysis of occupational performance Discuss information provided in the subjective and objective sections Should have statement of need for skilled therapy
assessment
Update goals Modification to frequency of therapy Plan of other interventions Guides future tx sessions
plan
Pt states “I get so tired trying to get ready in the morning. My hands are so stiff and painful I don’t even want to get dressed.
S
Pt became fatigued during seated self care tasks after 10 minutes(up from 5 minutes last week). Pt required Mod A for UE and LE dressing. Pt R shoulder ROM increase to 90 degrees of flexion and abd, ER now 45 degrees increasing her ability to don shirt. Difficulty with buttons due to digit pain. Pt fist -4cm from dpc.
O
. Pt reporting difficultly in self care tasks due to hand pain. Pt may benefit from AE to for UE/LE bathing and dressing due to pain level and ROM limitations
A
Continue to increase activity tolerance. Assess for AE need for UE and LE bathing and dressing tasks. Educate patient in adaptive UE dressing techniques for increased independence in ADLs. Progress exercise program from AA to AROM
P
Pt’s loss of shoulder IR limiting ability to don coat independently
assessment
