Test 1 Flashcards
Another person is not required for the activity
Independent
The patient safely performs all the tasks described as making up the activity within a reasonable amount of time, and does so without modification, assistive devices, or aids
FIM 7, complete independence
One or more of the following may be true: the activity requires an assitive device or aid, the activity takes more than reasonable time, or the activity involves safety (risk) considerations
FIM 6, modified independence
Patient requires another person for either supervision or physical assistance in order to perform the activity, or it is not performed, requires helper
Dependent
Patient expends half or more of the effort
Modified dependence
Patient requires no more help than standby, cuing or coaxing, without physical contact; alternately, the helper sets up needed items or applies orthoses or assitive/adaptive devices
FIM 5, supervision or setup
Patient requires no more help than touching, and expends 75% or more of the effort
FIM 4, minimal contact assistance
Contact guard assist, can do at least 75% of task
FIM 4
Helper just sets something up
FIM 5, supervision or setup
Helper just assists verbally
FIM 5, supervision or setup
Patient can do all dressing except buttons
FIM 4, minimal contact assistance
Patient requires more help than touching, or expends between 50 and 74% of the effort
FIM 3, moderate assistance
The patient expends less than half of the effort. Maximal or total assistance is required
Complete dependence
The patient expends between 25 to 49% of the effort
FIM 2, maximal assistance
The patient expends less than 25% of the effort
FIM 1, total assistance
Activity does not occur
FIM 0
Why is theory important?
To validate practice, guide practice, justify reimbursement, clarify specialization issues, enhance the growth of the profession, educate competent practitioners, unify practice and profession
Provides philosophy, values and ethics and knowledge for practice
Paradigm
Example of paradigm
OTPF
Explains the relationship between person, environment, and occupational performance
Occupational behavior models
Provide practice guidelines for specific domains
FORs/practice models
4 examples of occupational behavioral models
OA, MOHO, COPM, ecological model
Model that emphasizes adaptation
OA
Model that highlights occupational engagement
MOHO
Model that emphasizes client collaboration/client- centered therapy
COPM
Model that pays attention to contextual variables and interdisciplinary communication
Ecological model
Physical disabilities frames of references
rehabilitation, biomechanical, traditional motor control approaches, contemporary motor control approach
Phys Dys FOR that looks at adaptation/compensation
Rehabilitation
Phys Dys FOR that focuses on restoration
Biomechanical and traditional motor control approaches
Phys Dys FOR that looks at a mix of adaptation, compensation, and restoration
contemporary motor control approach
4 traditional motor control approaches
Bobaths’ Neurodevelopmental Treatment (NDT), Brunnstrom’s movement therapy, the Rood Approach, Proprioceptive Neuromuscular Facilittion
What is NDT used for?
neurological problems, associated with hemiplegia
Purpose of NDT?
remediate foundation skills that make normal skill acquisition possible
What does NDT start with?
postural control
What do manual techniques in NDT do?
Facilitate or inhibit primitive reflexes
What is the overall point of NDT?
Normalize muscle tone
Examples of normal movement in NDT?
clasped hands, weight bearing on affected extended arm, bilateral hand activities, free arm movement, compression/traction, tapping
Use of sensory stimulation to elicit motor response, consideration of mobility and stability, sensory techniques to facilitate hypotonic muscle activation in order to elicit movement, sensory technique to normalize hyperactive muscle tone, tactile/thermal/ proprioceptive stimuli
The Rood Approach
Used with neurological problems, move client through different reflective stages
Brunstrom
Reflexes and primitive movement patterns are normal stages of development and can be used to facilitate recovery of volunteer movement post-stroke
Brunstrom
Diagonal and rotational movement patterns
PNF
How does PNF treatment start?
by bringing attention to breathing and other vitals
What is the purpose of the body movements in PNF?
Improve proprioception
Rehabilitation focuses on what?
ADLs and functional abilities
What FOR looks at adaptive devices, orthotics, environmental modifications, WC modifications, ambulatory devices, adapted procedures, and safety education?
Rehabilitative
Focuses on strength, ROM, endurance, edema management, use of PAMs
Biomechanical
Equipment biomechanical FOR?
UBEs, theraband, weights
Model that usually doesn’t stand alone for reimbursement, need to correlate with function (usually rehab approach also)
Biomechanical
_________________ determines need for evaluation
Screening
_________ are sued to gather inf for an evaluation
assessments
Sames 9 steps in evaluation
- Synthesizing info from the occ profile
- Selecting appropriate OT theories
- Observation of occ performance and info gathering
- Selecting and measuring contexts, activity demands, and client factors
- Interpretation of assessment data
- Generating hypothesis
- Goal setting
- Confirming outcome measures
- Delineating intervention approaches
Critical pieces in an evaluation
Prior level of function, reason for referral to OT, assessment tools used, precautions and contraindications, accurate treatment diagnosis, occupational profile, analysis of occupational performance
Type of goal used for the client that used to be able to do something, but can’t now.
Restorative
Type of goal that teaches new skills, skills the client never had.
Habilitative
Type of goal used to maintain a level of function, despite influence of disease process. May not be covered by insurance
Maintenance goals
Type of goal written to change the activity demand, rather than the client’s abilities
Modification goals
Type of goal used for at-risk individuals
Preventative goals
Type of goal written for clients that do not have a disability, but are interested in enhancing occupational performance
Health promotion goals
Steps to goal writing
Developing a problem list and behavioral indicators, prioritize list with patient assets, frame of reference, treatment goals
What is always placed first on a problem list?
Safety, in order of importance
In general, activities where seem to be reimbursable?
In the home
Areas of reimbursable goals
ADLs, some IADLs, transfers/mobility, health promotion
Non-reimbursable goal categories
social participation, leisure, education, work, play/recreation
R in RHUMBA
Relevant, goal needs to relate to something important to client
H in RHUMBA
How long? When will goal be met?
U in RHUMBA
Understandable, does the goal make sense?
M in RHUMBA
Measurable, how will you know when the goal is met?
B in RHUMBA
Behavioral, outcome must be seen or heard
A in RHUMBA
Achievable, must be realistic for client to achieve
A in ABCD model
Audience (such as patient)
B in ABCD model
Behavior (such as will bathe)
C in ABCD model
Condition (such as using adaptive equipment)
D in ABCD model
Degree (such as independently in less than 15 mins)
ABCD model doesn’t include what but should?
Timeline
What is not noted in COAST format but should be considered
Relevance
F in FEAST
function
E in FEAST
expectation
A in FEAST
Action
S in FEAST
Specific conditions
T in FEAST
Timeline
What is not included in FEAST but should be?
A subject should be identified
S in SMART
Significant
M in SMART
measurable
A in SMART
Achievable
R in SMART
Related
T in SMART
Time-limited
What do STGs address?
performance skill, pattern, or step needed to complete LTG
What do LTGs address?
Occupational problem
Goals should focus on what 5 things?
function/occupation, underlying causes, progress, safety, state expectations to progress
Client-driven daily life activities that match goals
Occupations
Actions that support development of skills and patterns to meet occupational goals
Activities
Modalities, devices, and techniques to prepare for occupational performance
Preparatory
A plan that maintains the functional gains of skilled therapy
Maintenance Program
Who can create a maintenance program?
Skilled OT
Learning activities designed to assist people who are having experience with illness or disease in making changes in their behavior conductive to health
Patient education
3 caregiver needs?
information, assistance, respite care
