LifeSpan

Function Natural, required, or expected activity of a person based on stage of development Ability to exist with in environment Related to a persons physical, social, emotional, and mental development

Functional Activity All activities, tasks, and roles a person assumes that identify them as a person Depends on what is essential to that person to support their physical and psychological well-being Certain activities will be common to all adults, others will be specific to adults based on occupation, culture, lifestyle, home situation etc

Function from a LifeSpan Perspective Mastery and competency over the environment, throughout life the individual demonstrates varying abilities and levels of mastery over the environment.

Functioning: Life span perspective: self needs / survival within the home within the community

Functional Skills “skills that are frequently demanded in natural, domestic, vocational, and community environments allowing an individual to perform as independently as possible in all settings”

BADL’s Basic Activities of Daily Living Functional activities common ”basic” to everyone (personal care): Feeding Bathing Toileting Maintaining Continence Dressing Ambulation Bed Mobility Transfers

Instrumental Activities of Daily Living IADL: How well one can manage within the home and community Cooking Cleaning Handling finances, Shopping, Using transportation Working

Roles of Therapist PT’S & PTA’S address both BADL and IADL’S but not ALL BADL’s Bed mobility Transfers Gait OT & COTA’s address both BADL’s and IADL’s Dressing Cooking Fine Motor Activities

Domains of Function PHYSICAL sensorimotor skills to perform ADL’s PSYCHOLOGICAL cognitive ability ( judgement, problem solving, concentration) motivation affect (affective function ability to deal/cope with stresses) SOCIAL *ability to relate to and interact with others to complete social roles and obligations from FAMILY, COMMUNITY, CULTURE

Factors that Define Functional Performance Personal Characteristics: physical ability, emotional status, cognitive ability Environment: home, community Social Expectations: family, community, culture

5 Components of Physical Function 5 COMPONENTS OF PHYSICAL FUNCTION that effect quality of function Flexibility Balance Coordination Power Endurance

Developmental Stage Period of life with unique physical and behavioral changes Occurs from birth to death Age at which stages occur are somewhat relative Start/stop with in a range of time rather than absolute age

Functional Assessment Purpose: collect data to use for the following: Obtain Baseline Indicators of pt.’s abilities and progression with functional levels Criteria for placement decisions Level of safety with tasks/risk of injury Evidence of effectiveness of intervention on function

Standardized Functional Assessments should be administered the same to each person, each time Advantages: Easier to report on patient change Easier to communicate clients status among other health professionals. Disadvantages include: May not encompass all ADL’S pertinent to client May not be appropriate for the client based on age

Non-Standardized Assessments Non-standardized assessments are more informal and evaluate the ADLS the evaluator feels are important for that particular client.

2 Types of Functional Assessment Instruments Performance Based: patient is observed performing activities must be sure that accurately simulate home environment Self Assessment Instrument do not use direct observation Self-Administered: usually questionnaires, must be clearly written based on patient self reporting Interviewer Assessment: trained interviewer ask standard questions

Rating Performance 1. Check list present or absent 2. Rank-orderednumbers or letters 3. Visual Analog linear 4. Summarativedifferent items are weighted, score can only be compared within context of assessment instrument 5. Quality of Performance measures efficiency of performing a task (how long to cross street, or measure heart rate)

Measurement Issues Validity does the assessment tool measure what it says it will? Characteristics which may decrease validity use of assistive devices variations in performing activities at home versus hospital setting perspective of tester role expectations of the patient, motivation

Measurement Issues RELIABILITYmust be consistent Types: Test-Retest: if instrument has test-retest reliability it is stable and will not indicate change when none has occurred Intrarater Reliability: same therapist Interrater Reliability: consistent findings with same testing instrument even if different therapists perform the test