Maximizing Function-Goal Setting and the Rehab Perspective Deborah Gaebler-Spira, MD Rehabilitation Institute of Chicago Partnering for Progress: A Cerebral.

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Presentation transcript:

Maximizing Function-Goal Setting and the Rehab Perspective Deborah Gaebler-Spira, MD Rehabilitation Institute of Chicago Partnering for Progress: A Cerebral Palsy Conference for Parents & Caregivers August 11,2007, Chicago, Illinois

Goals of Rehabilitation Prevent secondary complications-deformity Improve and support function/development Promote assets-kids are not a sum of the deficits

Rehabilitation domains Self Care-dressing, bathing, toileting Communication Mobility-ambulation, transfers, stairs Continence-bowel and bladder

Developmental perspective Gross motor Fine motor Personal social language

Developmental Assements Vineland Peabody Batelle Bailey

Global Measurement of Disability/ Burden of care WeeFIM PEDI PECs

Prediction of Function-refined Gross Motor Functional Classification Spinal cord level/ Spina Bifida SMA MD

Goals change as the child grows Parent driven Therapist driven Doctor driven! Educationally driven

Mobility just gets you from here to there

National Center for Rehabilitation research model Pathophysiology Impairment Disability Functional limitation Societal limitation

Adopted as outcome paradigm

Old WHO Impairment Disability handicap

WHO 2001 model-International classification of function/components of health Impairment Activities Participation Impact of environment and personal factors

New/WHO/ICF

Body structure and function Physiologic functions of the body Anatomical parts of the body

Impairments Problems in body functions or structure, loss or deviations

Activities Execution of a task or action by an individual

Participation Involvement of a life situation

ICF Functioning and disability -body functions and structures Activities and participation Contextual factors Environmental personal

Environmental factors External factors Facilitating or hindering impact of the physical, social and attitudinal world

Personal factors Internal influences Or attributes of the individual

Maximizing function Therapy to Augment Function Compensate for Function Technology to assist function

What is the limitation ?

Quality of life-attention to the individual Modems-aaos Child Health Questionaire Care and comfort measure-perceived burden of care for the caregiver Canadian occupational measure

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