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

abilitiesand 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’sBasic Activities of Daily LivingFunctional activities common ”basic”to everyone (personal care):

FeedingBathingToiletingMaintaining ContinenceDressingAmbulationBed MobilityTransfers

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 absent2. Rank-ordered numbers or letters 3. Visual Analog linear 4. Summarative different 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

RELIABILITY must be consistentTypes: 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