Clinical Assessment ICF and Patient Interview & Tests and Measures
What are Depressive and Bipolar Disorders?
-disturbance of mood, exaggerated or limited range of feelings, large scale changes (rapid)
The individual level of the ICF includes
-personal's level of functioning -treatments and outcome measures -communication and self evaluation
Under Nagi's Disability Model what is an example of a physical impairment?
+ Lachman's test Knee flexion 80 degrees
What is ICF?
International Classification of Functioning, Disability, and Health A framework for describing and organizing information on functioning and disability.
What does the Intervention episode include?
Therapeutic exe, Functional Training, and Instructions
Nagi's Disability Model
a mean to describe how a disease or a pathology results in impairments, functional limitations, and disability and how this may vary across individuals
What is the ideal skeletal alignment?
body's center of mass directly over its base of support
What is Dementia?
global loss of cognitive ability (memory, attention, language, problem solving, and new learning)
Under Nagi's Disability Model what is a disability?
limitation in performance of socially defined roles and tasks within a sociocultural and physical environment
Under Nagi's Disability Model what are functional limitations?
limitation of performance at the level of the whole organism or person
What are the signs of Ideational Apraxia?
loss of ability to carry out learned tasks in the correct order
What are the signs of Ideomotor Apraxia?
loss of ability to perform learned tasks when provided with the necessary objects
What are some ways you can assess emotional and psychological factors?
observe posture, behavior, personal hygiene, grooming, and clothing, facial expression, manner, affect, and relationship to person and things
Under Nagi's Disability Model what frame of reference are physical impairments?
tissue, organ, body system
What are trauma related disorders?
-anger, aggression, inability to feel pleasure, state of unease -post-traumatic stress disorder
What is Aphasia?
-cognitive neurological disorder -difficulty or inability to produce or understand language
What is Schizophrenia Spectrum?
-delusions -hallucinations (visual, auditory, or tactile) -schizophrenia, Schizoaffective disorder
What is Apraxia?
-impairment of cognitive processing -inability to initiate or carry out learned purposeful tasks on command -patient understands the task and has the desire and physical ability to complete the task -may be able to complete the task involuntarily
What is Anxiety Disorder?
-increased HR, RR, muscle tension, sweating, tremors, sense of panic -no stimulus to justify such action -panic disorder, generalized anxiety disorder
What are substance related and addictive disorders?
-ingested or injected substances to alter the sense of being -addictive disorders; gambling -substance abuse
What is Wernicke's Aphasia?
-rapid, effortless speech -out of context -stems from parietal and temporal lobes of brain
What is Global Aphasia?
-receptive and expressive -usually unable to communicate
What is Broca's Aphasia?
-short, meaningful phrases -requires great effort -stems from frontal lobe of brain
What are Somatic symptoms disorders?
-signs and symptoms of a medical condition that does not physiologically exist -tests come out negative -conversion disorder
Under Nagi's Disability Model what is an example of an active pathology?
3-degree ACL tear
What percent of Dementia is reversible?
9-10%
Label Nagi's Disability Model
Active Pathology > Impairment > Functional Limitations > Disability
What are two forms of Dementia?
Alzheimer's and Neurodegeneration
Under Nagi's Disability Model what are physical impairments?
Anatomical, physiological, mental, or emotional abnormality or loss
What is the difference between BADLs and IADLs? Give examples of each
BADLs: self-care and independent living; i.e brushing teeth, toileting, showering, eating IADLs: required by most people but not for independent living; i.e brushing hair, grocery shopping
What are the different types of Apraxia that you can screen for?
Buccofacial Apraxia Ideomotor Apraxia Ideational Apraxia
What does the Evaluation episode include?
Data Synthesis, Diagnosis, and Prognosis
What are the four episodes of care?
Examination > Evaluation > Intervention > Outcomes
What are two examples of questionnaires for emotional and psychological factors?
Geriatric Depression Scale Zung Self-Rating Anxiety Scale
What would be some examples of impairments of someone post-stroke?
Hemiplegia ROM Trunk Control Balance Abnormal Tone Visual Language Cognitive Swallowing
What does the Examination episode include?
History, Systems Review, and Tests & Measures
What is the difference between mobility and locomotion?
Locomotion: means of moving from one location to another; walking, wheeling, crawling Mobility: body movements necessary to successfully walk, wheel, crawl
What is one example of a cognitive test/measure?
Mini Mental State Examination
Do all diseases lead to impairments?
No
Do all impairments lead to disability?
No
What are the different types of Aphasia?
Wernicke's, Broca's, and Global
What is reflection-in-action?
a reflective process used by expert clinicians during every patient encounter
What is reflection-on-action?
a reflective process used by novice clinicians after a patient encounter
What are examples of personal factors?
age gender life style education
What are some ways to assess cognition?
attention, orientation, memory, thought processes, calculation, abstract thinking, judgement, spacial perception, body perception, object perception, and sensory perception
The domains in the ICF (health and health-related) are described from the perspective of the ________, __________, and _________ around the following components:
body, the individual, and society -body functions and structures (impairment) -activities and participation (related to a specific task and actions by an individual)
Under Nagi's Disability Model what frame of reference is an active pathology?
cell
What are some extraneous variables that should be considered when choosing appropriate tests and measures?
cognitive state biopsychosocial factors comorbidities
What would be some examples of functional limitations of someone post-stroke?
decreased bed mobility decreased ability to obtain/maintain upright posture decreased ability to transfer and/or ambulate decreased ability to perform ADLs
What is Dysphonia?
difficulty in voice production
Under Nagi's Disability Model what frame of reference is a disability?
external environment/culture/society
Under Nagi's Disability Model what is an example of a functional limitation?
inability to run inability to jump
What are the signs of Buccofacial Apraxia?
loss of ability to perform movement of the lips, mouth, and tongue on command
What is the difference between mood and emotion?
mood: state of being; may not be outwardly expressed emotion: felt and often outwardly expressed; relatively temporary and easily changed
What are examples of environmental factors of the ICF?
products of technology natural environment human-made changes to environment support and relationships system policies
What does the Outcomes episode include?
results of intervention
What is Dysarthria?
speech difficulty due to impaired motor control
Posture faults can be ______ or _______. Differentiate the two.
structural: result from congenital or developmental anomalies, disease, or trauma functional: result from poor postural habits
What is the difference between symptoms and signs?
symptoms: patient experiences or feels signs: found by examiner, likely during tests and measures; observed, touched, smelled, heard, or measured
Under Nagi's Disability Model what is an active pathology?
the intrinsic pathology or disorder
Under Nagi's Disability Model what is an example of a disability?
unable to play basketball
Under Nagi's Disability Model what frame of reference are functional limitations?
whole person