39162 - Clinical and Functional Assessment in Physiotherapy (BO)

Learning outcomes

The student must know how to:
              → Identify the preventive and rehabilitative needs of the patient with neural lesion   

                   through the various methods of functional assessment
              → Administer rating scales presented in the lectures
              → Research different rating scales and learn to measure the items
              → Highlight the short to medium term and long term objectives to meet the  

                   demands of the patient  

Course contents

► IDENTIFICATION OF THE NEED FOR CARE AND REHABILITATION

► HISTORY TAKING

► SCREENING FOR REFERRAL TO  PHYSICIAN AND OTHER HEALTHCARE

    PROFESSIONALS

► DATA COLLECTION AND SCREENING:
           ● Collecting anamnestic data of therapeutic and rehabilitative interest and of   

               psychosocial data derived from existing documentation, directly from the Person or  

               family or other professionals
           ● Collecting  data relative to expectations, desires, collaboration, motivation, personal

              and economic resources of the Person and their family

► ASSESSMENT
           ● The assessment of structural and functional integrity and of impairments:
                      ─ The assessment of activities and their limitations
                      ─ The assessment of participation in social life and its restrictions
                      ─ The assessment of contextual factors: environment and people (potential

                         facilitators or barriers to achieving autonomy)
                      ─ The assessment, by clinical reasoning of the data collected, in team discussion

                         when necessary

► FOCUS ON TISSUE RESPONSE – TISSUE REACTIVITY, TYPES OF RESISTANCE,

     CAPSULAR AND EXTRACAPSULAR LIMITATIONS AND SLACK OF THE

     JOINTS

           ● Batteries of functional tests and relationship with articular limitations

           ● Specificity and sensibility

► CHARACTERISTICS OF  MEASURES
           ● Validity, reliability, sensitivity, encoding
           ● Levels of measurement: nominal scales, ordinal scales, interval scales, and ratio scales
           ● Composite scales, profiles, and indexes

           ● Validation of scales and cross-cultural adaptation of measurement scales
           ● The measurement of improvement
           ● Measuring the achievement of the criterion
           ● Measurements of follow-up
           ● The levels of outcome

► THE MAIN INSTRUMENTS OF MEASURMENT OF IMPAIRMENT
           ● The Glasgow coma scale (GCS)
           ● The Mini-Mental State Examination (MMSE)
           ● Motricity Index (MI) and Trunk Control Test (TCT)
           ● National Institute of Health Stroke Scale (NHISS)
           ● Sensory Stimulation Assessment Measure (SSAM)
           ● The coma/ near-Coma scale (CNC)

► THE MAIN INSTRUMENTS FOR MEASURING ACTIVITY LIMITATION
           ● Katz ADL-Index
           ● Funtional Independence Measure (FIM)
           ● Funtional Assessment Measure  (FAM)

► THE MAIN INSTRUMENTS FOR MEASURING PARTICIPATION RESTRICTION
           ● The questionnaire Craig Handicap Assessment and Reporting Technique (CHART)

           ● Community Integration Questionnaire (CIQ)

► REGISTRATION

           ● Compiling , storage and disposal of accurate, clear, legible and

              contemporaneously-managed rehabilitation and medical records and reports 

Readings/Bibliography

◘ Harald Mauser "Scale e Punteggi.Quantificazione di deficit neurologici"

ED: Edi-Ermes

◘ ICF Classificazione Internazionale del Funzionamento, della Disabilità e della Salute

ED: Erickson

Teaching methods

Frontal lectures 

◘ Simulations amongst students

◘ Consultation – reading of medical records

◘ In class Functional assessment of patients with neurological rehabilitation conditions 

◘ Compilation of rehabilitative medical records including a functional capacity evaluation

(FCE)

Assessment methods

Method of Grading:  

◘ A weighted mean of grades obtained in the tests of the single courses of the Integrated Course is calculated, with the attribution of weight being proportionate to the number of credits of each course comprising the Integrated Course

The student is examined and evaluated on the following 4 activities:

◘ Reading the medical record of a patient with neurological rehabilitation conditions and being able to refer detailed data on demand to a commission of professors

◘ Functional assessment of patients with neurological rehabilitation conditions in presence of a commission of professors

   ◊  The student must demonstrate to have developed the ability to perform correctly the

       manoeuvres  and gestures required for examination and functional tests and to be able to

       explain the intrinsic criteria guiding the performance 

   ◊  The student must choose and apply the appropriate assessment scales

◘ Compiling a rehabilitation data collecting chart recording the functional assessment

◘ Oral exam
   ◊  The student must demonstrate a thorough understanding of the theoretical aspects of the

       topics and a personal competence of problem solving through the acquired

Teaching tools

PowerPoint slides, overhead projector

◘ Physiotherapist beds for practical exercises and patients assessments

◘ Medical records, rehabilitation charts, assessment scale forms and instruments

for scale application

◘ A check-list is provided to the student to ensure the student a broad and comprehensive guide to the elements verified by the commission during the exam

Office hours

See the website of Viviana Montevecchi