FINALS

REVIEWER
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TOPICS
FUNCTIONAL & ENVIRONMENTAL
ASSESSMENT
VESTIBULAR ASSESSMENT
PEDIATRIC ASSESSMENT PART I
PEDIATRIC ASSESSMENT PART II
HI! I AM
GAB
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FUNCTIONAL
ASSESSMENT
REJECT LEARN
 INTRODUCTION

Clinicians must consider the purpose of obtaining

measurements, such as describing activity limitations, overall
function, assessing outcomes, determining discharge goals,
obtaining reimbursement, and meeting regulatory
requirements.
The ultimate goal is to return individuals to a lifestyle close to
their previous level of function or to maximize the current
potential for function and maintain it.
Rehabilitation for different conditions varies in complexity, but
the process involves describing the problem, examining body
systems, establishing a diagnosis, implementing interventions,
and documenting progress

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 INTRODUCTION

Independence is highly valued, and the construct of function

includes tasks, activities, and roles that define a person as
an independent adult or progressing child.
Functional activities require the integration of cognitive and
affective abilities with motor skills.
Certain categories of activities are common to everyone,
such as eating, sleeping, elimination, and hygiene, which are
essential for survival.
Evolutionary advancements like bipedal locomotion and
complex hand activities contribute to independence in the
personal environment

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CONCEPTUAL
FRAMEWORK
REJECT LEARN
CONCEPTUAL FRAMEWORK
A broad conceptual framework is essential for
understanding health, function, and disability.
The International Classification of Functioning,
Disability, and Health (ICF) provides a unified language
and framework for describing health.
ICF COMPONENTS:
ICF includes two parts: components of function and disability,
and contextual factors.
Function encompasses all body functions, structures,
activities, and participation, while disability includes
impairments, activity limitations, and participation
restrictions.

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ACTIVITY AND PARTICIPATION:
ICF defines activity as task execution and participation as
involvement in life situations.
Activity limitations and participation restrictions indicate
problems in these domains.
Differentiating between activities and participation can vary,
and no standard distinction exists.
CONTEXTUAL FACTORS:
Contextual factors include environmental factors (external
influences) and personal factors (individual characteristics).
The ICF emphasizes the interaction between the person and
the environment, critical for understanding functioning and
disability.

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NEXT
NEXT
EXAMINATION OF
FUNCTION
REJECT LEARN
PURPOSE OF EXAMINATION OF FUNCTION:
Identification of pertinent activities and measurement of an
individual's ability to engage in them.
Measures how a person performs tasks or fulfills roles in
dimensions described by the ICF (International Classification of
Functioning, Disability, and Health).
Establishes baseline information for setting function-oriented
goals and intervention outcomes.
Manifestations of an individual's safety level in performing a
task and the risk of injury with continued performance.
Provides evidence of the effectiveness of medical, surgical, or
rehabilitative intervention on function.
Supports payer requirements regarding changes in functional
status during an episode of care.

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TESTING PERSPECTIVES
Two Testing Perspectives:
1. Capacity: Identifies the patient's potential to perform certain tasks,
regardless of habitual performance.
2. Performance: Describes the habitual level of a patient's ability to perform
tasks and activities.
3. ICF Integration: ICF allows for the separate coding of both constructs.
Testing Perspectives
1. Therapists must consider the patient's capacity for function and habitual
function.
2. Patients accept recommendations if they perceive a need and motivation
to function habitually at their highest ability.
3. Understanding the difference between actual and potential capabilities is
crucial for setting realistic, achievable functional goals.

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TESTING PERSPECTIVES
Two Testing Perspectives:
1. Initial Examination: Information related to body functions, activities,
participation, and environmental factors should be generated during the initial
examination.
2. Retesting: Occurs at regular intervals during treatment to document progress.
3. Medicare G-codes: Functional limitation reporting required at the initial visit,
every 10 visits, and at discharge for Medicare G-codes for physical therapy
outpatients.
General Considerations
1. Physical therapists possess expertise in identifying, remediating, and preventing
movement dysfunction.
2. Traditionally involved in examining physical function.
3. Physical therapists often responsible for testing mobility-related aspects (e.g.,
bed mobility, transfers, locomotion).
4. In settings without a team or in noninstitutional settings, physical therapists
often determine all aspects of functional instruments.
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 TYPES OF INSTRUMENTS
Performance-Based Tests:
Involves observing the patient performing activities to understand capabilities.
Conditions should mimic the patient's natural environment for accurate
inferences.
Important distinction between assessing current level and maximal level of
function.
Tests include the 6-Minute Walk Test, Physical Performance and Mobility
Examination, Functional Reach Test, Get Up and Go Test, Timed Up and Go Test,
and Short Physical Performance Battery.
Data from such tests characterize a person's performance limitations due to
impairments
Self-Reports
Gathers data on how a person functions through direct questioning.
Can be therapist-administered or self-administered in paper-pencil or
electronic format.
Questions must be clearly worded, unbiased, and encourage accurate reporting.
Valid method, especially when performance-based methods are impractica

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 TYPES OF INSTRUMENTS
Self-Reports:
Clear guidelines for completion are essential, especially for individuals with
impairments.
Interviewers should be trained, practice consistently, and maintain a high
degree of agreement with expert examiners.
Considerations include time frame reference (past 24 hours, last week, etc.)
and distinguishing between habitual performance and perceived capacity.
Distinction between confidence and actual performance is crucial in some
instruments
Clear guidelines for completion are essential, especially for individuals with
impairments.
Interviewers should be trained, practice consistently, and maintain a high
degree of agreement with expert examiners.
Considerations include time frame reference (past 24 hours, last week, etc.)
and distinguishing between habitual performance and perceived capacity.
Distinction between confidence and actual performance is crucial in some
instruments.

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INSTRUMENT PARAMETERS AND FORMATS
Instrument Parameters and Formats
Descriptive Parameters
1. Descriptive terms should be well-defined and unambiguous.
2. Meanings should be clear to all users of the medical record.
3. Helpful to qualify a person’s performance by linking observations with nonspecific
indicators of impairments.
4. Considerations include energy consumption and the degree of exertion required.
Quantitative Parameters:
Time-Based Evaluation:
1. Time is often used to quantify function, especially when a specific speed of
performance is required or improvement is expected.
2. Common examples include timed functional skills for individuals on specific
therapies, such as L-dopa for Parkinson's disease.
3. Activities that may be timed include walking a set distance, writing a signature,
donning clothing, and crossing a street during a "Walk" light.
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 INSTRUMENT PARAMETERS AND FORMATS
Instrument Parameters and Formats
Quantitative Parameters:
1. Interpretation of Timed Tests: Scores of timed tests should not be considered
absolute but as one dimension of performance.
2. Completion of an activity in a specified time provides valuable data on overall
ability, but it may not always equate to better performance.
Comprehensive Interpretation:
1. Time scores alone do not always provide a complete functional picture.
2. When interpreted alongside other aspects of the patient’s clinical presentation,
they offer an added dimension to the evaluation of collected examination data.
Response formats
Function can be measured using nominal, ordinal, interval, and ratio measures.
Selection of the format depends on the purpose of the measurement.

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 RESPONSE FORMATS
Response formats
Nominal Measures: Simplest format with tasks scored as able or not able to do.
Useful for dichotomous decisions, e.g., readiness for discharge.
Ordinal Measures: Descriptive scales indicating a range of performance. Graded
scales lack equal intervals, limiting precise comparisons. Summary measures
may be considered interval if equal intervals are confirmed.

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 RESPONSE FORMATS
Response formats
Interval/Ratio Measures:
1. Visual analog scales use a
straight line to represent
quantities.
2. True zero and equal intervals
make them suitable for ratio
measures.
3. Numeric rating scales may
lack equal intervals, affecting
meaningful comparisons.
4. Understanding the level of
measurement is crucial for
appropriate data analysis.
5. Parametric statistics for
interval/ratio measures;
nonparametric for ordinal
measures
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RESPONSE FORMATS & INTERPRETING TEST RESULTS
Response formats
Considerations for Measurement:
1. Awareness of potential masking of individual differences in summated scores.
2. Scrutiny needed for the true equality of intervals in interval measures.
3. Knowledge of measurement level crucial for data analysis and statistical methods in
group studies
When examining functional status, the therapist must:
1. Clearly delineate the contributing factors that result in the functional deficit.
2. Establish and revise anticipated goals and expected outcomes of intervention based on
the test results.
3. Identify impairments that inhibit performance of the task, such as poor motor planning
and execution, decreased strength, decreased range of motion, or altered joint integrity.
4. Evaluate whether communication, perception, vision, hearing, or cognition contribute to
the patient’s functional deficits.
5. Analyze functional tasks by breaking them down into subordinate parts or subroutines to
better identify areas of deficit and guide intervention. In-depth analysis and
consideration of these factors contribute to a comprehensive understanding of func-
tional status, enabling the therapist to develop targeted interventions for improved
outcomes.
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 EXAMINATION FUNCTION
Sample Instrument to Assess Function
THE FUNCTIONAL INDEPENDENCE MEASURE
1. 18-item measure covering physical, psychological, and social functions.
2. Utilizes a 7-point scale to assess independence, with precise definitions for
each level of assistance.
3. Interrater reliability established, and Rasch analysis applied for interval
scale measurements.
4. WeeFIM, based on FIM, developed for children aged 6 months to 18 years
OUTCOME AND ASSESSMENT INFORMATION SET (OASIS):
1. Designed for home care settings to assess outcomes and quality of care.
2. Core items cover sociodemographics, environmental factors, social support,
health status, and functional status.
3. Mandated for use by home health agencies participating in the Medicare
program.
4. Discipline-neutral record for administration by various health professionals

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 EXAMINATION FUNCTION
Sample Instrument to Assess Function
SF-36 (SHORT FORM 36):
1. 36-item questionnaire based on the RAND Health Insurance Study.
2. Measures eight scales, including vitality, physical functioning, and mental
health.
3. Demonstrated high reliability and validity, used in various studies to
describe health status.
4. SF-12, a shortened version, allows for quicker completion but may sacrifice
precision.
PATIENT-SPECIFIC FUNCTIONAL SCALE (PSFS):
1. Allows patients to identify three important activities, quantify limitations,
and measure change.
2. Activities scored on a 0-10 scale, reflecting inability to full ability.
3. Total score obtained by averaging scores for each activity.
4. Validity demonstrated across various musculoskeletal conditions and
suitability for individual and group assessments.
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ENVIRONMENTAL
ASSESSMENT
REJECT LEARN
 EXAMINATION FUNCTION

Physical Environment
Comprises built (human-made) and natural objects. Built objects include
buildings; natural objects include humans, vegetation, mountains, rivers, etc.
Encompasses home, neighborhood, community, transportation, educational,
workplace, entertainment, commercial, and natural settings.
Barrier
Environmental factors that prevent optimal function and create disability.
Identified risk factors include diminished access to home, school, work, or
community.
Accessibility
Degree to which an environment allows use based on an individual's function
level.
Accessible design meets standards (e.g., ADA Standards for Accessible
Design, Fair Housing Amendments Act)
World Health Organization's (WHO) ICF
Recognizes disability and functioning as outcomes of dynamic interaction
between health conditions and contextual factors.
Environmental factors include physical, social, and attitudinal elements.
Personal factors include sex, age, coping styles, and other characteristics
influencing disability experiences.
 BARRIERS & UNIVERSAL DESIGN

Environmental factors that prevent optimal function and create disability.

Identified risk factors include diminished access to home, school, work, or
community
UNIVERSAL DESIGN
Inclusive design for all, emphasizing social inclusion.
Rooted in the disability rights movement, promoting equal opportunity and
eliminating discrimination.
Human-centered framework accommodating diverse abilities across generations.
Terms associated: Inclusive design, accessible design, life span design, aging-in-
place design, sustainable design.
PRINCIPLES OF UNIVERSAL DESIGN
Aim: Guide the design of products and environments, promoting usability for
everyone
Key Elements of the Principles:
Equitable Use: Design is useful and marketable for people with diverse abilities.
Flexibility in Use: Accommodates a wide range of individual preferences and
abilities.
Simple and Intuitive: Easy to understand, regardless of user experience,
knowledge, language skills, or concentration level.
Perceptible Information: Communicates necessary information effectively,
considering ambient conditions and user's sensory abilities.
 PRINCIPLES OF UNIVERSAL DESIGN

Aim: Guide the design of products and environments, promoting usability for
everyone.
Key Elements of the Principles:
Tolerance for Error: Minimizes hazards and adverse consequences of accidental
or unintended actions.
Low Physical Effort: Can be used efficiently, comfortably, and with minimal
fatigue.
Size and Space for Approach and Use: Provides appropriate size and space for
approach, reach, manipulation, and use, regardless of user's body size, posture,
or mobility
PURPOSE OF EXAMINATION
Rehabilitation Outcome:
Goal: Full functionality in the patient's former environment and lifestyle.
Continuity of accessibility within the individual’s environmental context is crucial.
Environmental Examination:
Focus on accessibility, safety, usability, and function. Aims to:
1. Determine patient safety and functional level in the physical environment.
2. Identify barriers affecting usability or compromising customary tasks.
3. Provide realistic recommendations on accessibility, modifications, and safety.
4. Assess the need for adaptive equipment or assistive technology.
5. Assist in preparing the patient and family for the return to the former
environment
 PURPOSE OF EXAMINATION

Recommendations and Communication:

Recommendations extend to the patient, family, employer, government agencies,
potential funding sources, and third-party payers.
Communication involves practical suggestions for accessibility, modifications,
and safety.
EXAMINATION STRATEGIES
Adaptive Equipment and Assistive Technology
Determine the necessity for adaptive equipment or assistive technology to
support and promote function.
Transition Planning:
Assist in preparing the patient and family for the return to a former
environment.
Evaluate whether further services (e.g., outpatient) may be required.
Purpose:
Identify physical impediments affecting the patient-environment relationship.
Guide recommendations for modifications, adaptive equipment, and alternative
approaches.
Data Collection Tools
Interviews, self-reports, performance-based measures, measures of
environmental impact.
Visual depictions (photographs, video recordings), dimensions of physical space.
On-site visits or viewing remotely, using a combination of strategies
 EXAMINATION STRATEGIES

Cost-Effective Alternatives
Implement alternatives like interviews, self-reports, performance based
measures, and simulations.
Use of photographs, diagrams (floor plans with dimensions) for
environmental examination.
Telehealth in Environmental Examination
Use of electronic communications for health-related information and
services over distances.
Utilizes telecommunication technology (e.g., Skype) for remote examination.
Offers cost-effective and efficient means for assessing the environment.
Interview
Typically begins exploration of the environment.
Effective for isolated tasks, limited accessibility issues, or identifying
barriers.
May suffice for providing recommendations in less complex cases.
Identifies special problems and potential safety hazards.
Determines the need for further tests and measures.
Understanding Family/Caregiver Dynamics:
1. Gains insight into family/caregiver characteristics.
2. Attitude toward the patient.
3. Desire for the patient to return to their environment.
4. Caregiving goals and capabilities.
5. Attitude toward rehabilitation team members.
6. Influences receptivity to suggested environmental modifications.
 EXAMINATION STRATEGIES

Self-Report
Gather patient information on task and activity performance in specific
environments.
Paper-and-pencil or therapist-conducted interview.
Focus on a recent time interval.
Distinguish between actual performance and perceived ability without
consistent execution.
Performance-Based Measures
Classify functional abilities, identify activity limitations, and participation
restrictions.
Therapist observes patient performance using quantitative scoring
systems. Examples: Functional Reach (FR) Test, Multidirectional Reach
Test (MDFR), Timed Up and Go (TUG) Test, Performance-Oriented Mobility
Assessment (POMA), Berg Balance Scale (BBS).
Environmental Factors and Outcome Measures
Environment directly impacts task and activity performance, affecting
physical, social, and psychological well-being.
Environmental factors can either constrain or promote patients' abilities
within their social/cultural contexts.
Numerous instruments, including those from sources like the Academy of
Neurologic Physical Therapy EDGE Taskforce and Rehabilitation Measures
Database, examine the impact of environmental determinants on
function.
EXAMINATION STRATEGIES
EXAMINATION STRATEGIES
 EXAMINATION STRATEGIES

Description of Physical Environment:

Therapists can request family input on the physical environment
using visual depictions (e.g., streaming video, photographs,
diagrams) along with actual dimensions.
Obtaining structural specifications with a tape measure enhances
the understanding of the patient's expected functional setting
Suggestions for Modifications
Visual representations and measured dimensions help in
suggesting modifications for the patient's environment.
Allows therapists to simulate aspects of the patient's
surroundings for task practice, emphasizing safety and function.
On-Site Visits:
Observe patient performance in the actual environment (home,
community, work/school).
Reduce apprehension and identify safety hazards.
Allows direct observation, provides a real-world context.
Addresses patient, family, caregiver, and employer concerns.
Identifies safety hazards and recommends environmental
modifications.
 EXAMINATION STRATEGIES

Intervention Strategies
Assistive or adaptive devices (e.g., grab bars,
reachers, adapted utensils, canes, walkers).
Safety devices (lighting, smoke detectors, sensing
devices).
Structural alterations (widening doors, installing
railings or ramps).
Modification or relocation of environmental objects.
Task modification (sensory cueing, work
simplification, energy conservation)
VestIBular
aSSessment
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PEDIATRIC
ASSESSMENT
PART I
Start Now!
PEDIATRIC ASSESSMENT

Sample Case Scenario: A 35 year old

female is currently 32 weeks pregnant.
She had a miscarriage at 10 weeks
gestation three years ago. She has a five
year old who was born at 28 weeks. What
is her GTPAL?
PEDIATRIC ASSESSMENT

COMMON PEDIATRIC MILESTONES

 NEWBORN ASSESSMENT

Infancy (1st year of life)

1 . Neonatal period – first 28
days
2 . Post neonatal period – 29
days to 1 year
Immediate assessment at birth
1 . Adaptation to extrauterine life
2 . Important for determining:
General condition
Developmental status
Abnormalities in gestational
development Presence of
congenital abnormalities
NEWBORN ASSESSMENT

APGAR SCORING SYSTEM

 GESTATIONAL AGE &
BIRTH WEIGHT

1 . Gestational Age & Birth

Weight
Help predict medical
problems and morbidity
Ballard scoring system:
Estimates gestational
age to within 2 weeks,
even in extremely
premature infants
GESTATIONAL AGE &
BIRTH WEIGHT

Gestational Age & Birth Weight

 INFANT
EXAMINATION

Denver Developmental
Screening Test (DDST)
The standard for measuring
developmental milestones
throughout infancy and
childhood
Designed to detect
developmental delays in
personal–social, fine motor–
adaptive, language, and
gross motor dimensions from
birth through 6 years of age
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GENERAL SURVEY
SOMATIC GROWTH: Height,Weight, Head
circumference
To assess growth, it is important to compare a child’s
growth parameters with respect to:
1 . Normal values according to age and sex
2 . Prior readings on the same child to assess trends
Should be measured carefully, using a consistent
technique and, optimally, the same scales
HEIGHT
Children under the age of 2
years : Measure body length
by placing the child supine
on a measuring board or in
a measuring tray

SAMPLE
HEIGHT Children older than age 2
years
Measure standing height
using wall-mounted
stadiometers
Have the child stand with
heels, back, and head
against a wall or the back of
the stadiometer
If using a wall with a marked
ruler, make sure to place a
flat board or surface
against the top of the
child’s head and at right
angles to the ruler
After age 2 years, children
should grow at least 5 cm
per year
WEIGHT
Weigh infants directly with
an infant scale
Children who can stand
should be weighed in their
underpants on a standup
scale

SAMPLE
BMI
 HEAD
CIRCUMFERENCE

Supine or sitting
Head upright
Tape measure
Measure from inion
(external occipital
protuberance) to
the forehead just
above the
supraorbital ridge
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PEDIATRIC
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